Delivering serious news in oncology has evolved from a one-time “bad news” event to an ongoing, preference-sensitive process, as patients’ desire for prognostic information varies and often changes over time. The Serious Illness Care Program provides a more flexible, longitudinal framework—using tools like “I wish, I worry, I wonder”—to demonstrably facilitate earlier, iterative conversations that align with patient values and reduce psychological distress. Clinically, rather than forcing discrete advance care planning discussions, oncologists can embrace prognostic uncertainty and use it as an entry point to explore goals, recognizing that readiness for end-of-life discussions fluctuates along the illness trajectory. | Borregaard Myrhøj, JAMA Netw Open 2026
