One of the challenges faced by doctors who treat terminally ill patients is determine the length of life remaining for their patients. It is a very difficult task, and its estimates are based on different factors.
This Saturday, the Daily Mail publishes a report with the opinion of different experts that explain how these estimates are made and What are the traits that are observed?
Generally speaking, the closer a patient is to death, the the more accurate the doctors’ predictions will be. This is because certain biological signals, such as a patient’s blood pressure, appetite and alertness, as well as high doses of medications such as painkillers, can give doctors a fairly accurate idea of ​​whether the patient has days or even hours to live. .
But when it comes to longer periods, the situation can become more complicated and, therefore, uncertain.
Estimates vary by study. Some suggest that doctors get about the 50% of the time, while others suggest it is only a third of the time.
The teacher Karol Sikora, retired oncologist and former director of the World Health Organization’s cancer program, reveals to the Email that the estimates doctors give when patients ask how much time they have left are based on population averages of other patients.
These calculations take into account the specific disease the patient has, their age, and the severity of the condition. This means that an older person with multiple tumors will probably will die sooner than a younger personeven at the same stage of cancer.
An important factor to remember is that these estimates are based on averages, meaning that exceptions apply at both ends of the scale: some will die sooner than expected and others will defy the odds and persist much longer.
Professor Sikora adds that the reliability of these estimates can naturally vary depending on how common or rare the condition is. “Of course you can be wrong,” says Professor Sikora. “It’s a totally inexact science,” he adds.
Other experts agree. The teacher Paddy Stoneformer director of the Marie Curie palliative care research department at University College London, says there is no estimation method reliable enough to act as a safeguard for assisted dying.
“My research shows that there is no reliable way to identify patients with less than six or twelve months to live… at least, no method that is reliable enough to act as some kind of ‘safeguard’ for the proposed legislation on assisted dying,” says Stone, in the context of the recent approval by the British parliament of the assisted dying law.
The teacher Irene Higginsonan expert in palliative care at King’s College London, added: “All the studies from this country and beyond show that estimating the six months of life left is extremely difficult and not that accurate.”
“Science is not that developed and I’m not sure it can be, because individuals vary greatly“Higginson adds.
Experts cite studies such as one carried out in 2023 on almost 100,000 patients which shows that doctors were correct almost three out of four times in estimating whether the patient would die within a fortnight.
They were even more precise, getting it right four out of five times, when it came to whether a patient would live more than a year. But the intervening period, if a patient He had “weeks” or “months” left, It was much more complicated: doctors were only right a third of the time.
Another estimate, made by The Telegraphrevealed that in 7,000 occasions Doctors were correct in predicting whether a patient would survive six months a little less than half of the time.
Professor Sikora added that another less scientific factor he had seen throughout his career was that some patients defy the odds with a specific goal in mind.
“They want to live for some specific reason, e.g. “His daughter is getting married,” explains. He recalled a patient in such circumstances whose life expectancy was just a few weeks.
“His daughter was getting married in two months and he just wanted to go to the wedding,” said. “He arrived at the wedding and died the following Sunday, which was fantastic for him because it happened against all odds,” he concludes.