But, according to Dr. David Spiegel, a Stanford University psychiatry professor who has been studying women with advanced breast cancer, facing death can be a period of growth.
Research on the effects of stress and support on breast-cancer patients has been ongoing since the 1970s under Dr. Irv Yalom, who conducted support groups for women with breast cancer that had spread, or metasticized. His concern was whether the "support" groups would actually demoralize the women, Spiegel said. Instead, he found they "remoralized" them.
"They faced decisions about how to live their lives," he said.
Spiegel has interviewed women who have changed their lives. He said a woman who had been a frustrated poet all her life published several books of poetry by the time she died.
Another quit her job to spend time with her 5-year-old child.
A journalist had planned in her will to help young journalists. After her diagnosis, she decided to implement her idea before she died, he said.
"'Why start after I'm gone?'" she told him. Instead, she got involved in setting up the program and meeting women to help launch their careers.
A Silicon Valley engineer said she'd always wanted to be an artist. "I'm not going to die without doing what I want to do," she told him before she quit her job, went to art school and taught art.
But not everyone makes a radical shift.
"Some who feel life is pretty balanced will continue doing what they're doing," Spiegel said.
"A big part is having the courage to face that: 'My life is not the same, but maybe I can make it better,'" he said.
Dr. Spiegel thinks often about his own life-balance, weighing his commitment to career and work at Stanford with family.
"I've lost both parents in the last few years. I took time to deal with those losses, spent time with my sister. Earlier I might have worried about all that work to do. ...
"I'm behind on a number of projects. I'll get them done, but I'm not losing sleep over it."