 The root of this problem is undoubtedly complex, but likely relates to deficiencies in patient-doctor communication about incurable cancer. At the outset of treatment, it is important for oncologists to establish trust, a strong rapport, and convey hope even when prognosis is poor. As a result, oncologists may describe difficult information about prognosis and the limitations of chemotherapy in a telescopic or vague manner that makes it difficult for patients to understand what lies ahead. While this approach may initially provide solace, downstream it can impede patients ability to make truly informed choices about how to allocate their limited time and energy. 