Gregory Crawford, MBBS, MPHC, MD, FRACGP, FAChPM of The University of Adelaide, Adelaide, Australia discusses how to handle end of life discussions as a doctor. In case of uncertainty it is important to ask patients how much information they want, as some patients would like to know details, while others prefer to talk in general terms. Dr Crawford mentions that it is useful to plan for the worst and hope for the best. Hope is important to patients, but it changes over time. Systems are required to provide support for pain control and physical care, not only in hospitals, but also in their homes. Listening, talking about patients’ feelings, and pain relief knowledge can help doctors manage difficult conversations. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in Cancer held in Adelaide, Australia.