Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: We agree with Dr Gagnon that not
all patients diagnosed as having cancer should be considered terminally ill
from it. Gagnon also notes that hospice use for patients with breast cancer
was less than that of patients with lung cancer and suggests that this difference
is because of the higher likelihood that patients with breast cancer die from
We did not suggest that patients dying of breast cancer had less access
to hospice than patients with prostate or lung cancer. Indeed, when we restrict
our analysis to patients who died from cancer, as ascertained by cause of
death, 28.9% of patients with breast cancer, 30.1% of patients with lung cancer,
and 31.8% of patients with prostate cancer received hospice care before death.
McCarthy EP, Phillips RS. Hospice Use in Medicare Beneficiaries With Cancer—Reply. JAMA. 2003;290(12):1578. doi:10.1001/jama.290.12.1578-a