Cancer patients on the verge of death exhibit eight warning signs, a new study reveals. Declining neurocognitive function was found to be indicative of impending death in victims of cancer. Of the eight signs identified which predict death within three days, seven were neurological. Drooping of the nasolabial fold - lines on the face commonly known as smile lines - were observed in 80 percent of patients who died in hospitals from advanced cancer. Upper gastrointestinal bleeding was only observed in a small percentage of patients, but was a highly-accurate means of predicting impending death.
Cancer deaths could already be foretold through five markers, three of which were neurologic.
The new study examined patient records based on symptoms observed in the subjects on admission to hospitals, without knowledge of their prognosis.
"In the past, studies trying to understand the signs associated with impending death were conducted in people who were recognized as dying, so there's a potential bias built into this model. With our study, we observed a list of signs in patients from the time they were admitted to the palliative care unit. They were observed systematically, twice a day, without knowing if the patient would die or be discharged," David Hui, assistant professor of palliative care and rehabilitation medicine at the University of Texas M.D. Anderson Cancer Center, said.
Hui and his team believe their new findings could assist medical professionals and families in care of patients with advanced cancers. This could include decisions about hospice care and end-of-life decision-making by loved ones of those facing death.
Research on the natural clues bodies exhibit before death has been minimal, and this pair of studies are among the few that examine such markers in the body.
The five signs of impending cancer death identified in the earlier study include reduced urine production, a lack of pulse in the radial artery within the forearm, movement of the jaw while breathing, A type of irregular respiration called Cheyne-Stokes breathing, and a particular sound called a death rattle. Each of these signs was found to be 95 percent accurate at predicting death within the next 72 hours.
The new study also adds decreased responses to visual and auditory stimuli, grunting of vocal cords, an inability to close eyelids, non-reactive pupils, and hyper-extension of the neck.
"Taken together with the five physical signs identified earlier, these objective bedside signs may assist clinicians, family members, and researchers in recognizing when the patient has entered the final days of life," the researchers concluded.
Identification of the eight newly-recognized signs of impending death in patients suffering from the class of diseases was profiled in the journal Cancer.
