Critically III Cancer Patients: Benefit and Expense

To the Editor. —The recent article by Schapira et al 1 reinforces the need to evaluate carefully the benefit of intensive care interventions in cancer patients. Unfortunately, this article, as subsequently presented in the media, tended to promote a view of cancer patients as poorer risks and thus bad investments for intensive medical care. However, the quoted mortality figures of 40% for patients with solid tumors and 50% for those with hematologic malignancies are similar to typical mortality rates for other intensive care unit (ICU) admissions, eg, septic shock (57%), gastrointestinal bleeding (37%), pneumonia with respiratory failure (40%), and acute renal failure requiring dialysis (57%). 2,3 The study also pointed to poor postdischarge survival; this is also common in patients with other chronic conditions who are discharged from the ICU. The same adverse cost benefit seen in this study would seem likely in all ICU patients. It would therefore have