Informed consent is central to management decisions in modern medical practice. However, sharing information with patients about the value of chemotherapy for advanced metastatic cancer is highly challenging. In the linked study (doi: 10.1136/bmj.a752), Audrey and colleagues assess how much oncologists tell patients about the survival benefit of palliative chemotherapy during the first consultation after a diagnosis of metastatic colorectal cancer, pancreatic cancer, or non-small cell lung cancer.1

Although chemotherapeutic options have improved, life expectancy in people with metastatic cancer is often short, survival benefits of treatment may be modest, and the potential for unpleasant or life threatening side effects is high. Nevertheless, chemotherapy is increasingly given closer to the end of life,2 and patients are having to decide whether or not to have treatment at the same time as facing the harsh realities of dying.

To make informed choices, patients need up to date consistent information and comprehensive and expert communication from their oncologists and supportive care teams. However, …