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Gentle reader, the hour is late. As the poet said, almost all of the grains of sand allotted to 2016 have sifted down onto the pyramid of memory. Before this year’s hourglass empties, though, let’s take a moment to reflect on some of the phenomena we observed during the past months in this esoteric branch of medicine.

Likely, most doctors would say they are good listeners. It is an essential skill when studying and practicing medicine. But under stress of limited time or a patient not responding to treatment—maybe our ability suffers a bit. Perhaps we are listening but also talking and not checking for understanding.

The relationship between oncologists and their patients is labor-intensive and arouses great emotions. The specter of death is always in the shadows; as it waits patiently, it makes conversations poignant. Oncologists should be skilled in soothing the fears of their patients without appearing trite or patronizing.

We present a summer reading list of 15 must-reads that cover the history of genes and cancer, the link between so-called junk DNA and disease, uncertainty in medicine, and more.

Patients continue to say they want more information, so they can make informed decisions. But repeatedly, studies tell us that the patient and the family are not hearing us, not understanding us, or both.

Most metastatic cancer patients are still receiving aggressive methods of treatment near the end of life, and palliative/supportive measures are significantly underutilized.

I hope to see many of the exciting agents presented this year become available and affordable for my patients. But when the miracle isn’t happening we have an obligation to talk it out and be candidly compassionate. We need to know when to put the pedal to the metal and when to hit the brake.

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