In a survey of patients with advanced cancer, 69% of those with lung cancer and 81% of those with colorectal cancer had an inaccurate belief that chemotherapy was likely to cure them. Better methods of speaking realistically with patients about prognosis seem to be needed. Chemotherapy remains the primary treatment approach for patients with metastatic lung or colorectal cancer. Although efficacy has improved over time, chemotherapy is not curative, and the survival benefit that has been seen in clinical trials is usually measured in weeks or months. 1 – 3 Chemotherapy may provide some palliation, but it is also often associated with substantial treatment-related toxic effects. 2 – 5 To make informed decisions about whether to receive chemotherapy, patients with advanced lung or colorectal cancer need a realistic understanding of its likely benefits. Previous studies have shown that patients with advanced solid tumors overestimate their life expectancy. 6 – 9 Typically, . . .