Medicine’s Uncomfortable Relationship With Math

of the patients who died with a diagnosis of hematologic malignant neoplasm had received treatment within 14 days of the end of life, indicating a major difference in treatment practice for these disorders compared with solid tumors.Communication with patients about realistic prognosis, treatment planning, and advanced care planning is a critical component across the continuum of oncology care. 5 A recent report issued by the Institute of Medicine specifically emphasizes that "patients with advanced cancer should receive end-of-life care consistent with their needs, values, and preferences." 6 We hope that analysis and reporting of observed practice patterns and disease outcomes will drive discussions between physicians and patients that address realistic concerns and the patient's values around end-of-life care.