Life’s Final Decision: To Save or Not To Save?

Johor, Malaysia

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Life’s Final Lesson: Dignity, Not Regret

In one of my previous videos, a viewer left me a question:

"Dr. Teo, does cancer always end in death? Don’t you have patients who recover?"

Of course I do.

Many of my patients go back to living a fulfilling lives after their treatment — returning to work, caring for their families, raising their children and achieving their life goals. Even for older or frailer patients who cannot undergo aggressive treatments, many still live stable, meaningful lives with cancer through gentler therapies, while enjoying their later years with dignity.

These are stories worth celebrating. And I am proud to have been part of them.

But if you’ve been following my sharings, you might have noticed: I don’t only talk about recovery. I often talk about the end of life too.

Not because I’m pessimistic — but because I know: medicine has its limits. And life, no matter what, eventually reaches its end — whether it’s because of cancer, age, or something else.

When there’s still a chance, we doctors will never give up. It’s our duty — and our mission to save lives.

But when medicine can no longer change the outcome, our question must shift from "Can we save them?" to "How do we accompany someone to the end of their lives — with dignity?"

Why I Insist on Talking About End-of-Life

We live in a society that loves positive stories. Sharings of "succesfully conquering cancer" and "miraculous recoveries" spread easily.

But what about those who don’t survive? Their stories are rarely told. The media doesn’t cover them. Sometimes even family members avoid talking about them — because those final days were too painful, too chaotic, too heartbreaking.

When hospitals can no longer save, some families, driven by love and desperation, chase after unproven alternatives. But in doing so, they often unknowingly add more pain, more suffering, and more regret — simply because they couldn’t bear to let go.

As an oncologist, I walk with patients through their final journeys every day. I hear the silence and pain left behind. The truth is: it’s not that people don’t care about dying — the topic is just too emotionally heavy, and people don’t know how to talk about it. Many fear that discussing death means giving up hope.

But I want to tell you: Talking about end-of-life is not about giving up. It’s about preparing — while the decision is still in your own hands.

Real Hope Isn’t About Miracles.

It’s about having a choice to decide. We prepare for new beginnings — buying cribs for newborns, planning for a child's education. But very few of us prepare for the final chapter of life.

And when that day suddenly comes, the story often unfolds like this:

The patient is rushed into the ICU, unconscious, hooked to countless tubes.

Family members scramble to decide — To save or to let go? & caught between panic, guilt, and exhaustion.

But much of this chaos, much of this suffering, could have been avoided — if only we had talked about it earlier.

Real hope isn’t about clinging to life until the last second. It’s about preserving dignity and choice to still live a comfortable life, even when medicine can no longer help.

What Does "Dignity" Really Mean at the End of Life?

It’s easy to think that dignity only matters when you’re healthy. But I often see heartbreaking scenes of:

• Patients struggling in ICU, unconscious, bodies full of tubes.

• Family members blaming themselves, filled with sorrow.

• Knowing the treatments are futile, yet too afraid to stop.

• No chance for a proper goodbye — only exhaustion and regret.

  
  

But imagine a different ending:

• Being at home, surrounded by loved ones.

• Listening to a favorite song, saying their final words.

• No longer forcing the body to endure harsh treatments — but easing pain instead.

• Saying goodbye with a clear mind, not in a coma.

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Which ending would you want for yourself? For someone you love?

Sometimes we think that "fighting until the end" is the only way to show we care. But sometimes —choosing not to prolong suffering is the greatest act of love.

Fighting on isn’t always filial piety. Sometimes it only extends pain, not true life.

A full life’s final chapter shouldn't be chaos and tubes —but calmness, clarity, and love.

Whether or not cancer can be cured, every patient deserves to know:

✅ How to live their best life during treatment.

✅ How to reduce suffering — both physically and emotionally.

✅ How to preserve dignity when medicine can no longer offer cures.

✅ How to leave without regret — for themselves and their families.

Don’t Wait Until the Last Moment to Learn How to Say Goodbye

Many families realize too late:

• "If I had known we didn’t have to intubate, I wouldn’t have forced her to suffer."

• "If I had known there were other options, I wouldn’t have insisted on aggressive treatment."

• "If I had known that ‘not fighting’ didn’t mean giving up, but respecting her wishes, I could’ve accompanied her through a gentler farewell."

  
  

What I truly want to talk about here, is not death. I want to talk about how we live — fully — until the very last day.

To stay awake. To have choices. To still be able to say "I love you" and "goodbye."

The last chapter of life should be gentle, not filled with regrets and pain.

I hope you and your loved ones will never have to learn this the hard way: Not choosing to fight till the very end doesn’t mean you’re giving up. Sometimes, it’s the bravest way to protect someone’s dignity and give them peace.