Doctor, how long do I have left to live? A question frequently asked in serious illnesses and to which doctors do not always have a precise answer. A new blood test developed in Japan can predict with an accuracy of 75 to 80% the survival time prognosis for cancer patients.
The study, presented at the ESMo Asia 2016 congress, was carried out in two stages. The researchers first developed six prognosis models using data from 5,000 cancer patients. Normally, this forecast is based on criteria such as dyspnea (difficulty breathing) or delirium, which are subjective and depend on the interpretation of the nursing staff. Here, the scientists measured three elements in the blood: albumin, neutrophils, and lactate dehydrogenase. The six models give a prognosis between 1 and 6 months and can be used throughout the course of the disease. Subsequently, Japanese researchers tested the accuracy of the tests on 1,015 cancer patients under palliative care, including 166 at home and the rest in hospital or specialized service. Blood measurements have shown an ability to accurately predict survival 75-80% of cases, within 1-3 months.
Better therapeutic and palliative care
But why know the survival prognosis so precisely? To adapt the support. Indeed, there is no point in embarking on heavy chemotherapy if the patient’s days are numbered. He is more likely to suffer from the side effects of the treatment on the body than from the consequences of the cancer itself. This prognosis would thus make it possible to focus, with the informed consent of the patient, on palliative care and comfort to support the end of life while reducing suffering and pain as much as possible. For example, the chronic sedative midazolam relieves symptoms but is often addictive. It is contraindicated for people who will survive beyond a month. The blood test developed would therefore be a tool to help with therapeutic and palliative choices. The authors of the study still point out that “it remains a crucial point, to conduct research on the ethical and psychological implications”.
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