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There is growing interest in the psychological distress and quality of life of cancer patients. The aim of this study was to compare the responses of 102 advanced cancer patients on a quality of life scale (as measured by the SF12) with the Beck Depression Inventory (BDI) and the Beck Hopelessness Scale (BHS), as well as the impact of depression and hopelessness on quality of life. Significant associations were found between gender (P = .027), performance status (P = .003), opioids (P = .002), depression (P<.0005), and hopelessness (P<.0005) with the SF12-Mental Component Score (MCS). Gender (P = .07), metastasis (P = .001), opioids (P = .0005), and education (P = .045) correlated significantly with SF12-Physical Component Score (PCS). In the prediction of MCS, the dimensions of age, hopelessness, gender, and performance status were statistically significantly high (P<.0005), explaining 48% of variance. For PCS, the predictor variables were education, metastasis, and opioids (25% of variance). Quality of life, in this patient population, was predicted by the level of hopelessness and patients' demographic and clinical characteristics.