In part one of this two-part ASCO Education Podcast episode, Drs. Stephen Berns (University of Vermont), Tyler Johnson (Stanford Medicine) and Katie Stowers (Oregon Health & Science University) chat candidly about what it takes to deliver serious news to people with cancer effectively and compassionately. Subscribe: Apple Podcasts, Google Podcasts | Additional resources: education.asco.org | Contact Us Air Date: 2/16/22   TRANSCRIPT Steve Burns (Dr. Burns):  Hello. My name is Steve Burns. And I am a Hospice and Palliative Care Specialist and Associate Professor of Medicine at the Larner College of Medicine in Vermont. I’m pleased to moderate this episode of the ASCO Education Podcast focused on clinician patient communication in the context of delivering serious news to patients and family. I am joined Katie Stowers, a Hospice and Palliative Care Physician and Assistant Professor of Medicine at Oregon Health & Science University and Tyler Johnson, a Medical Oncologist and Clinical Assistant Professor of Medicine at Stanford University. Well, this is a serious discussion on delivering difficult news to patients and families. It is an extremely important one that I’m glad to be having. Let’s first start with our question, what is bad news? I’m delighted to answer the question first mostly because I have an issue with calling it bad news. It really comes down to some of the training that I had as a palliative care physician when one of my attending said, don’t assume it’s bad. And I remember an example that I had for one of my first couple of patients, where the patient, when we were explaining that she had metastatic cancer and that she was likely going to die from this illness, she said, “Oh my gosh. I’m so relieved because I’ve been looking for an answer for months.” So what made me realize during that moment and also what my palliative care attending reminded me of is don’t assume. And this is consistent with a study that came out, I think, by Anthony Balkin like 2011 where they did a qualitative review of patients encounters with serious news and bad news. And patients actually gave feedback that said, “We don’t want the physicians to judge our news.”  Again, sort of reframing that, it’s better to call it serious news rather than bad news. Dr. Tyler Johnson (Dr. Johnson):   I’ll build off of that and just say that I think it’s also important that we recognize that sometimes when we call something bad news, what that’s actually reflecting is what our experience is going to be or what we anticipate that our experience is potentially going to be, which is totally fair. It’s absolutely valid to say having to share this news is going to be a difficult part of my day. And therefore, I think of this as sharing bad news. In fact, I think that recognition is important and can lead to important reflection and even to self-compassion. We should be candid about the fact that this is a hard part of our jobs. I mean, who likes to share life-changing, sometimes devasting news with patients?  Nobody wants to do that. That’s never going to be a fun part of your day. I think, though, that it is important to recognize that that’s a different question from how the news is going to land to the patient.  Sometimes those things will match up and sometimes they won’t. And it’s important for us to be circumspect and careful in the way that we think about both how the news is going to impact us and how the interaction is going to impact us and also how it’s going to impact the patient. Dr. Burns:  I’ll move to the second question, which is what is the ideal circumstance or modality, in person or video call or telehealth, to deliver serious news to patients? Dr. Katie Stowers (Dr. Stowers):  I was actually struck on reflecting on that question about the ideal modality. I think COVID has actually really changed the way that I think about that question. Pre-COVID, I would have said hands down, everybody sitting in the same room being able to reach out a