A patient with stage IV lung cancer in his 70s has been dealing with residual disease in one of his lungs and a painful tumor in his upper spine. We reviewed the PET scan with him and his family and kindly suggested radiation to these individual sites. The patient's most recent scan showed a favorable response, and his pain has improved markedly. He is well-aware he most likely has a terminal illness and has a great relationship with his oncology team in India.

A family of a woman in her mid-50s with end-stage breast cancer was considering her options. We reviewed her several prior treatments and responses to therapies. We had an open conversation with her family and indicated that focusing on her quality of life and restricting further chemotherapy was her most reasonable option. They were hurt by the situation but were kindly appreciative of the honest input.