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June 9, 2010

Palliative Care at US Cancer Centers

JAMA. 2010;303(22):2251. doi:10.1001/jama.2010.733

To the Editor: The observations of Dr Hui and colleagues1 on palliative care at US cancer centers are timely. Hospice and palliative care is a rapidly emerging discipline encompassing the care of many patients with terminal illness in addition to those with cancer. For many reasons, including the limited ability until recent years to cure most malignancies, the foundations of palliative care were laid by programs focused on cancer patients. Although cancer is the second leading cause of death in the United States, accounting for 23% of deaths in 2007, 44% of deaths occurred from other categories of chronic conditions, including heart disease, cerebrovascular disease, chronic lung disease, dementia, diabetes, and renal disease.2 Many of the deaths in these categories occurred in patients with advanced stages of their illness for whom the palliative model, which emphasizes symptom control over disease eradication, should become the primary focus of care.