Assessing how well a patient is overall is an important factor in decisions regarding their treatment and ability to take part in clinical trials. Overall, the fitter people are, the better they are able to withstand their cancer and treatment. This is known as the performance status.

Assessment scales

There are different tools available, but the ECOG scale is the most commonly used:

There are different tools available, but the ECOG scale is the most commonly used. Many trial protocols may say they are open to people who have particular performance status, for example 0–1.

0 – you are fully active, more or less as you were before your illness

1 – you can’t carry out heavy physical work, but can do anything else

2 – you are up and about more than half the day, you can look after yourself but can’t work

3 – you are in bed or a chair for more than half the day, you need help to look after yourself

4 – you are in bed or a chair all the time and need complete care

Karnofsky Performance Status

Similar to the WHO scale, but goes to up 100.

• 100 – you don’t have any evidence of disease and feel well
• 90 – you only have minor signs or symptoms but can carry on as normal
• 80 – you have some signs or symptoms and it takes a bit of effort to carry on as normal
• 70 – you can care for yourself but can’t carry on with all your normal activities or do active work
• 60 – you need help from time to time but can mostly care for yourself
• 50 – you need quite a lot of help to care for yourself
• 40 – you always need help to care for yourself
• 30 – you are disabled and may need to stay in hospital
• 20 – you are ill, in hospital and need a lot of treatment
• 10 – you are very ill and unlikely to recover

Clinical Frailty Scale

Moorhouse P, Rockwood K. Frailty and its quantitative clinical evaluation. J R Coll Physicians Edinb. 2012;42(4):333-40. doi: 10.4997/JRCPE.2012.412. PMID: 23240122.

https://www.doi.org/10.4997/JRCPE.2012.412

West H, Jin JO. Performance Status in Patients With Cancer. JAMA Oncol. 2015;1(7):998. doi:10.1001/jamaoncol.2015.3113 doi:10.1001/jamaoncol.2015.3113.