LAUSR

OBJECTIVE In this review we will focus on doctor-patient communication as one of the most important modifiable factors which may have a significant impact especially on the important transition between the ambulatory and terminal phases of cancer. BACKGROUND High quality communication about prognosis for cancer patients is a critical component of advance care planning, and it plays a critical role among all the complex factors that affect end of life care decisions. In this review we focus on doctor-patient communication as the most important modifiable factor impacting the transitional period between the ambulatory phase and the terminal phase of cancer. We also discuss how prognostic understanding among advanced cancer patients influences decisions in regard to their cancer care. METHODS We investigated studies that examined advanced cancer patients and prognosis-related communication. CONCLUSIONS We believe that oncologists' skills, experience, and comfort level in managing patients' reactions to negative information is a principal barrier that contributes substantially to the deficit of highquality prognosis-related communication described in the literature. We also believe that it is useful to categorize oncologists with regard to their ability to engage in high quality communication, and we suggest category-specific strategies to improve oncologists' skills to conduct more effective prognosis related communication with their patients.