Though more and more individuals diagnosed with cancer become survivors, there still remains hundreds of thousands forced to succumb to their disease. How oncology specialists communicate bad news, discuss treatment options, and interact throughout the cancer journey greatly influences the expectations patients and their loved ones have regarding the goals and outcomes of treatment. There is limited residency education or nursing education about how to communicate effectively with patients who we know will be facing end of life rather than survival. Research studies have validated that more than 40% of patients with metastatic disease believe that their chemotherapy treatments they are receiving just weeks before they die were for the purpose of curing them of their cancers. Hospice remains an under-utilised service due to the uncomfortable feelings it causes when discussing alternative options to treatment rather than continuing toxic drug therapy. On average, patients do not get referred until too ill to receive any more chemotherapy treatments. This is a time to be truly providing the patient and family patient centred care, factoring in their life goals, their hopes for themselves that transition over time, their hopes for their family without them, and how we can innovatively help them reach these important goals even after they have died, by identifying or serving as a Hope Fulfiller .