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Murray F. Brennan, MD
New York, NY

Arch Surg. 2001;136:778.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Palliation, like class, is hard to describe but easy to recognize. The authors describe palliative surgery as comprising 12.5% of total surgical operations (not "surgeries"!). They emphasize the difficulties in both definition and evaluation of efficacy. One might surely question their definitions by examining the examples given in Table 4. Most surgeons would not see the diagnosis of metastatic cancer as a palliative procedure but rather a diagnostic one. Similarly, local control in the absence of metastatic disease would seem to be a primary treatment.

Central to the theme of palliation is a clear understanding between patient, surgeon, and family of both expectations and ability to fulfill those expectations. As with many other aspects central to the care of the cancer patient, an overriding tenet is "do not promise what you cannot deliver." This central theme is particularly important for the surgeon committed to the care . . . [Full Text of this Article]

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