Mona Gupta

Mona Gupta

Cleveland Clinic, USA

Title: Is it time to talk? End-of-life discussions in cancer


Mona Gupta, MD, is an Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM), Faculty in Palliative Medicine section of the Taussig Cancer Institute and Geriatric Medicine of Medicine Institute at the Cleveland Clinic. She is the Co-Chair of palliative care Special Interest Group at American Geriatric Society, Co-Chair palliative care for Indo American Cancer Association, a charitable organization and Vice- Chair for the Visionary Executive Leadership Team of Elite Women Around the World. She is the Co-Chair of the upcoming Academy of integrative Health and Medicine (AIHM) “Transformative; Health, Wealth and Wellness” conference in October, 2015. She was the Most Valuable Person for Chief of Staff, Cleveland Clinic and received caregiver celebration award for compassionate care of patients.


Breaking bad news is part of the clinical experience of many physicians who care for patients with cancer. It is also important in the end-of-life experience of patients and families. How this information is conveyed may effectively reduce the level of stress and misunderstanding. A family meeting is an effective communication tool for difficult conversations in which potentially bad news is discussed. Special courses have been introduced on how to communicate bad news which connects theoretical aspects (knowledge on com-munication protocols) with practical aspects (skills to interpret and control the body language, express empathy, and knowledge of reactive strategies). One of the strategies helpful in disclosing unfavorable news is called a “Six¬-Step Protocol for Delivering Bad News” or “SPIKES” [Setting, Perception, Invitation, Knowledge, Emotions, Strategy, and Summary]. In this presentation we will discuss the benefits of family meetings, propose a structure for them and discuss skills that can be useful for practitioners. We will apply the SPIKES protocol for end- of- life conversations in patients with cancer using role-play. The purpose would be to develop an insight into unspoken attitudes, thoughts and feelings, which often determine the behavior of others; to enhance communication skills through the interactive discussion; to identify challenges with the communication of prognosis and the breaking of bad news. Candid but compassionate communication between physicians and patients about prognosis is essential to informed decisions about both disease-directed (curative) and palliative therapies.