T HE PSYCHOLOGY of death and dying in human cancer is very complicated, almost impossible to study in an empirical and objective way, and full of contradictory hints and hypotheses. Simple approaches to its understanding lead to clinically unproductive knowledge. There are always two major themes intertwined. On the one hand, all illness and disease must be regarded as potentially treatable, a goal that leads to emphasis at least on those factors promoting healing, recovery, and survival in the face of threats to life. On the other hand, all human beings reach a time when they must die and when treatment is no longer reasonable or feasible; then the goal is often emphasis on those factors promoting comfort of the dying, disengagement, and a’cceptance in the face of inevitably approaching death. These two situations do not generally succeed one another with a moment of clear-cut division between them. 111 most cases, they exist side by side and are further complicated by possibly different perceptions on the part of the physician, other medical personnel, the patient, the spouse, other family members, the community, the church, the courts of law, and the professional ethics review committee. No simple model will fit, but perhaps some increase in understanding will result from generalizations drawn from observations and investigations of human psychologic responses to a variety of catastrophic and disastrous conditions involving a threat to life. The diagnosis and subsequent treatment of breasr. cancer is a psychologic catastrophe to the woman who experiences it. The prediagnostic anxieties are resolved in the diagnosis, and the entire psychologic situation changes. From fear and worry and the defenses against them, we move