We designed this talking map to give you a just-in-time route through a complex conversation. Think of it as a series of signposts—you might find that not all apply to a particular patient.
What you say:
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What have other doctors told you about what your prognosis, or the future?
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How much have you been thinking about the future?
What you say:
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For some people prognosis is numbers or statistics about how long they will live.
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For other people, prognosis is about living to a particular date. What would be more helpful for you?
What you say:
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Talking about the future can be a little scary.
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If you’re not sure, maybe you could tell me how you see the pros and cons of discussing this.
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If clinically deteriorating: From what I know of you, talking about this information might affect decisions you are thinking about.
What you say:
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To provide using statistics:
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The worst case scenario is [25th percentile], and the best case scenario is [75th percentile].
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If I had 100 people with a similar situation, by [median survival], 50 would have died of cancer and 50 would still be alive with cancer.
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To provide without statistics:
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From my knowledge of your situation and how you cancer has been changing /responding, I think there is a good/50-50/slim chance that you will be able to be around [on that date/for that event].
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What you say:
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I can see this is not what you were hoping for.
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I wish I had better news.
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I can only imagine how this information feels to you. I appreciate that you want to know what to expect.