MCs | Period in disease trajectory | Specific topics of the manual |
---|---|---|
I | Diagnosis | • Warn patient that there is bad news (SPIKES) • Open and honest statement of diagnosis and prognosis • Discuss further procedure (diagnostic, therapy) • Show limitations of therapy options |
II | Stable disease | • Summarize last conversation • Clarify how patients think about the disease (Prognostic awareness) • Use stable disease to talk about advance care planning regarding end-of-life care. • Define precautionary authorized representative • Advance care planning can also be discussed later (depends of patient’s psychological condition) |
III | Tumour progression | • Communicate tumour progression • Check patient preferences • Define new therapy goals regarding quality of life • Bring in palliative care offers (IPOS) • Question Prompt List |
IV | Best supportive care | • Communicate the end of tumour centred treatment options • Transition to best supportive care • Include always patient preferences |
General topics | In every conversation | • Organisation • Physical condition • Psychological condition • Therapy • Complementary medicine • Patient preferences |