Study Refutes Notion That Death Takes a Holiday

No spike or drop in cancer deaths seen around Christmas or birthdays

TUESDAY, Dec. 21, 2004 (HealthDayNews) -- Among health-care workers and relatives of the terminally ill, tales of patients who somehow "held on" past the holidays or birthdays are common. Over time, these stories have given rise to the widespread belief that patients can delay death through sheer force of will.

But new research suggests that may not be the case.

In the largest such study ever conducted, researchers report no trend toward fewer deaths immediately before either Thanksgiving, Christmas or dying patients' respective birthdays.

"We looked at data on over 309,000 cancer deaths -- we would've seen a trend, and there just wasn't any," said study co-author Donn Young, a statistician and research scientist at Ohio State University's Comprehensive Cancer Center.

While the study results may come as a disappointment to some, Young believes they convey an important, positive message.

For families caring for a loved one with terminal disease, the findings suggest that "we need to do stuff now -- don't delay for a holiday," Young said. "If there's an important event, celebrate it now, or give that person a call. We need to give them the early gift of letting them know that we love them, to give them our attention and our time."

He and co-researcher Erinn Hade report their findings in the Dec. 22/29 issue of the Journal of the American Medical Association.

The Ohio State researchers' interest in the theory of "holiday death postponement" arose this time last year, when a journalist called Young regarding a story on the phenomenon.

"When the article came out, it turned out that I was the only naysayer -- everyone else said, 'Oh yes, this process really happens,'" Young said.

Looking through the available literature, he discovered that the few studies ever conducted on the subject focused on relatively small samplings of specific subgroups.

As a statistician, Young had access to a much larger sampling, the Ohio mortality database. In their study, he and Hade examined data on all cancer-related mortality in Ohio between 1989 and 2000 -- over 309,000 deaths. They focused on deaths occurring within two weeks of Thanksgiving, Christmas and the individual patient's birthday.

Contrary to the popular wisdom predicting a pre-holiday dip in cancer deaths and a post-holiday peak soon after, "we didn't see any dip or peak [in deaths] for any of those specific dates," Young said.

The popular notion that patients can delay their demise may be based on a combination of "wishful thinking and selective memory," Young said.

"We remember those patients who hang on, precisely because it's so memorable," he said. "We forget the story of the patient who dies on the day before Christmas, however."

Dr. Michael Thun, head of epidemiological research at the American Cancer Society, said the findings underline the importance of a large and varied study population.

"When you base a study on an adequately sized population, associations that have been commonly reported appear to be chance events, rather than a real trend," he said. "There are always going to be individual surprises, but this is a pretty substantial study and it suggests those surprises are the exceptions, not the rule."

Thun agreed with Young that Americans should interpret the findings as life-affirming.

"You should live your life as if every day might be your last -- we should all do that," Thun said.

Celebrating now rather that later is always a win-win situation, Young added.

"My father died of chronic renal failure last summer, a week after his 88th birthday," he said. "We celebrated his birthday early, because we just didn't know if he'd make it or not. Fortunately he did make it, so we simply celebrated it again. I don't think anyone's going to say that celebrating an event like that twice is a bad idea."

More information

Advice and information on end-of-life care can be found at the American Cancer Society.

SOURCES: Donn Young, Ph.D., research scientist, Ohio State University Comprehensive Cancer Center, Columbus; Michael Thun, M.D., head, epidemiological research, American Cancer Society, Atlanta; Dec. 22/29, 2004, Journal of the American Medical Association
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