#Breast cancer statistics

[wellhealthhub]

How long can you have breast cancer without knowing?

Curious about the timeline of undetected breast cancer? Dive into the intricacies of silent breast cancer development, its potential duration, and the crucial significance of early identification. Breast cancer stands as a prominent health concern, demanding timely recognition for effective treatment. Yet, the question remains: how long can breast cancer remain concealed, evading discovery? This…

[1-ufo]

,

[mourningmaybells]

cant believe how many filipinos there are in guam. i should check out later how that happened

[thebibliosphere]

On a less funny note, the breast clinic was filled with really super lovely people, but the changing room had a "coping with an unexpected divorce" pamphlet in it that made my stomach drop.

I know that famed statistic about cis men who leave their wives after receiving a breast cancer diagnosis is supposedly overblown, but seeing that still made me need to sit down and breathe for a bit.

[sharklovingaquarist]

So I saw a video of a woman taking care of her disabled wife and said, "a man could never. "... the replies 😭 you would've thought I brutally dismembered a man. The lengths some women go to dick ride the men who are rapidly reverting all our work is crazy to me. Men statistically leave partners due to health issues. That's the end of the story. "What a baffling thing to say" idk girl it's not baffling when looking at how many men leave women when they get breast cancer. I've seen too many stories of women bleeding while pregnant and their male partner ignoring them, so they have to drive to the hospital themselves. Yall are ridiculous. Cry harder. Me pointing out a statistic isnt the same as men leaving a woman bleeding out on the floor because their fetus is causing issues for her. The misandry bullshit is getting worse and worse.

[letters-to-lgbt-kids]

My dear lgbt+ kids, 

The idea of finding a lump in your breast is scary. If this ever happens to you, you may panic and think about cancer - so let’s talk about what to do if this happens. 

It may feel like a hard irregular mass. Or you may feel like there’s a pea or a marble under your skin. Or maybe one area of your breast feels thickened (or just different) from the rest of it. Maybe it isn’t directly a lump but you feel like one breast, or a part of it, changed in size or color, looks dented or looks red/inflamed… in any of these cases, the first step you wanna take is a no-brainer:

You call your doctor, tell them what’s up and ask for an appointment. (This should ideally be a gynecologist, because they’re the experts on breast cancer. But if it’s difficult to get an appointment there or you feel more comfortable going to your primary care doctor, you may also call them first. They will send you on to a gynecologist if they consider it necessary.) 

The most important second step is: calm down. 

At first glance “calm down” may seem like bad advice here. Fear can be a helpful emotion because it motivates you to do the right thing in potential dangerous situations, and worrying about cancer when you find a lump in your breast is a good example for that - you need to worry about it, so you’ll take it seriously and get it checked out! An early diagnosis and quick treatment can save lives. 

But after you already took the right step and called your doctor, when all that’s left to do is waiting for your appointment, panicking is no longer helpful. The best thing you can do now is trying to stay calm and optimistic. Some facts that may help: 

If you are below 40, and especially if you are below 30, remember that breast cancer is considered possible but rare in your age group. (Important: this is not a free pass to just ignore breast changes! Get them checked out anyway! But it can be comforting to know that it’s not statistically likely that you’ll get a cancer diagnosis when getting them checked out.)

Regardless of age, even if you are above 40, know that there are plenty of other, more harmless explanations for breast changes, including lumps. Again, this doesn’t mean “don’t take it serious”, but it’s good to keep in mind while waiting for your doctor appointment: it could be something as simple as natural changes in your hormones (for example related to your period or to menopause), it could be a fibroadenoma (a benign lump that is completely harmless but can be surgically removed if it bothers you), it could be a simple cyst, it could be the result of a small injury you don’t even remember happening, it could even be a skin infection … 

About 20% of all lumps turn out to be cancer. That means that the chances are good that your doctors appointment will bring the relieving news that you don’t have it! Don’t think of it as “I definitely have cancer and need to go to the doctor because of that”, but as “I go to the doctor for peace of mind, to confirm that I do not have cancer”. 

Now you may think “But what if I’m in those 20%?”. Well, in that case, it would still be a good thing that you noticed that lump/change and got it checked out - in early stages, breast cancer is often curable with the right treatment! The sooner you get the diagnosis, the quicker you can start lifesaving treatment. If the cancer is caught and treated in an early stage, your survival chance is pretty high. At stage 1 or 2, almost all patients survive (over 90%)! Even at stage 3, more than 70% survive. So even if your lump turns out to be cancerous, it wouldn’t be an automatic death sentence. 

So, to recap: if it ever happens, take it seriously and call your doctor - but stay calm and optimistic while waiting for your appointment. 

With all my love, 

Your Tumblr Dad 

[mariacallous]

A little bit of alcohol was once thought to be good for you. However, as scientific research advances, we’re gaining a clearer picture of alcohol’s effect on health—especially regarding cancer.

The complex relationship between alcohol and cancer was recently highlighted in a new report from the American Association for Cancer Research. The report’s findings are eye-opening.

The authors of the report estimate that 40 percent of all cancer cases are associated with “modifiable risk factors”—in other words, things we can change ourselves. Alcohol consumption being prominent among them.

Six types of cancer are linked to alcohol consumption: head and neck cancers, esophageal cancer, liver cancer, breast cancer, colorectal cancer, and stomach cancer.

The statistics are sobering. In 2019, more than one in 20 cancer diagnoses in the West were attributed to alcohol consumption, and this is increasing with time. This figure challenges the widespread perception of alcohol as a harmless social lubricant and builds on several well-conducted studies linking alcohol consumption to cancer risk.

But this isn’t just about the present—it’s also about the future. The report highlights a concerning trend: rising rates of certain cancers among younger adults. It’s a plot twist that researchers like me are still trying to understand, but alcohol consumption is emerging as a potential frontrunner in the list of causes.

Of particular concern is the rising incidence of early-onset colorectal cancer among adults under 50. The report notes a 1.9 percent annual increase between 2011 and 2019.

While the exact causes of this trend are still being investigated, research consistently shows a link between frequent and regular drinking in early and mid-adulthood and a higher risk of colon and rectal cancers later in life. But it’s also important to realize this story isn’t a tragedy.

It’s more of a cautionary tale with the potential for a hopeful ending. Unlike many risk factors for cancer, alcohol consumption is one we can control. Reducing or eliminating alcohol intake can lower the risk, offering a form of empowerment in the face of an often unpredictable disease.

The relationship between alcohol and cancer risk generally follows a dose-response pattern, meaning simply that higher levels of consumption are associated with greater risk. Even light to moderate drinking has been linked to increased risk for some cancers, particularly breast cancer.

Yet it’s crucial to remember that while alcohol increases cancer risk, it doesn’t mean everyone who drinks will develop cancer. Many factors contribute to cancer development.

Damages DNA

The story doesn’t end with these numbers. It extends to the very cells of our bodies, where alcohol’s journey begins. When we drink, our bodies break down alcohol into acetaldehyde, a substance that can damage our DNA, the blueprint of our cells. This means that alcohol can potentially rewrite our DNA and create changes called mutations, which in turn can cause cancer.

The tale grows more complex when we consider the various ways alcohol interacts with our bodies. It can impair nutrient and vitamin absorption, alter hormone levels, and even make it easier for harmful chemicals to penetrate cells in the mouth and throat. It can affect the bacteria in our guts, the so-called microbiome, that we live with and is important for our health and well-being.

Alcohol consumption is also linked to other aspects of our own health and lifestyle and it’s important not just to consider this alone. Tobacco use and smoking, for instance, can significantly amplify the cancer risks associated with alcohol. Genetic factors play a role too, with certain variations affecting how our bodies metabolize (break down) alcohol.

Physical inactivity and obesity, often associated with heavy drinking, also separately increase cancer risks but on top of alcohol makes this much worse. Despite this, misconceptions persist. The type of alcoholic beverage, be it beer, wine, or spirits, doesn’t significantly alter the cancer risk. It’s the ethanol (the chemical name for alcohol) itself that’s carcinogenic (cancer-causing).

And while some studies have suggested that red wine might have protective effects against certain diseases, there’s no clear evidence that it helps prevent cancer.

The potential risks of alcohol consumption probably outweigh any potential benefits. The takeaway is not that we should never enjoy a glass of wine or a beer with friends. Rather, it’s about being aware of the potential risks and making choices that align with our health goals. It’s about moderation, mindfulness, and informed decisionmaking.

Alcohol has lots of effects not just in terms of causing cancer. A recent large study of more than 135,000 older drinkers in the UK has shown that the more people drink, the higher the risk of death from any cause.

These and similar findings underscore the importance of public awareness and education about the potential risks associated with alcohol consumption. As our understanding of the alcohol-cancer link grows, it becomes increasingly clear that what many consider a harmless indulgence may have more significant health implications than previously thought.

Unfortunately, not many people appear to be aware of these risks. In the US, around half of people don’t know that alcohol increases the risk of cancer. Clearly, a lot of work needs to be done to overcome this lack of awareness.

[that-stone-butch]

hi, i have a question and i mean this in good faith, but why do some butches get top surgery? you mentioned it in some of your recent posts and i’m just trying to understand. i 100% believe in bodily autonomy so i’m not judging anyone for that decision, i’m just trying to understand so i can support people better. obviously there’s a lot of overlap between butches and transmascs but i don’t really understand why someone who still identifies as a woman (not all butches do, but “lesbian”/“wlw” still implies some connection to womanhood) would want to have that surgery unless it was to prevent breast cancer? i have chest dysphoria too but i guess it’s not bad enough for me to understand this. is this higher level of dysphoria common in butches? again i mean this in good faith and i just want to understand. i wish you well for recovery and i hope everything goes smoothly!

my pal you have like fifty gender biases here that you're gonna want to unpack. this pile of questions has so much added baggage it's going to take so many steps to unpack holy shit

not all lesbians are women/have an 'implied connection to womanhood'

'top surgery' may mean mastectomy but there are also people out there who get 'top surgery' meaning breast implants, among whom some are butches, and for whom that is an equally momentous instance of gender-affirming care. is this a part of your question?

you don't have to understand why someone would want a procedure in order to support them

i cannot speak to whether or not butches experience an especially 'high level' of chest dysphoria

even if i could produce some statistic that indicates that we do experience a 'high level' of chest dysphoria, i am not especially equipped to speak for all of us as to why

i have no idea what amount of people counts as 'high' to you. is one in five high? one in ten? what if it was one in ten sure about getting top surgery, but an additional two in ten were considering it? would that be high, to you? i have no frame of reference for you

'has tits' does not necessarily mean 'is woman' and some women do not want to have tits. period

other people's chest dysphorias are going to look different from your own. there are as many different reasons to feel dysphoric about one's chest as there are people

like i'm taking your good faith seriously, but even if i wanted to answer these questions i couldn't. i'm just one person. so let me reiterate the only answer that matters:

you don't have to understand why someone would want a procedure in order to support them

[allthebrazilianpolitics]

Researchers map genetic variants associated with pancreatic cancer in Brazilian patients

The pioneering initiative by scientists at the University of São Paulo aimed to promote early diagnosis and improve treatment of the disease, which is relatively infrequent but one of the leading causes of death from cancer in Brazil.

Pancreatic cancer has recently been included in the list of diseases about which Brazil’s National Cancer Institute (INCA) periodically publishes statistics. Although it is not the most frequent type of cancer, its high lethality makes it one of the leading causes of death from cancer in Brazil, partly owing to late diagnosis. 

“It’s striking how little data on the disease is available in Brazil and indeed in Latin America as a whole. There are no studies on pancreatic cancer involving Brazilian patients because its incidence is low in this country compared with breast and lung cancer, for example. Yet it’s the type of cancer with the highest mortality rate – and it kills very quickly,” said Lívia Munhoz Rodrigues, a researcher at the São Paulo State Cancer Institute (ICESP) with a PhD in oncology from the University of São Paulo’s Medical School (FM-USP). 

Leading a team that included other researchers at ICESP, as well as collaborators at FM-USP’s Department of Legal Medicine, Bioethics, Occupational Medicine and Physical Medicine and Rehabilitation, and the D’Or Research and Education Institute (IDOR), Rodrigues conducted a pioneering study of 192 pancreatic ductal adenocarcinoma patients treated at ICESP between 2018 and 2022 at the expense of the SUS (Sistema Único de Saúde), Brazil’s public health network. Pancreatic ductal adenocarcinoma is the most common type of pancreatic cancer.

The scientists used genomic DNA sequencing to look for alterations to 113 oncogenes – genes that can cause cancer when they undergo mutation or are activated in an abnormal manner – in the shape of pathogenic germline variants (PGVs), which are hereditary mutations. 

Continue reading.

[celestie0]

kickoff!gojo dyes part of his hair pink for breast cancer awareness. ladies go crazy for it. our mans a feminist

prolly says some shit like “statistically speaking 🤓👆men can also get breast cancer. it’s just more prone to women because they have more breast tissue”

im deaaaddd also. imagine how easy it would be to dye gojo’s hair LMAO since it’s white. also. imagine how hard it would be to get the color OUT lol

ok im soooooo sorry to say this, but that would so totally work on me 😭😭 i wld be in his bed after that. and i’m seriously not proud at all to say it 💀💀💀 he got me at the “statistically speaking ☝🏼🤓” like i’d suck his dick fosho

anon (im assuming you’re the same anon that sent the other headcanons too) im just DYING at how perfectly youve nailed the frat boy gojo vibes 🤣🤣 bc thats such a sleazy thing to do to get pussy but i feel like he has 100% done that in the past LMFAO

[wellhealthhub]

What is the very first stage of breast cancer?

Introduction: Unveiling the Complexity of Breast Cancer Breast cancer, a multifaceted ailment affecting numerous individuals annually, stands as a formidable medical challenge. A profound grasp of its various stages is indispensable for accurate diagnostics and efficacious treatment. Within the confines of this discourse, we shall embark on a comprehensive expedition into the intricacies of the…

[neil-perrys-suicidal-tendencies]

My dad refuses to believe healthcare has gender inequality in healthcare.

His evidence - there are so many maternity and childcare hospitals and there has been so much research doe for breast and cervical cancer.

Privilege fucking goes hard man. Like, when I talk about my pain, even he doesn't believe me. Why would doctors💀💀.

And maternity and childcare hospitals exist so women don't fucking die in childbirth or from its complications.

Gonna pull out the statistics.

What's a man gonna tell about medical gaslighting?

[nico-esoterica]

Cardi's Self Worth Awakening (Astro Analysis x Surprise Channeling) ✨

Disclaimer: I did not expect Cardi's energy to just come rushing in to tell me everything but apparently..that happened as you read along.

I love the way the eclipse season finishing up in Cardi's chart w/ Libra/Aries is helping her fully realize her worth. We're seeing a massive shift w/ this where many in her position are having wake up calls more than ever due to Saturn in Pisces because it makes us what's aware of the wrong that needs to be exorcised or rectified. With Pluto transgressing back into Capricorn one final time w/ said Saturn ruling it, for some, it's about demolishing structures where we were taught we needed to save space and handle business as usual that can't be tolerated any longer.

Belacalis was born on a full moon in Libra-Aries and is experiencing a Mars Return in Cancer. This eclipse season will be all about her vocalizing and expressing the years of pent up rage she was made to endure. It'll feel like a phoenix rising from the ashes best case scenario. Especially since her Juno's also being hit since it's also in Cancer. There's a lot of 'aha' moments she's been feeling in private. She's wanted to pull away but I'm intuitively getting that the timing just wasn't right and she needed time to properly process and let him go. She has a tendency to want to not only fight for her family, as she should, but fight to hold onto things which don't want her anymore.

There's an insecure attachment issue and as a Cancer placement we have a tendency to just keep things and people around that hurt us but that pain is familiar and brings us comfort. We often don't realize how dangerous it is. I think she genuinely wanted him to change. But a lot of it had to do with this image of a perfect family she wanted to fight to maintain so she wouldn't look like a stereotype or a statistic in public while she was being humiliated privately. She was keeping it together for her children's sake. But in the back of her mind, she knew this man could never actually want her. He would never fight for her and wanted to make her feel small to punish her for being powerful. I feel like she could smell that coming but he was very good at manipulating and gaslighting her because she'd never make a fool of him or smear his reputation publicly and could 'take the abuse' and he used that to his advantage.

The man is a child, honestly. Energetically, he's extremely immature but his dreams/creativity but overall childishness are facilitated/enabled by his team and the people around him. He hasn't grown up since he was 11 (I also see 8!) and still has the mind of someone much younger. He may have grown up in other ways physically or responsibility wise but nothing else caught up with him because he wasn't challenged to do so. As in, if no one around him held him accountable, he never took it upon himself to be. I felt this from Beyonce's energy too when hers came to me but they both wanted to nurture the wounded children in their partners. Cardi always loves feeling needed and cherished but it's exploited by people who don't honor and appreciate her properly. You also cannot breast feed a grown man, she's realizing. Like, this phrase came up in my head just now.

Her family helps her feel the most secure but there's also this..feeling I'm getting..that she didn't feel exactly..welcome? So she overcompensated by leaning into more of her Madonna/Mother-Mary side (there's a lot of religious feeling and reverence/iconography here) to be the perfect mother to support the family as a whole. But it drained her and cannibalized her. I'm seeing that they rely on her for everything as a suped-up breadwinner and 'all of a sudden, no one wants to take responsibility'. People are just dumping things on her like 'Cardi, fix it, Cardi fix it' and it's not as if she doesn't have money per se but she's being abused as a resource.

A lot of her best brand deals and money moves happen when there's the right surge of creativity and 'perfect timing' is what I'm hearing. There's a lot of that's divined that she trusts in. Like, she just 'knows' it's the right move for her to make and she's taken care of. She rests a lot of her faith in intuition and God because the combination has honestly saved her in many ways. I really think that she wanted this man to change. I keep getting that. Because I'm also getting that she thought that he was the only man that could ever 'deal' with her so she just endured and kept him around. She felt like she could make him into the man that she deserved but 'nothing worked..we done talked to all the therapists and counselors and head shrinks'. So what I'm getting is that she just tapped out at some point.

Disassociated. There's a lot of feelings of her using drugs/alcohol to help her do it. There's also an underlying addiction issue here that's a coping mechanism. But a lot of it has to do with him. The way this man would talk to her is 'ungodly' and she needed to cope in ways which hurt her but allowed her to keep her head straight or save face or seem like nothing was going on. But she was very big on making sure it never happened around her kids or anything because she 'isn't stupid'. But he...wasn't so careful himself, apparently. She literally had to play Mommy for him too. She was always telling him to not do this and not do that. There's a lot of him that felt like a teenager trying to raise children. I think she feels as if he loved their kids more than her..but she kept that buried. That resentment. But it was never aimed at their kids. It was just like...'If I'm their mother...how come you don't love me???'

For the sake of personal boundaries, I'm cutting this off now because I really genuinely feel like she's fine with letting me just see everything and I'm going to let her keep that private. Her energy is just very..spill-y at the moment and I appreciate what she's shown me but I know when to stop.

But ...jesus fucking christ? This eclipse finally helped her leave for the better. BUT SHE NEEDS TO STAY GONE. SHE NEEDS SKY HIGH BOUNDARIES WITH THIS MAN.

[swinging-stars-from-satellites]

my mom read one or two articles with supposed "statistics" that say sleeping in a bra or even just frequently wearing a bra causes breast cancer and like I cannot believe that she's fearmongering to me about "would you rather wear a bra to bed because 'it's so uncomfortable without it' and have to fight breast cancer, or would you rather get your priorities fixed?"

[occultist-romantic]

Don't you realize that male and female are social constructs? They're ideas. Scientists don't even believe biological sex is a thing anymore, we're all just people. Gender is almost like religion, it can change, some people are really sure on theirs and others aren't, forcing someone into one is always wrong. Do you know why you're cis? Do you ever think about the possibility that you're not, about what it would be like to be something other then what you were born as. Would you still feel like a woman if you didn't have a womb, if you didn't have breasts or genitals or estrogen? It was a combination of contemplating these things, and mystical experiences with the goddess Hel that got me to realize I was agender. I thought I would lose certain things when becoming nonbinary and genderless, but I didn't. I don't know about you, but know you can be happy as an enby or a boy, you can be loved, and cherished and comforted as an enby or as a boy. I don't know if you're nonbinary like I am. You might find you really do identify with womanhood, but if you do really want to be a woman, then know that that's the same feeling amab women have. I know what it's like to think the way you do, I used to think that way, and I've had bad experiences with men and with the expectations society has for people with bodies like mine. But you don't have to take your pain and call it womanhood.

hi, give me one article stating that science believes biological sex isn’t a thing anymore when your sex determines how you live, the diseases you are prone to (xx/xy-linked disorders, endometriosis, breast cancer, vaginal cancer, prostate cancer, certain mental illnesses, etc) the treatment you receive, how you are perceived, down to the money you earn. there are statistics of women earning significantly lower compared to men, women facing abuse significantly higher than men, and so on. in el salvador, a female gets killed every 24 hours, in bangladesh at least one woman is raped every 9 hours, in somalia girls suffer from the highest rates of FGM, which is completely only because they are females. families don’t have the same expectations and plans for their child when it’s a female, especially in countries where FGM, child marriage, and so on is high. because a woman is seen as the “honor” of the family, the one who has to stay pure no matter what. this is why so many women get forcefully married with their rapists and forced to carry their babies. to save the honor. however a man does not have this responsibility. these are all related to sex and the fact that you say sex isn’t a real thing is the MOST delusional thing i have ever heard in my life. gender is a social construct, a way to oppress women and have them live under the patriarchy. if they don’t fit they must either be a man or unwanted, unloved, ugly, etc. no one is forcing you into any gender because gender isn’t real, but a construct like you said. however biological sex is everyone’s reality and if you are an “anarchist” like you claim you are then you should know this. did you not read kropotkin? anything? which anarchist denies biological sex?

not only this but who are you to act like i’m secretly trans or something? can you PLEASE respond to this and tell me one thing that made you realize you weren’t a “woman” and have it be something else than a gender role? did you hate wearing dresses as a kid? did you want short hair? did you feel like you didn’t fit in with the other girls because you didn’t share the same experiences? did you play football and video games? were you loud and messy? what made you realize you weren’t actually a woman nor a man?

what makes a woman is her biology, not if she has long hair, not if she has a feminine face or dresses to wear, or if she puts on makeup. this is why it’s so freeing. because you don’t have to waste your time thinking of countless terms to further reinforce your “uniqueness” or “individuality” that’s pushing you to microlabels. you can simply exist in your body as a woman because you are a woman due to your sex, not due to the gender roles.

you are saying you had bad experiences with men and society’s standards. don’t you see that it’s that way with every women? when men constantly rape, abuse and kill women; is it ever easy to feel safe? in this case, it would make sense to reject womanhood and want to be something else because a woman is the one who faces the abuse, not someone else. since you are perceived as a woman, you face the violence a woman would. so by becoming “non-binary” you simply try to escape that painful reality.

i’m not going to go into the religious side of it because it’s your relationship with your deity. and simply i don’t care. but i do wish you heal your relationship with womanhood and understand you can be anything you are now simply being a woman, because it’s not a gender, it’s a reality

i want to add that you can be loved as a woman too. you are not alone as a woman

[apenitentialprayer]

article by Sunita Puri, published October 5th, 2024. Bolded emphases added.

The first person who taught me something about death and defiance was the mother of a family friend, an older woman who had moved from Punjab to the United States to be closer to her son. I remember her as delicate and draped always in pastel salwar kameezes. After she was diagnosed with breast cancer, which moved quickly to claim her bones and her brain, her desire to return to Punjab intensified. When my parents told me about the end of her life, it was with a mixture of disbelief and conviction: She survived the days-long journey to the village where she’d been born—laboring to breathe for nearly the entire flight, grimacing through prayers when she ran out of pain medication—and died two days after she arrived.

I thought of her story this week as I read about former President Jimmy Carter’s intention to live long enough to vote for Kamala Harris. Carter, who has been on hospice for well over a year, turned 100 on Tuesday and has survived far longer than many expected he would. The notion that he has rallied in order to contribute in one final way to American democracy raises a familiar question that arises in my own work with patients and families: Do we have some control, conscious or not, over when we die? Can a person stretch the days of their life to include a last meaningful act or moment?

As a palliative-care physician, I have encountered the phenomenon of people dying only after specific circumstances materialize. There was the gentleman whose family held vigil in the intensive-care unit while he continued on, improbably, even without the support of the ventilator, dying only after his estranged son had arrived. There was the woman whose fragility precluded any further chemotherapy, but who survived long enough without it to witness the birth of her first grandchild. There was the woman who was deeply protective of her daughter, and died from cirrhosis only after she’d left for the night, possibly to spare her the agony of witnessing her death. The unexpected happens frequently enough that I tell patients and families that two timelines shape the moment of death: the timeline of the body, governed by the more predictable laws of physiology, and that of the soul, which may determine the moment of death in a way that defies medical understanding and human expectations. When people wonder about the circumstance of the last heartbeat, of the final breath, I can see how they never stop searching for their loved ones’ personhood or intention, a last gesture that reveals or solidifies who that person is.

Despite the prevalence of stories suggesting that people may have the ability to time their death, no scientific evidence supports this observation. Decades ago, several studies documented a dip in deaths just before Jewish holidays, with a corresponding rise immediately afterward, suggesting that perhaps people could choose to die after one final holiday celebration. A larger study later found that certain holidays (Christmas and Thanksgiving, in this case) and personally meaningful days (birthdays) had no significant effect on patterns of dying. But this phenomenon doesn’t lend itself easily to statistical analysis, either: The importance of holidays, for instance, can’t quite stand in for the very individual motivations that define the anecdotes shared in hospital break rooms or around a dinner table. And the human truth that many recognize in these stories raises the question of whether we believe them any less fully in the absence of proof.

Palliative care often involves helping people confront and develop a relationship to uncertainty, which governs so much of the experience of illness. And when my patients tell me about themselves and about who they are now that they are sick, willpower often makes an appearance. Many say that if they focus on the positive, or visualize the disappearance of their cancer, or fight hard enough, they will win the battle for more time. I hear in their words echoes of what Nietzsche wrote, what the psychiatrist Viktor Frankl used to make sense of his years in German concentration camps: “He who has a why to live for can bear almost any how.”

And we want to believe that love or desire or commitment or heroism is still possible right up until the very end. As my patients grow sicker, and as death approaches, I talk with them and their families about what they can hope for even if a cure isn’t possible. That, in fact, death can still contain something generative. A time that may have seemed beyond further meaning becomes instead an opportunity, or an extension of the dying person’s commitments to their country, their family, their dreams. Soon, President Carter will be able to cast that vote: Next week, Georgia registrars will start mailing out absentee ballots; early voting begins the week after that. His promise to himself is a reminder that dying cannot fully dampen purpose, even as a person’s life narrows.

The idea that willpower can be an ally against death is appealing too, because it offers the possibility of transcendence, of defying the limits that the body, or illness, may impose. But, having also seen the many ways that the body does not bend to the mind, I do find myself regarding willpower with caution: What if you as a person are a fighter, but your body simply cannot fight the cancer any longer? I wonder, with my patients, if they can strive for more time without shouldering personal responsibility for the limits of biology. Similarly, two people on ventilators may love their families equally. One may die only after the final beloved family member arrives, whereas the other may die before the person rushing across the ocean makes it home. We don’t always know why. If Carter casts his vote and dies shortly thereafter, that might affirm the notion that others, too, can write the final sentence in their story. But what would it mean if Carter died before casting his vote? If he lived another year, or if he lived to see Donald Trump take office again, or watch the election be violently contested? Living with loss requires remembering that we can locate the person we have loved or admired in any given set of events that comprised their life, not just the last one.

I try to imagine my family friend’s long flight from Los Angeles to Delhi, and her ride in the taxi back to Punjab. I think about how she found a way to endure what she was told she couldn’t, all to feel beneath her feet the soil she knew best, to die in the one place that she felt belonged to her. What if her doctors had been right and she had died on the plane? My family might have mourned her single-mindedness, or we might have admired her defiance nonetheless. What makes these stories so compelling is that they remind us that death, however ravenous, cannot devour hope or possibility, even if what transpires is not the ending we imagined.