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Stuart Scott’s ESPY speech omits mention of dying the good death

After being diagnosed with a rare cancer seven years ago, ESPN anchor Stuart Scott has been living life on his own terms, fighting — as he told a crowd of television viewers during the ESPY awards on Wednesday night — and never giving up.

It was a powerful, heartfelt moment. Left unsaid, however, was that Scott, 48, is likely going to die at some point from his cancer that has metastasized, causing liver and kidney complications. I worry that the expectation he sets for cancer patients to fight the good fight leaves those who choose to accept the inevitable feeling ashamed or defeated.

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Scott hardly looked ill — dapper in his gray suit with lavender shirt, tie, and pocket square — as he accepted the Jimmy V Perseverance Award. He quoted the famed college basketball coach’s battle cry uttered 21 years ago at the ESPYs, “don’t give up, don’t ever give up.” Scott said, “To be honored with this [award], I now have a responsibility to also not ever give up.”

But Valvano succumbed to his cancer eight weeks after giving that speech, at the age of 47, and we don’t know whether he knew his death was imminent or what he said in the privacy of his own home when the cameras weren’t on him.

We also don’t know what Scott has said to his two teenage daughters and his girlfriend who slept on a cot in his hospital room for a week, just a few days before he went to the ESPYs.

“I can’t ever give up because I can’t leave my daughters,” Scott said. Does this mean cancer patients have a choice — whether to keep fighting and living or to give up and die?

Hardly, and in his speech Scott expressed the sentiment beautifully when he said it’s the fight and not the outcome that’s important.

“When you die, it does not mean that you lose to cancer,” he said. “You beat cancer by how you live, why you live, and in the manner in which you live.”

But what if a cancer patient doesn’t want to fight to the last breath? What if that person elects to skip chemotherapy — and perhaps live a few months less — to be able to sit on the porch and watch the sunrise or die peacefully surrounded by family at home?

Can we not celebrate the lives of those patients as well, even if they choose to opt out of the fight? When cancer cruelly strikes a person young, like Valvano and Scott, doctors, loved ones, and friends expect them to try every treatment possible (regardless of the side effects) to have the best shot at a cure.

While that’s understandable, some patients with advanced cancers may not want to go through the rigors of chemotherapy, radiation, or multiple surgeries based on the slim hope that such treatments may offer them, not a cure, but a little more time to live.

Studies suggest discussions about end-of-life care — especially for cancer patients — is an area of medicine that’s severely lacking in this country. Oncologists don’t want to broach the sad subject of death to their patients, especially those in the prime of their lives.

A Dana-Farber Cancer Institute study published in March found that more than half of end-stage cancer patients receive chemotherapy during the last few months of their life, and those who received such treatment were more likely to die in a hospital intensive care unit, hooked to a ventilator, rather than at home as they would have preferred.

“There’s a subtle dance that happens between oncologist and patient,” study leader Dr. Alexi Wright, an assistant professor of medicine at Dana-Farber, told me in a previous interview, “where doctors don’t want to broach the subject of dying, especially in younger patients, because it makes those patients think we’re giving up on them.”

Scott spoke of how important it was to have his doctors and family members fight for him when he was too tired to fight on his own. He’s opting to enter a clinical trial for a new drug to help him in his battle. While I respect him for this decision, I would have respected him the same had he chosen not to try an experimental treatment.

But I question whether society would have or whether he would have been given the “perseverance award” if he had spoken about his decision to die on his own terms.

Related:

Farah Stockman: The end of life and giving everything away

End-of-life care rarely discussed

Campaign aims to spur end-of-life conversations

Study says many patients enter hospice care too late

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.
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