title: Health-related quality of life during the last three months of life in patients with advanced cancer.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  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.
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden. Marianne.Ahlner-Elmqvist@med.lu.se
authors.forename: Marianne Ahlner
authors.initials: MA
authors.lastname: Elmqvist
authors.forename: Marit S
authors.initials: MS
authors.lastname: Jordhøy
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjordal
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.forename: Magnus
authors.initials: M
authors.lastname: Jannert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification*; D009664:Norway; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden; D019452:Terminally Ill / Q000523:psychology*