Decision Making for Older Adults With Cancer

Inclusion Criteria for Oncologists:

1. Independently practicing medical oncology physician (non-ACGME oncology fellows who practice independently are eligible).
2. Annually care for at least 10 patients age \>=65 years with solid tumor malignancies in the outpatient setting (this criterion will be confirmed by oncologist report).
3. Willing to complete the two-hour intervention training.
4. At the time of enrollment, plans to continue outpatient practice at a University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center (HDFCCC) affiliated site for the duration of the pilot study.

Inclusion Criteria for Patients:

1. Age \>= 65 years.
2. Diagnosed with a solid tumor malignancy of any stage.
3. 3\. Upcoming decision-making discussion (in-person or via video conferencing) with a participating medical oncologist.
4. Able to read, write, and understand English.
5. Able to understand and provide written, informed consent. Adequate decisional capacity to consent for this study will be determined using the UCSF Decision-Making Capacity Assessment Tool. Patients with mild cognitive impairment who have adequate decisional capacity to consent for this study will be included.

There are no performance status, organ function, or comorbidity eligibility criteria for this study.

During the CRT phase, patients will be given the option to select a caregiver to participate in the study (not required). Caregivers cannot participate without an enrolled patient. Caregivers may be a family member, partner, or friend of the participating patient.

Inclusion Criteria for Caregivers:

1. Age \>=18 years.
2. Must plan to be present during the medical oncology decision-making discussion and follow-up visits within the first 3 months.
3. Able to read, write, and understand English.
4. Able to understand and provide written, informed consent.

Exclusion Criteria:

Exclusion Criteria for Oncologists:

1\. Medical oncologists who practice solely in the inpatient setting are not eligible.

Exclusion Criteria for Patients:

1. Plan for UCSF second opinion evaluation only. Patients are eligible if they plan to transfer care to UCSF at the time of enrollment.
2. Planned decision-making discussion via phone only (without video).
3. Patients participating in another cancer communication/decision support intervention study with their medical oncologist.