Cancer is still, for many patients, an incurable disease. For many patients, cancer takes on a chronic course, with repeated recurrences and bouts of treatment. For still too many patients, it takes a fatal course, as the recurrences worsen and the patient slowly or quickly develops disease that results in death. Those who work with cancer patients must grapple with giving them, or helping them to hear from others, bad news of many sorts. Questions of how to handle bad news in cancer have been widely discussed. In the April 15, 2002, issue of the Journal of Clinical Oncology, Walter F. Baile and his colleagues at the M. D. Anderson Cancer Center addressed this issue again in a paper titled “Oncologists’ Attitudes Toward and Practices in Giving Bad News: An Exploratory Study.” Their study surveyed 167 oncologists attending the 1998 annual meeting of the American Society of Clinical Oncology. The participants were asked to fill in questionnaires on the frequency with which they discussed bad news of a variety of types and the difficulties they encountered in these discussions. Participating physicians were able to rate difficulties on a scale of 0 to 4. Results from the questionnaire were analyzed by gender, age, practice setting (academic or nonacademic), and whether the physician practiced in a Western or non-Western country. Findings of the study included the calculation that the physicians discussed bad news with patients an average of 35 times per month. Bad news included new cancer diagnosis, recurrence, treatment failure, lack of further curative treatments, referrals to hospice, do not resuscitate (DNR) orders, and euthanasia. The study population found discussions of lack of availability of further curative treatment the most difficult of these items to discuss (an average of 3.8 points out of 4 possible), while new cancer diagnosis was the least difficult (2.6 points). Other difficult issues that received an average of 3 or more points were difficulties in finding enough time to talk to patients, dealing with the families of patients, responding to patients’ emotions, being honest with patients without being depressing, and handling one’s own negative emotions. Specific types of communications were also explored with the participants. More than 40% of the physicians reported that they occasionally to frequently adopted these communication strategies: shielding patients from grave prognoses if the patient does not ask about the subject, withholding discussion of the prognosis from the patient at the request of his or her family, using euphemisms when discussing issues of prognosis in order not to destroy the patient’s hope, and proposing treatments that the physician knows will not work in order to maintain hope. Physicians practicing in non-Western countries were more likely to use these strategies. Male physicians were more likely to use euphemisms than were female physicians, and they were also more likely to give patients specific probabilities that treatments would not work. Participants were also asked the time at which they thought it was best to discuss DNR orders. Close to 40% of physicians felt the time of diagnosis or presentation with metastatic disease was optimal, and a similar number felt that the time after treatment failure was the best time. Smaller numbers reported that the time just before hospice referral or a few days to hours before the patient’s death were the optimal times. Integrative cancer physicians are not spared from the necessity of delivering bad news about treatment failure to patients or from referrals to hospice, DNR orders, or any other of the topics discussed in the paper of Baile et al. The staff of Integrative Cancer Therapies wondered, however, if the openness of many integrative practitioners to a variety of alternative therapies and the commitment of most integrative practitioners to treating the patient in a holistic framework would change the strategies they use in discussing painful topics with patients. Will they, for instance, be more ready than conventionally practicing Point-Counterpoint