Study identifies signs of impending death in cancer patients

Researchers from the United States and Brazil said Monday they have found eight clinical signs that, if present, strongly suggest that a patient with advanced cancer will die within three days.

The signs include non-reactive pupils, decreased response to verbal stimuli, decreased response to visual stimuli, inability to close eyelids, drooping of the nasolabial fold, hyperextension of the neck, grunting of vocal cords, and upper gastrointestinal bleed.

"Simple bedside observations can potentially help us to recognize if a patient has entered the final days of life," lead author David Hui, assistant professor of the University of Texas, said in a statement.

"Upon further confirmation of the usefulness of these 'tell- tale' signs, we will be able to help doctors, nurses, and families to better recognize the dying process, and in turn, to provide better care for the patients in the final days of life," Hui said.

Hui and his colleagues observed 357 cancer patients who were admitted to acute palliative care units in two cancer centers: MD Anderson Cancer Center in Houston and Barretos Cancer Hospital in Brazil, of which 57 percent ultimately died.

The researchers systematically observed 52 physical and cognitive signs, -- identified by Hui and his colleagues in previous research -- twice a day from the patient's admission to discharge or death.

Of those 52 signs, the researchers identified the eight most highly associated with impending death within three days.

Hui stressed that the findings are only representative of imminent cancer death and should not be generalized to other causes of death.

The study was published in the U.S. journal Cancer. Endite