8 signs of imminent cancer death identified in new study

The onset of certain physical changes in patients with advanced cancer may signal that death is likely within three days, according to new research that could lead to improvements in the quality of care the patients receive at the very end stages of the disease.

Researchers identified eight changes, mainly neurological and neuromuscular, that were strong predictors of impending death.

“If we know for sure the patient is imminently dying, then blood work and other treatments that may be burdensome may not be necessary, because they may not change things,” said study co-author, Dr. David Hui, of the palliative care and rehabilitation medicine department at the MD Anderson Cancer Center, Houston.

The “tell-tale” signs that were routinely associated with a higher likelihood of death within three days of onset are:

Study investigators systematically looked at 52 physical signs in advanced-stage cancer patients during evaluations conducted every 12 hours from the time the patient was admitted to their death or discharge. The study included 357 patients admitted to acute-palliative-care units at MD Anderson and the Barretos Cancer Hospital in Brazil. The findings were published Monday in the journal Cancer.

The presence of just one of the changes could suggest with more than 80% confidence that the patient won't live more than three days, and additional signs increased the confidence level, Hui said. The findings are preliminary and the study authors aim to validate the results in other healthcare settings.

However, simple bedside observations may be useful tools in helping clinicians decide about care, the researchers say. “Just noticing these subtle changes might be able to help us understand what's happening to the body,” Hui said, noting that most of the changes were neurological, suggesting changes in brain activity. “We may also be able to inform the family in advance, so they could make informed decisions for themselves and the patient.”

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