A Different Path Forward for Patients with Advanced Cancer
For patients with advanced cancer experiencing severe symptoms such as nausea, vomiting, weight loss, and uncontrolled pain, or frequent hospitalizations related to treatment, hospice offers a different path forward.
Instead of continuing with aggressive intervention, hospice focuses on comfort care. It is an ideal option for patients who physically or emotionally can’t sustain their treatment regimen and instead choose to prioritize quality of life.
Hospice Eligibility Guidelines for Patients with Advanced Cancer
Hospice eligibility is determined on a case-by-case basis but is most closely tied to a patient’s functional status. Patients with certain types of cancer with poor prognoses may be hospice eligible without meeting the referral indications below.
Baseline
| Prognosis | A life expectancy of six months or less if the disease follows its usual course |
| Functional Status |
Palliative Performance Scale (PPS) score ≤ 70%
ECOG Performance Status Scale score ≥ 2
|
| Activities of Daily Living |
Dependent for 2 or more activities of daily living:
|
Cancer Specific
| Disease Progression |
Disease with distant metastases Disease progression with curative treatment Frequent hospitalizations or emergency room visits related to diagnosis |
| Goals of Care | Patient decision to pursue comfort care instead of curative treatment |
Recognizing Functional Decline in Patients with Advanced Cancer
The Palliative Performance Scale can help healthcare professionals quickly assess a patient's functional decline and inform hospice-eligibility decisions. Research shows that earlier referrals and greater utilization of hospice during the last six months of life are associated with:
- increased satisfaction and quality of life for patients and their families
- fewer unwanted and costly hospitalizations
- less strain on caregivers
For patients with advanced cancer, a score of 70% or below may indicate hospice eligibility.