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The surgical mantra “to cut is to cure” does not apply uniformly to patients with advanced malignancies. Palliative surgery can relieve pain and improve quality of life for patients who are battling terminal illnesses. Not surprising, surgical risks can be greater for terminal patients, leaving surgeons reticent to operate, given the narrower definitions of success.
Researchers at a single institution in Rhode Island prospectively tracked 227 surgical consults for palliative surgeries from 2004 to 2009. Patients participated in a previously described structured encounter, called the “palliative triangle,” that involved the patient, his or her family, and the physician. During these encounters, a surgeon elicits a patient's goals and values a…