The number of patients that decline conventional cancer treatment is substantial enough to warrant close attention. Effective patient-doctor communication is crucial in addressing this challenge. Communication is crucial in establishing trust with patients, gathering information, addressing patient emotions, and assisting patients in decisions about care. The quality of communication in cancer care has been shown to affect patient satisfaction, decision making, patient distress and well-being, compliance, and even malpractice litigation. Treatment decision making is an ongoing process; thus, patients who initially refuse treatment may later choose to undergo conventional cancer treatment if given the adequate support, information, and time necessary to make the decision. Even if patients have declined oncologic care, they may continue to see their primary care providers and family physicians. Patients need to feel that they have not been permanently excluded from the health care system even if they make choices that are contrary to the recommendations of their medical team