A diagnosis of advanced cancer is devastating to patients and their families. The cancer care team has typically been ineffective in communicating honestly but sensitively on issues of concern, including treatment options, prognosis, and factors that affect quality-of-life. In a presentation at the NCCN 18th Annual Conference, palliative care experts Dr. Anthony Back and Ms. Lillie D. Shockney discussed the challenge of communicating about advanced disease, offered a new paradigm, and described approaches that can make physicians and nurses more comfortable and more effective in this role.