Changes in the Last Months of Life

Jaclyn Yoong, Fiona Runacres

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review


This study aimed to assess symptoms and performance status of cancer patients during the last six months of life. In Ontario, Canada, Edmonton Symptom Assessment System (ESAS) scores and Palliative Performance Scale (PPS) scores of outpatients with cancer were systemically collected. This was an observational cohort study of cancer decedents’ ESAS and PPS scores between 2007 and 2009. Outcomes were the average ESAS and PPS scores per week before death. A total of 10,752 decedents with ESAS and 7,882 with PPS scores were included. General patterns of symptoms scores were observed: (1) generally stable (pain, nausea, anxiety, depression) versus (2) increased severity over time (shortness of breath, drowsiness, well-being, lack of appetite, tiredness). More than one-third reported moderate to severe symptom scores in the last month of life. Average PPS scores declined slowly for the initial five months, then more rapidly in the last month before death
Original languageEnglish
Title of host publication50 Studies Every Palliative Care Doctor Should Know
EditorsDavid Hui, Akhila Reddy, Eduardo Bruera
PublisherOxford University Press
Number of pages6
ISBN (Print)9780190658618
Publication statusPublished - 2018
Externally publishedYes

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