Quality of life of cancer patients at different stages in the disease trajectory.

Building on prior work with cancer patients, our analyses sought to determine whether the process of decline in quality of life identified for patients served by hospices applied to those in nursing homes; and to relate these findings to the broader community cancer population. We found the change in quality of life to be similar for terminal cancer patients in nursing homes and in the community. Findings from the broader spectrum of cancer patients in the community suggest that cancer patients tend to undergo serious reductions in life quality prior to the last 12 weeks of life, followed by another major loss during the last few weeks of life. Finally, we were unable to identify a sizable subgroup of cancer patients with positive quality of life scores in the period immediately preceding death. Further research is needed to specify the process of decline prior to the last few months during which diminution of life quality occurs.