According to a study published on bmj.com, life expectancy of patients with advanced cancer can be accurately forecasted with a new scoring system that defines the remaining survival duration in terms of “days,” “weeks,” or “months.”
A Clinician’s estimation of life expectancy in cancer patients is often unpredictable, over-optimistic, and prejudiced. Hence, this data is vital for clinicians and caregivers so that they know the exact duration of their survival and provide suitable care for terminally ill cancer patients and. A scoring system designed by Dr. Paddy Stone and team at St George’s, University of London is intended for patients with advanced cancer in different care settings that is as good as or superior than a clinician’s forecast.
The study involved 1,018 patients with advanced incurable cancer. They were recently referred to palliative care services across the UK, and no longer received treatment.
Two prognostic scores (PiPS-A and PiPS-B) were designed by the team. A combination of clinical and laboratory variables were used and compared with actual survival and clinicians’ predictions. In this manner, researchers predicted the patients’ remaining life expectancy in “days” (0-13 days), “weeks” (14-55 days) or “months” (more than 55 days). Researchers factored in aspects such as such as age, gender, ethnicity, diagnosis, and extent of disease that might affect results.
Although both scores were as precise as a clinician’s estimate, the PiPS-B score requiring a blood test, turned out to be considerably more accurate than individual doctor’s or nurse’s approximation. However, none of the scoring scales compared to a multi-professional estimate of survival.
The authors state that this is the first yardstick study for a prognostic scoring system against current best practice. However, the scoring scales necessitate further validation before being recommended for use in routine clinical practice.
In an accompanying editorial, Paul Glare from the Memorial Sloan-Kettering Cancer Center in New York opines that prognosis “needs to be restored as a core clinical skill, to optimize the patient’s treatment and planning. He agrees that prognostic tools can help, but should not be applied blindly, and suggests that “communicating the prediction to the patient is as important as forecasting it.”