Instead, Smith will remain on the air while undergoing palliative care designed to make what time he has left as comfortable as possible. And then he simply went on with the show.
"That's the way I've conducted my career," Smith, 69, said Thursday from his home in southern York County, Pa., where he's been doing most of his broadcasting work since announcing his inoperable Stage 4 cancer diagnosis on Oct. 17. "I have never been one to hide anything. 'Here it is, here's what's happening, and here's what we're going to do about it.'"
Last month, Smith sounded optimistic. "Going forward," he told listeners, "I'm going to fight this and see what happens — how the cancer responds to the treatment, how my body responds to the treatment."
But his body did not respond well to that first round of chemotherapy, Smith said Thursday. "All I did was get really violently ill," he said. "The whole point of doing chemo was to preserve some life with quality. But it was quite obvious that, while I might be preserving life, there wouldn't be any quality in it."
Smith said he decided against further chemotherapy after talking it over with his wife, doctors and nurses. "This kind of cancer is as virulent as they come," he said. "There weren't going to be any miracles; it was just time to face it."
Still, Smith insisted, he has no immediate plans to leave the airwaves. Although doing his three-hour morning program leaves him "pretty exhausted," he said, "as long as I feel strong enough to join in, I will."
In addition to his radio work, Smith has been writing an op-ed column for the Baltimore Sun since August 2008. In what was announced as his last column, posted online shortly before the start of his radio program Thursday morning and which appears in today's editions on the op/ed pages, Smith wrote, "My life will end sometime in an undetermined number of weeks in home hospice care."
Pancreatic is among the most lethal forms of cancer. For patients diagnosed with the disease, less than 5 percent survive beyond five years, said Joseph Herman, a radiation oncologist at Johns Hopkins Hospital and co-director of its Pancreatic Multi-Disciplinary Clinic. In 2011, more than 44,000 people will be diagnosed with pancreatic condition, according to statistics from the National Cancer Institute. More than 37,000 will die of the disease.
"Ultimately, almost all patients will develop cancer that spreads to the liver, the lungs or the abdomen," said Herman, stressing that he was not involved in any way with Smith's case. "The reality is that, over the years, we have not made much progress in improving the survival rate of patients with pancreatic cancer."
It is not unusual for those suffering from inoperable pancreatic cancer to opt out of treatments aimed at eradicating the disease, Herman said. Like Smith, many opt for palliative care, which uses medicine, therapy and whatever else is available to make the patient's remaining days as comfortable as possible.
New combinations of drugs have helped increase the survival time, Herman said, but only by a matter of months. "The therapies we can offer do increase survival, but it's a minimal increase," he said.
Since last month's announcement, Smith said, he's been inundated with statements of support and encouragement. "What I get is all these people who have been listening to me for years, starting as children often, and they tell me how I helped shape their thinking," he said from his home Thursday afternoon. "That's pretty humbling stuff, you know?"
WBAL General Manager Ed Kiernan said he discussed Smith's role at the station with him Wednesday, and promised that he would remain on the air as long he wants.
"We're going to give him as much support as we can during this time," Kiernan said. "As long as he can do a show, that's what we're going to do."
Smith came to Baltimore in 1973; his first job was as a weekend news anchor on WBAL-TV. For more than a quarter-century, his conservative viewpoint has been a favorite among local radio listeners. Last year, his show was moved from afternoon drive-time to the morning slot.
Labeling himself "the voice of reason," Smith has not always followed conservative dogma. He was, for instance, an early and vociferous critic of the war in Iraq.
"I'm not afraid to die," Smith said after his show Thursday. "I'd prefer to be healthy, I'd prefer to be 35 years old and healthy. But this is it for me. This is my exit, this is my fate."