Mode of Death in Patients with Terminal Stomach Cancer

Han, Jung Kee; Suh, Gil Joon; Joo, Jae Sik; Lee, Sung Kyu; Lee, Ho Suk; Son, Gyung Soo

Abstract

The mode of death was investigated according to 14 easily accessible clinical symptoms in terminal patients with stomach cancer. The purpose of this study was to understand the mode of death during the terminal period in patients with stomach cancer and to identify possible ways in which to improve patient care. Data were collected on all 65 patients with terminal stomach cancer admitted Department of Surgery, Korean Veterans' Hospital between April 1984 and April 1996. Pain was the most common main symptom on admission, occurring in 34 (52.3%) of the 65 patients. Fourteen patients (21.5%) had weakness, 12 patients (18.5%) had anorexia, 10 patients (15.4%) had edema or ascites, and 5 patients (7.7%) had dyspnea. Statistically significant clinical symptoms were as follows: anorexia, pain, weakness, dyspnea, and ascites or edema. Although the ranges of symptoms were similar on admission and at 1 week before death, there was a shift in prevalence of different types (dyspnea 7.7%-->98.5% and weakness 21.5%-->100%). In the last week of care (the week of death), weakness and dyspnea were the most common symptoms. Anorexia together with weakness and dyspnea was also a common problem. Near death, 65 patients (100%) had weakness, and 64 patients (98.5%) developed dyspnea as their main symptoms. Dyspnea became the most severe symptoms at death and appeared to be the most common uncontrollable problem, especially as death approached.