Palliative care has long been shown to be effective at improving quality of life in patients with advanced cancer, but greatly under-used. Some recent work in collaborative decision-making in advanced disease has suggested that patients and families are open to greater utilization of palliative care, but research is needed to establish 1) to what extent patients and families wish to be actively engaged in decision-making, 2) how the framing of messages about prognosis affects patient/family readiness to engage in dialog about palliative care. The first phase of this project will consist of a survey of MDs, RNs, Social Workers and Religious Chaplains in Michigan Cancer Centers to determine what services are offered and the perceived quality of those services. Based on the initial findings, a shared decision-making intervention will be tested to measure the impact on length of time in palliative care, content of palliative care decisions, and quality of life. The purpose of this investigation is to develop ways to support patient decision-making and improve the quality of life across the survivorship period.