Disease progression or recurrence after a period of remission can be a challenging event for individuals seeking cancer treatment. Those referred for possible phase 1 trial enrollment are often motivated to participate in these studies with hope for a cure despite approximately 5% response rates in this setting. Addressing such commonly held misunderstandings during the initial evaluation for phase 1 trial eligibility could provide a valuable opportunity to improve physician communication by identifying signs of distress or psychiatric conditions, addressing underlying psychological biases, and encouraging adaptive coping strategies.