Cancer steals the lives of approximately 6.6 million people world wide each year, according to the International Association for the Study of Pain, or IASP. Symptoms of cancer at the end of life vary widely depending on the type of cancer and extent of the disease. However, many general signs occur commonly in cancer patients that indicate the end of life.
Pain
Pain unfortunately occurs in the majority of cancer patients with advanced disease. The IASP reports that up to 75 percent of cancer patients experience pain in advanced disease, and those most likely to feel pain include those with head, neck, pancreatic, uterine, breast, prostate or genitourinary cancers. Although a significant fear at the end of life, health care professionals skilled in pain management can bring pain under control.
Breathing Changes
As the organ function in the body diminishes, breathing changes occur. At the end stages of cancer, breathing often becomes more shallow and slows. Breathing stops for several seconds at a time before breathing resumes. This condition is known as apnea. Breathing becomes moist and congested. Saliva that sits in the back of the throat often causes noisy breathing but is not stressful to the patient.
Circulation Changes
Circulation of blood slows at the end of life and cancer patients often experience changes in temperature and coloration. The Hospice Foundation of America reports that skin changes color--from pink to gray or bluish at the end of life. Blotchy bruise-like discoloration, known as mottling, also takes place on the legs and/or arms. Skin of the hands and feet also cools as circulation slows.
Mental Status Changes
Changes in levels of activity both physically and psychologically take place at the end of life due to slowed blood flow and metabolism. The National Cancer Institute lists increased drowsiness, sleeping and unresponsiveness as common signs of approaching death. Restlessness, confusion and visions of people who have died previously also commonly occur at the end of life in both patients with and without cancer.
Other Signs
As the body's systems begin to shut down, nutritional requirements tend to decrease. Cancer patients typically lose their appetites and may deny food and fluids altogether. Urine production slows and becomes less frequent, darker, and more concentrated. At the end of life, bowel and bladder function often relaxes, causing incontinence.
References
- "Core Cirriculum for Oncology Nursing"; Joanne, Itano PhD.; Karen Taoka MSN; 2005.
- National Cancer Institute: End of Life Questions and Answers
- Hospice Foundation of America: Signs of Approaching Death
- International Association for the Study of Pain: Epidemology of Cancer Pain
