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Health-related quality of life during the last three months of life in patients with advanced cancer

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Abstract

Goals of work

The aim of the study was to explore the development of functioning impairments and symptom occurrence during the last months of life of advanced cancer patients.

Materials and methods

Self-reported data from 116 patients who all completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 (EORTC QLQ-C30) at 3, 2 and 1 month before death were analysed.

Main results

All functioning aspects deteriorated. For physical, cognitive and social function, the most marked changes occurred between 2 and 1 month before death. The proportion reporting serious difficulties with self-care activities increased from 14% to 43%. The most seriously affected activity could not be distinguished from the EORTC QLQ-C30 scores. Levels of fatigue, dyspnoea and appetite loss increased significantly. More than 50% of the patients had severe pain at all assessments, and only a minor number (8%) reported any improvement.

Conclusions

The findings have implications for the planning of care and indicate that further research is required to improve assessment, treatment and follow-up procedures. Adequate pain treatment seems still to be a challenge. Anorexia, fatigue as well as dyspnoea are all symptoms that need further focus.

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Acknowledgements

We would like to thank all the patients who participated in the trial to the end. We also thank Eva Almqvist Wedeberg for her invaluable work as a research assistant. The study was supported by grants from The Swedish Cancer Society (grant no. 3650-B95-01XAC), The Vårdal Foundation for-Health Care Sciences and Allergy Research (grant no. V98262), the Association for Cancer and Traffic Victims (grant: C24405), The Norwegian Cancer Society (grant nos. 95147 and 98004) and The Norwegian Medical Association Fund for Quality Improvement (grant no. 4488/93). None of the sponsors influenced any part of the planning of these studies or the writing of the manuscript.

Conflict of interest statement

None of the authors has any financial or personal relationship with other people or organisations that could inappropriately influence (or bias) the work.

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Authors and Affiliations

  1. Department of Clinical Sciences, Lund University, Lund, Sweden

    Marianne Ahlner Elmqvist & Magnus Jannert

  2. Faculty of Health and Society, Malmö University, Malmö, Sweden

    Marianne Ahlner Elmqvist

  3. Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, NTNU, Trondheim, Norway

    Marit S. Jordhøy & Stein Kaasa

  4. Cancer Unit, Department of Internal Medicine-Gjøvik, Innlandet Hospital Trust, Gjøvik, Norway

    Marit S. Jordhøy

  5. Department of Oncology, Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo, Norway

    Kristin Bjordal

  6. Palliative Medicine Unit, Department of Radiotherapy and Oncology, University Hospital of Trondheim, Trondheim, Norway

    Stein Kaasa

  7. Department of Oto-Rhino-Laryngology, Malmö University Hospital, 205 02, Malmö, Sweden

    Marianne Ahlner Elmqvist & Magnus Jannert

Authors
  1. Marianne Ahlner Elmqvist
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  2. Marit S. Jordhøy
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  3. Kristin Bjordal
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  4. Stein Kaasa
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Correspondence to Marianne Ahlner Elmqvist.

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Elmqvist, M.A., Jordhøy, M.S., Bjordal, K. et al. Health-related quality of life during the last three months of life in patients with advanced cancer. Support Care Cancer 17, 191–198 (2009). https://doi.org/10.1007/s00520-008-0477-2

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  • DOI: https://doi.org/10.1007/s00520-008-0477-2

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