Critically III Cancer Patients: Benefit and Expense

Abstract

To the Editor. —Schapira et al 1 provided important information on the high costs per year of life gained for cancer patients who were admitted to an ICU. However, their findings leave us once again searching for a crystal ball to tell us for whom the bell will toll. The authors conclude that: Physicians who treat patients with neoplastic disease should discuss potential outcomes and the possibility of withdrawing life-supportive therapy if appropriate with the patient and family, so that a reasonable strategy can be agreed on before the initiation of therapy. However, determining when it is appropriate to withdraw life support and what is a reasonable strategy remains a problem. The authors note that previous studies have shown that only 23.7% of cancer patients admitted to an ICU will be alive 6 months later. 2 These statistics do not sound all that grim to many cancer patients who have