8 signs of impending death in cancer patients identified

Scientists have identified eight highly specific physical and cognitive signs associated with imminent death in cancer patients.
Researchers at The University of Texas MD Anderson Cancer Center identified eight signs most highly associated with impending death in cancer patients within three days.
The signs include nonreactive pupils; decreased response to verbal stimuli; decreased response to visual stimuli; inability to close eyelids; drooping of the nasolabial fold; neck hyperextension; grunting of vocal cords; and upper gastrointestinal bleeding.
Knowing with a high degree of confidence that death is imminent could have significant implications for clinical practice. It may also help families and caregivers make more informed decisions, researchers said.

David Hui, assistant professor, Palliative Care and Rehabilitation Medicine, and colleagues observed 357 cancer patients admitted to palliative care units, of which 57 per cent ultimately died.
The researchers systematically observed 52 physical and cognitive signs - identified by Hui and 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.
"When cancer patients reach the last days of life, this is an extremely emotional time for families - their stress levels cannot be understated," said Hui.

"Knowing when death is imminent would provide more information so caregivers can plan appropriately. For clinicians, having this information could help reassure families that we are providing the best care possible," Hui added.
The research is published in the journal Cancer.