Cancer Illness Trajectory Pattern — SCE Palliative Medicine MCQ

Correct answer: E — Cancer typically follows a predictable pattern: relatively preserved function for a period, then a rapid decline over weeks to months with a recognisable terminal phase — this is distinct from the organ failure trajectory of gradual decline with acute episodes

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E

Option C is correct. UK and international palliative care frameworks consistently describe the cancer trajectory as one of relatively preserved function for a period, followed by a rapid decline over weeks to months—distinct from the gradual, fluctuating decline of organ failure and the slow, insidious deterioration typical of dementia or frailty. The NHS England framework (Panel B ‘terminal malignancy’) clearly illustrates this pattern ([england.nhs.uk](https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Advanced-kidney-disease.pdf?utm_source=openai)), and classic analyses of illness trajectories delineate the three pathways including cancer’s characteristic sharp tail ([bmj.com](https://www.bmj.com/content/330/7498/1007?utm_source=openai)). Options A, B and D are clearly incorrect; option E erroneously equates cancer with dementia trajectories.

Reference: NHS England framework on illness trajectories (‘terminal malignancy’ pattern) and Murray et al BMJ 2005 article on illness trajectories, https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Advanced-kidney-disease.pdf