Cancer Patient Prognosis Using Routine Blood Test

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Highlights
  • Scientists have now identified that a routine blood test can reveal how long a cancer patient on palliative care will survive
  • The test can be used to determine a period of survival between 1 to 3 months and it was found to be accurate in 75 to 80% of the times
  • The period of survival will aid in giving doctors and caregivers time to decide on further course of treatment

Many cancer patients, who are on palliative care, feel the need to find out how long they will survive but are often not given definite answers. Scientists have now found that a routine blood test carried out on cancer patients on palliative care could predict how long a patient would survive.
Cancer Patient Prognosis Using Routine Blood Test

Palliative Care
Palliative care is specialized care that is provided to patients who are terminally ill, it includes psychological as well as spiritual factors in the treatment process. This type of care is focused on relieving symptoms and stress associated with the medical condition but does not hasten death or delay it using any extensively invasive procedure.

Identifying patients who may not survive for a long time will aid in taking critical decisions like avoiding chemotherapy sessions that give rise to serious side effects, ascertaining the place where they would like to live the last days of their lives and the people among whom they would like to spend time. Though the test results are sensitive and should not shatter the hopes of the patient as well as family members, it can give the patient and family members the necessary time to cope with the terminal stage of the disease.

Chemotherapy is cytotoxic and leads to a range of symptoms like nausea, vomiting, drop in energy levels and can make the patient highly vulnerable to infections. Many cancer patients die due to the effects of chemotherapy rather than due to the invasiveness of the disease.

When tests show that the patient will not survive for longer than a few weeks, they may be prescribed a sedative called midazolam which can relieve pain and let the patient sleep peacefully. However, prolonged use can make the patient resistant to the drug, therefore, it is only prescribed for patients who only has a few weeks to live.

Previous Models of Prognosis

Initially clinicians predicted prognosis of cancer patients based on dyspnea (uncomfortable breathing) and delirium (acute confusional state), which are generally scored at the start of therapy. The scoring of these two conditions varies from one doctor to another.

Six Adaptive Prognostic Test Model (SAP)

This test model was identified by Kyoto University researchers who studied more than 5000 cancer patients receiving treatment at the Kyoto University Hospital. The test identifies levels of albumin, neutrophil and lactate dehydrogenase at the start of chemotherapy treatment and whenever it is required after that. This test was found to identify survival within 1 to 6 months after the start of chemotherapy.

Routine Blood Test for Cancer Prognosis

Data from Japan-prognostic assessment tools validation (J-ProVal) study was used to identify the cancer survival model for advancer cancer patients on palliative care. The SAP model was tested on 1,015 cancer patients in palliative care at a different setting, 385 in a hospital, 464 in palliative care units and 166 at home.

The test was able to
  • Predict that a patient would die within a period of 1 to 3 months.
  • Accurate prediction was achieved in 75 to 80% of the cases.
  • Found to be a promising aid for doctors as well as caregivers.
  • Will aid in planning further course of treatment.
  • Useful in making end of life decisions.

The rising number of treatment options that are available for cancer treatment like chemotherapy, immunotherapy and personalized therapy have greatly increased the lifespan of cancer patients in terms of controlling the spread of the disease. However, many of these treatment options are also found to lead to a number of side effects, which can be debilitating or even lead to fatality.

There are monetary restrictions associated with advanced treatment options, and if these interventions are futile, then the monetary burden on caregivers could be unjustified. Moreover, invasive treatment procedures could drain the patient of energy which may be better spent on being with loved ones.

There is an increasing need by doctors and caregivers to understand the prognosis of a cancer patient to better prepare for the final few days, which could include a stay at home rather than at a hospital receiving an invasive treatment that will not increase the lifespan of the patient.

The test that requires just a routine blood test could soon become an essential test in the battery of tests that cancer patients is required to take.

References:
  1. What Is Palliative Care? - (https:getpalliativecare.org/whatis/)
  2. Palliative Care in Cancer - (https:www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet)



Source: Medindia

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