The terminal period of cancer: definition and descriptive epidemiology

There is considerable current interest in the care of the terminally ill. This study provides information on the incidence, prevalence and duration of terminal cancer, and examines patient characteristics and patterns of care during the terminal care period (TCP). The data were derived from a retrospective study of 144 cancer deaths, utilizing information from physicians, medical records, and interviews with surviving relatives. It was estimated that 90% of all cancer deaths had a TCP, of average duration 94 days. Better functional status was associated with a longer TCP, and with spending a greater proportion of the TCP at home. Several areas of concern were noted in patterns of care, including use of a tumor-directed therapy during the TCP (in 18% of patients with a TCP) and the lack of face-to-face contact with the physician outside institutions, particularly as death approached.