End-of-Life Care for Older Patients With Malignant Brain Tumors

To the Editor We read with interest the report by Dover and colleagues regarding the costs of end-of-life care for older adults with malignant primary and secondary brain tumors. To be honest, we expected the numbers to be worse. A typical increase in medical cost of $13 000 to $16 000 in the last 30 days of an older patient's life inherently argues that these patients did not undergo heroic operations, multiple imaging studies, or long stays in the intensive care unit. It argues that physicians are generally good at not going for broke when it is unlikely to help anymore.

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