e said it simply, “I’m dying, one of the more natural rocesses of life.” He coughed, causing him to put the xygen mask on for 2 min. Finally he took it off. “I just ish it would not take so long!” (an anonymous cancer atient). A 70-year-old man entered the hospital severely physially impaired because of a large oat cell carcinoma of the ung with a “solitary” brain metastasis. In addition to being dministered “curative” chemotherapy, a neurosurgical conultation was obtained. The neurosurgeon thought that an perative procedure was not best but recommended radiourgery to the patient and family. A 60-year-old man, having had myeloma for 3 years was n relapse with increased pain at T9, the left humerus, and he right radius. The patient was given 20 Gy in 2-Gy ractions to the three painful regions. Although both of the patients described above were cared or by bright, well-intentioned physicians, certain verifiable acts, known in the oncologic literature, were being ignored. n both cases, the doctors did not act as if they were onvinced that palliation was the goal, in the sense that atients need to be treated quickly with a cost-effective chedule. The patient with Stage IV lung cancer needed hole brain irradiation, 20 Gy in 4-Gy fractions, because he probability was that he had more than one brain metasasis. His lung cancer was asymptomatic; why then chemoherapy? The bone pain of the patient with myeloma would ave been equally relieved by a 600–800-Gy dose in one raction. The lengthy treatment course was unnecessary. Treating palliative conditions aggressively, expensively, nd optimistically avoids telling the patient that he is dying. ne of many difficulties with telling patients they are going o die of their cancer, because they are no longer curable, is hat even though many patients want to be told, some do not ant to know. In addition, if and when you tell patients they re dying, many want to know how long they have. This is ften difficult to quantify. Owing to the advances in medial/technological “curing” of disease, it is even possible that