Cancer

Cancer

Cancer

LCD Guideline

Cancer

A. Disease with distant metastases at presentation

OR

B. Progression from an earlier stage of disease to metastatic disease with either:

1. a continued decline despite therapy

2. patient declines further disease directed therapy

Note: Certain cancers with poor prognoses (e.g. small cell lung cancer, brain cancer and pancreatic cancer) may be hospice eligible without fulfilling the other criteria in this section.

Comparative Data

Increase in tumor size - Tumor was size of golf ball now size of softball

Decrease in activity - Was able to go out and enjoy activity, now staying in room Comorbidities - CHF, COPD, ETC

Decrease in intake - Was eating 100% of meals 1 month ago, now eating only one meal a day, complains of change in taste

Weight Change, Anorexia

Depression and Anxiety - Was very social interacting with people, now staying in room, not talkative

Medication changes - Add anxiety medication, depression medication

Increase in Pain - Change in pain intensity, interferes with activity

Change in ADL’s - Needs assistance with bathing, needs assistance with dressing, PPS was 60% 2 months ago today, PPS 40%, increased weakness

Change in Skin - Pallor, lesions, wounds, nonhealing wounds, dusky, bruising

Comorbidities

Kidney failure

Pain

SOB

Bleeding

Skin Problems

Anorexia

Ascites