Special Issue on the Role of the Oncologist in Palliative CareCommunication Skills for Discussing Treatment Options When Chemotherapy Has FailedSaraiya, Biren MD*; Arnold, Robert MD†; Tulsky, James A. MD‡Author Information From the *Cancer Institute of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ; †University of Pittsburgh, Pittsburgh, PA; and ‡Duke University and Durham VA Medical Centers, Durham, NC. Reprints: Biren Saraiya MD, 195 Little Albany St, New Brunswick, NJ 08901. E-mail: [email protected]. The Cancer Journal: September 2010 - Volume 16 - Issue 5 - p 521-523 doi: 10.1097/PPO.0b013e3181f28800 Buy Metrics Abstract Palliative care is defined as care for symptoms throughout the disease trajectory delivered along with disease-modifying therapies, whether the patient has curable or incurable cancer. Patients have unique informational and emotional needs at each point in their disease trajectories. To meet each patient's needs, oncologists can follow a road map presented here for discussing treatment options that include palliative care. Oncologists can learn what patients need cognitively by eliciting perceptions about cancer and its treatment before giving any bad news. Emotional reactions can be anticipated and handled with empathy to reduce patient distress. After patients' emotions have been addressed and they are ready to discuss treatment options, oncologists can establish shared treatment goals. These shared treatment goals may need to be negotiated, including resolving conflicts between perceptions and knowledge. Finally, based on these goals, the oncologist can offer patient-centered recommendations and help establish a treatment plan. © 2010 Lippincott Williams & Wilkins, Inc.