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June 23, 2017. We all know that when it comes to brain tumors, our older patients do worse. But according to yesterday’s JAMA Onc pub, more than half of these patients still receive aggressive care in the final month of life. More important than this significantly adding to overall Medicare expenditures, this pattern of care has been show time and again to be undesired by patients and families. We see this as a pretty clear reminder not to neglect goals of care discussions among our older patients with uniformly poor prognoses.