From the Guidelines
The prognosis of advanced cancer patients should be based on a comprehensive assessment of clinical, laboratory, and prognostic factors, including performance status, cancer anorexia-cachexia syndrome, dyspnea, and delirium, as well as the use of prognostic scores, such as the Palliative Prognostic Score, to provide accurate and personalized predictions of life expectancy. When discussing prognosis with patients, healthcare providers should consider both statistical outcomes and individual factors, and communicate prognosis in a clear and compassionate manner, taking into account the patient's right to be informed or not to be informed about their prognosis 1. The clinical prediction of survival is a valid tool to obtain a general prognostic evaluation of patients, but it is subject to a series of factors that limit its accuracy, and its use is recommended together with other prognostic factors 1. Some key factors that have been identified as having a prognostic impact in advanced cancer patients include:
- Performance status
- Cancer anorexia-cachexia syndrome
- Dyspnea
- Delirium or cognitive impairment
- Laboratory variables such as leukocytosis, lymphocytopenia, and high C-reactive protein
- Prognostic scores, such as the Palliative Prognostic Score Regular reassessment of prognosis is essential as conditions evolve and treatments progress, and prognostic information should be used within an ethically valid approach, taking into account the patient's individual trajectory and personal history 1. Healthcare providers should balance honesty with hope when communicating prognosis to patients, using clear language while acknowledging uncertainty, and should place emphasis on a holistic therapeutic approach beyond time limits, considering the individual value of the patient's residual life 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Prognosis
- The prognosis of a patient can be influenced by various factors, including the effectiveness of the treatment and the patient's overall health condition 2.
- Studies have shown that certain medications, such as lisinopril, can have a positive impact on the prognosis of patients with diabetes and hypertension by reducing blood pressure and preserving renal function 2.
- The EUCLID trial demonstrated that lisinopril can slow the progression of retinopathy in patients with insulin-dependent diabetes mellitus (IDDM) 2.
- In addition to its effects on blood pressure and renal function, lisinopril may also improve neurological function, although this finding is preliminary 2.
- The use of ACE inhibitors, such as lisinopril, in combination with other medications, like manidipine, may have beneficial effects on insulin sensitivity and metabolic markers in patients with hypertension and metabolic syndrome 3.
Clinical Decision-Making
- Clinical decisions should be based on a thorough evaluation of the evidence and consideration of the patient's individual needs and preferences 4, 5.
- The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach provides a framework for evaluating the quality of evidence and assigning a strength to recommendations 5.
- However, strong recommendations may be made based on low certainty evidence in certain situations, such as life-threatening conditions 5.
- Clinical reasoning and experience are essential components of clinical decision-making, particularly in situations where high-quality evidence is limited or absent 6.