Confronting Therapeutic Failure: A Conversation Guide

Abstract

We reflect on the impact of bad news on both clinician and patient in the setting of cancer treatment failure. We review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. The goal of such aconversation guide is todescribe both theprocess andthe tasks that constitute vital steps for clinicians and to comment on the emotional impact of the conversation on the clinician. Confrontingtherapeutic failureis thehardest task foroncologists.Weoffer practical tipsderivedfromathoroughreviewof theevidenceand our clinical experience. © Alpha Med Press.