End-of-life discussions in practice: survey among Canadian radiation oncologists

End-of-life (EOL) discussions improve patient satisfaction, quality and cost-effectiveness of care (1,2). Guidelines and educational objectives are available to help clinicians engage in quality EOL discussions (3,4). However, many radiation oncologists (ROs) are unlikely to discuss EOL issues until patients develop significant symptoms or families initiate the discussion (5,6). Previously described barriers among oncologists include limited knowledge or training, sense of failure in not being able to provide curative treatment, belief that patient’s outcome will be negatively impacted, uncertainty about the prognosis, ambiguity about the responsible physician, and lack of time