Table 1.

Specific topics of the MCA manual

MCs	Period in disease trajectory	Specific topics of the manual
I	Diagnosis	• Warn patient that there is bad news (SPIKES) • Open and honest statement of diagnosis and prognosis • Discuss further procedure (diagnostic, therapy) • Show limitations of therapy options
II	Stable disease	• Summarize last conversation • Clarify how patients think about the disease (Prognostic awareness) • Use stable disease to talk about advance care planning regarding end-of-life care. • Define precautionary authorized representative • Advance care planning can also be discussed later (depends of patient’s psychological condition)
III	Tumour progression	• Communicate tumour progression • Check patient preferences • Define new therapy goals regarding quality of life • Bring in palliative care offers (IPOS) • Question Prompt List
IV	Best supportive care	• Communicate the end of tumour centred treatment options • Transition to best supportive care • Include always patient preferences
General topics	In every conversation	• Organisation • Physical condition • Psychological condition • Therapy • Complementary medicine • Patient preferences