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May 25, 2005

Patterns of Care for Adults With Malignant Glioma—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(20):2469-2470. doi:10.1001/jama.293.20.2470

In Reply: As a multidisciplinary group of investigators, some of whom began our careers in palliative care, we agree that the issues Dr Shannon and colleagues raise, such as relief of common symptoms like fatigue or cognitive deficits, as well as medical and psychosocial support to improve quality of life, are of critical importance to patients with brain tumors throughout their entire illness. Whether trained as surgeons, neurologists, or medical or radiation oncologists, clinicians who care for patients with brain tumors should all receive instruction in these basic principles of palliative care that are central to the care of all patients and should be familiar to all physicians.1 The declared specialty of the physician providing these aspects of care seems less important, since patients with brain tumors receive their primary treatment from members of several specialties during the course of their disease. We agree that research into symptom palliation for patients with brain tumors is a pressing need,2 and the Glioma Outcomes Project has already investigated aspects of palliative care such as depression3 in addition to those addressed in our article.