The new guide, 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.
Scientists said that the 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, funded by Cancer Research UK, looked at 18 palliative care services including hospices, hospital support teams and community service and more than 1000 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 study 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.”
Professor Chris Todd, another author based at the University of Manchester, 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.”
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Notes to editors
**Macmillan Cancer Support, Unpublished survey conducted February 2010 of 1019 people
About the NCRI Cancer Conference
The National Cancer Research Institute (NCRI) Cancer Conference is the UK’s major forum for showcasing the best British and international cancer research. The Conference offers unique opportunities for networking and sharing knowledge by bringing together world leading experts from all cancer research disciplines. The sixth annual NCRI Cancer Conference is taking place from the 7-10 November 2010 at the BT Convention Centre in Liverpool. For more information visit www.ncri.org.uk/ncriconference
About the NCRI
The National Cancer Research Institute (NCRI) was established in April 2001. It is a UK-wide partnership between the government, charity and industry which promotes co-operation in cancer research among the 21 member organisations for the benefit of patients, the public and the scientific community. For more information visit www.ncri.org.uk
NCRI members are: the Association of the British Pharmaceutical Industry (ABPI); Association for International Cancer Research; Biotechnology and Biological Sciences Research Council; Breakthrough Breast Cancer; Breast Cancer Campaign; Cancer Research UK; CHILDREN with LEUKAEMIA, Department of Health; Economic and Social Research Council; Leukaemia & Lymphoma Research; Ludwig Institute for Cancer Research; Macmillan Cancer Support; Marie Curie Cancer Care; Medical Research Council; Northern Ireland Health and Social Care (Research & Development Office); Roy Castle Lung Cancer Foundation; Scottish Government Health Directorates (Chief Scientist Office); Tenovus; Welsh Assembly Government (Wales Office of Research and Development for Health & Social Care); The Wellcome Trust; and Yorkshire Cancer Research.