Patient advocate and death doula Deltra James on how Compassion & Choices’ End-of-Life Decisions Guide offered hope and agency after a terminal cancer diagnosis

By Deltra James

I no longer think of my cancer as something I need to “beat.” Rather, it’s a question of how much time I can get coexisting with it. I’ve been learning, slowly, to accept and prepare for my death.

A terminal diagnosis can be an opportunity for advocacy

In the summer of 2019, at 33 years old, I just happened to notice a lump in my breast. I made an appointment to see my doctor, who said the lump was probably nothing to worry about, but scheduled me for an ultrasound. 

Very quickly, I went from being told “You have cancer” to being told I was stage 4. 

I’ve had to advocate for myself each step of this journey. In 2022, I fought for a lumpectomy due to a solid tumor in my breast that was very painful. Chemo was doing nothing for it, but surgery is not the standard of care for people at stage 4. Eventually, however, my doctor agreed to perform the surgery. It gave me peace of mind to finally be free of that tumor.

I always say “Push until you get peace,” and I make sure I live by that. 

Choice and agency are important at every stage of life

As a mother of five children, I’ve had beautiful birth experiences bringing my children into the world, and I got to feel very empowered and in control of those situations. Could I completely control everything that happened? No. But I could feel a sense of peace because I’d been able to plan and identify how I wanted to be supported. I would want my death to be that way as well. 

When I started looking into end-of-life planning and options, I was really grateful to come across Compassion & Choices. Their End-of-Life Decisions Guide has been an incredible tool for helping me feel confident that my death can be as beautiful as my children’s births were. When I threw a huge party celebrating five years as a cancer survivor in August 2024, I even handed out the End-of-Life Decisions Guide as a party favor to my guests. 

Amplifying my voice with Compassion & Choices

I decided to share my story with Compassion & Choices after seeing the work they’re doing and the platform they have. I know that being young, being a person of color and being diagnosed so late-stage make mine an important story for others to hear, whether they have a diagnosis or not. 

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