How should we enhance the process and purpose of prognostic communication in oncology?

We propose that effective prognostic communication requires attention to the process and purpose of communication, where purpose represents the will and process the ability to communicate. Prognostic communication has historically challenged clinicians and patients. Few interventions have been developed to improve prognostic communication, and those that have been developed largely target the process of communication. We argue that more work is needed to address the purpose of prognostic communication, because the first step in all effective communication is desiring to communicate well. In developing communication interventions, investigators should be thoughtful about the audience they are targeting, the goals of the intervention, and the feasibility of disseminating and implementing the intervention in busy health care systems with limited resources.