New guide can predict cancer patients' survival

The research, funded by Cancer Research UK and presented today (Tuesday) at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool*, is based on blood tests, white cell blood count, pulse rate and patient symptoms and can predict survival at least as well as a doctor.

Professor Chris Todd, in the School of Nursing, Midwifery and Social Work, said that the prediction model differed from previous scales in that it could help to give a more accurate picture of whether patients might have only two weeks or two months left to live, independently of a doctor’s estimate.

The scale could help families, carers and nurses make plans with cancer patients who are close to the end of their life.

The study, carried out with colleagues at St George’s University of London, looked at 18 palliative care services, including hospices, hospital support teams and community service and more than 1,000 patients with advanced cancer who were no longer receiving treatment.

A combination of markers like blood tests, pulse rate, weight loss, tiredness, breathlessness and white blood cell count were used to produce two versions of the scale.

Dr Paddy Stone, lead author based at St George’s University of London, said: “These scales can provide valuable information for patients, carers and health professionals. It is important to remember that these results do not provide a definitive model for predicting how long someone will live, but it will give everyone concerned a clearer idea of what it is likely to happen.

“This study provides a solid starting point for improving accuracy in survival predictions which can continue to be refined and improved.”

Manchester’s Professor Todd said: “An instrument like this will also help us identify which patients could take part in studies aimed at improving the quality of life for people receiving end-of-life care. We are already looking at how to improve the prediction models and how to make them readily available to clinicians through, for example, iPhones and other mobile devices.”

Scientists claim that one form of the scale, which does not require a blood test, provides a prediction of survival as good as a doctor’s estimate, while another version using a blood test is better than a clinician’s prognosis.

The model could also be adapted to a patient who may not be able to respond to questions about their health.

Mike Hobday, head of campaigns at Macmillan Cancer Support, said: “This scale could prove useful to patients, families and clinicians who are wondering whether to begin discussions around palliative care arrangements.

“All too often this conversation is left until it is too late to make arrangements while patients wait to know what their future is. Having the conversation at an earlier point, alongside ensuring a 24 hour community nursing service is in place will vastly improve the chances of the 57%** of people with a cancer diagnosis who want to die at home being able to do so.”

More information: *Gwilliam B et al., The prognosis in palliative care study (PiPS) (http://www.ncri.or … cts/PP35.htm)

**Macmillan Cancer Support, unpublished survey conducted February 2010 of 1019 people

Provided by University of Manchester