Living (2022): A Terminal Diagnosis, Unnamed

Living (2022) is a film about a man told he has only months to live. This page is for anyone who has seen it and wants to know what it gets right, what it leaves out, and what it means for real life.

Spoilers throughout. Mr Williams keeps his diagnosis to himself. This page does not.

London, 1953. Mr Williams is a senior clerk in the County Council's Public Works department. He is a man reduced to a bowler hat and a habit of moving awkward files to the bottom of a pile. A hospital appointment tells him he has cancer and only months to live.

He cannot say it to his son and daughter-in-law. He withdraws his savings, goes to the seaside, and asks a stranger — a bohemian writer — to show him how to enjoy himself. The night out leaves him hollow. Back in London he keeps seeking out Margaret, a young former colleague whose appetite for life he envies, until she guesses the truth.

Then he goes back to the office. Local women have petitioned for a children's playground on a bombsite, and he drives through the obstruction that has stalled it. He dies not long after it opens, last seen on a swing in falling snow. At his funeral his colleagues vow to work as he did, then quietly slide back.

Oliver Hermanus directs from a screenplay by Kazuo Ishiguro. It is an English-language remake of Kurosawa's Ikiru, transplanted to postwar England.

The film is precise about a specific kind of appointment: the one where treatment stops being the subject.

It is just as precise about what many people do next, which is nothing. Williams cannot say the word to his son. He rehearses the sentence silently and abandons it. He becomes suddenly intimate with near-strangers, because they carry no history and expect nothing. Many people find this familiar.

The film shows the physical decline quietly: tiredness, a shrinking appetite and growing stillness. Loss of appetite is on NCI's list of stomach cancer symptoms.

The film also shows a person wanting to finish one thing that will outlast them. It can be worth asking a relative with a serious illness what matters most to them.

The film shows no oncology, no palliative care team, no district nurse, and no symptom control of any kind. Williams stays upright, tidy and able to walk to work and lobby committees almost to the end. His death happens offscreen and appears serene.

The 1953 setting explains part of this. Diagnoses were often withheld, treatment options were thin, and the modern hospice movement did not yet exist. It is not a fair complaint that a period film shows period medicine.

The risk is that a modern viewer reads it as a forecast. Advanced cancer can bring pain, nausea, weight loss and a need for more help. Ask your care team what symptom control and home support are available, such as a nurse who visits and a palliative care team you can phone.

The film never names the cancer. Its source, Ikiru, gives the equivalent character stomach cancer, so that is the closest real subject.

Gastric cancer is notorious for early symptoms that read as ordinary indigestion. NCI's list for early disease is deliberately unremarkable:

• Indigestion and stomach discomfort.
• A bloated feeling after eating.
• Mild nausea.
• Loss of appetite.
• Heartburn.

Later signs are harder to explain away. They include stomach pain, vomiting, blood in the stool, unintended weight loss, trouble swallowing, jaundice, and fluid collecting in the abdomen. NCI says early stomach cancer usually has no symptoms, which makes it hard to detect.

NCI's screening pages for average-risk people list breast, cervical, colorectal and lung cancer, and do not list stomach cancer. Endoscopy — a thin camera passed down to look at the stomach lining — is a diagnostic test your doctor can order if symptoms call for it.

Indigestion that goes on and does not settle is worth raising with your doctor rather than managing indefinitely with antacids. Tell them right away if it comes with weight loss, vomiting, blood in the stool or trouble swallowing. These are on NCI's list of later signs.

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Living is a film about what a person does with a deadline, and it is very good at that. It is not a description of how the last months of an untreatable cancer feel, and it should not be used as one. The thing to carry out of the cinema is smaller. Symptoms that stop being temporary deserve an appointment. And a diagnosis you cannot say out loud is much heavier carried alone. Living cannot tell you what to watch for, but screening and possible warning signs can.

This page discusses Living for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.