Treating advanced cancer requires an ability to wrap the treatments we have available around the patient's own goals and priorities. For some, that is extension of life at any cost; for others, it's all about the quality of living; for many, it's a mixture of concerns and a fear about dying itself. Clinicians who are comfortable to talk about dying can move between 'best hope' and 'worst case' scenarios, ensuring that patients are well enough informed to be true partners in decisions about their care.