Inclusion Criteria:

1. Terminal, progressive cancer with poor prognosis whose treatment intent is
palliative, based on the following definition:

- All patients with brain cancer, liver cancer, inoperable non-small cell lung
carcinoma, pancreatic cancer, or gallbladder cancer; OR

- Patients with the following cancers: metastatic colon cancer or stage III or IV
non-small cell lung cancer; OR

- Patients with the following cancers, if first-line therapy has failed and
limited response is expected to second-line therapy: breast cancer, colorectal
cancer, head and neck cancer, stomach cancer, esophageal cancer, melanoma,
leukemia, ovarian cancer, prostate cancer, renal cancer, sarcoma, lung cancer,
myeloma, or lymphoma.

- The terms terminal, progressive, poor prognosis, palliative intent and limited
response will be judged by the patient's oncologist (and not by the RSA or
consenting professional).

2. Return patient visit (defined as a patient known to the oncologist from previous
assessments and treatments, where the working and personal relationship has been
established and not a new patient to the clinic).

3. English speaking. Only English-speaking patients will be included in our present
study since English is the validated language of our study tools.

4. Given the sensitive nature of the study, clinicians will decide whether the patient
is a potentially appropriate subject based on their knowledge of the patient.

5. Able to provide informed consent.

6. Age greater than or equal to 21.

Exclusion Criteria:

1. MMSE < 25.

2. Psychological state not appropriate for end-of-life discussion as determined by the
treating clinician.