DYING OF DISEASE, MALIGNANT AND NONMALIGNANT, is becoming increasingly protracted and difficult. In Victorian times a cancer diagnosis represented an acutely fatal disease. With modem oncology, cancer is now a chronic disease, and many infectious, immune, and neurodegenerative disorders now have long lives. Medical and social complications accumulate, which may erode the quality of remaining life for these patients. Often the organ to suffer most is the brain. Previously prostatic cancer infrequently metabolized to the brain, MND/ALS apparently rarely caused fronto-temporal dementia, radiotherapy did not cause neuronal necrosis, chemotherapies did not result in painful peripheral neuropathies, and leptomeningeal involvement was an unusual complication of breast malignancy. The brain and the mind are increasingly casualties of modern medical managements.
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