The individual withdrew the request in 13 % of cases and the physician refused the demand 12 % of the time. The most frequent reasons for requesting EAS had been pointless suffering, loss of dignity and weakness. The patients’ scenario met the state requirements for approved practice greatest in requests which were granted and least in refused requests. Refusal of requests had been associated with a lesser amount of competence, and less hopeless and unbearable suffering. The complexity of EAS decision producing is certainly reflected in the fact that besides granting and refusing a request, three other situations could possibly be distinguished, the authors conclude.‘These outcomes provide evidence for a possible interactive effect of tumor CTNNB1 signaling and individuals’ energy balance position in determining tumor cell behavior. Our data support the hypothesis that progression of a tumor with an inactive WNT-CTNNB1 signaling pathway might be influenced by energy intake and expenditure, whereas a tumor with a dynamic WNT-CTNNB1 signaling pathway may improvement independent of energy stability status. Although our data have to be verified by independent data sets, tumor CTNNB1 status may serve as a predictive biomarker for response to a prescription for exercise in clinical practice.