Table 2 Main themes

Timing and conduction of

EOL-conversations

Should be offered early in the disease

Most GPs see the responsibility to start the conversation in the hands of the center’s physicians

Importance of honest information

GPs often lack information about prognosis and content of diagnosis disclosure in the center

Individual approach depending on patient’s preparedness

Varying communication partners (physicians and other health care professionals) in the center with different attitudes

Concern of patient’s reactions/fear to destroy hope

GPs often do not interfere with center’s treatment decisions

Patient’s process of assimilation of information and coping with the disease

GPs are often not involved in the process during cancer treatment

Important role in EOL-care (support/coordination)

Abrupt shift to GP after end of cancer treatment

Influencing factors of

EOL-conversations

Lack of specific medical knowledge (because of rapid advances in oncology)

Insufficient medical information given to the GP by the center

Growing prognostic uncertainty (because of rapid advances in oncology)

Vulnerable patient-physician communication in the center: risk of overly optimistic communication

Steady communication partner, longer relationship with patient

Varying communication partners in the center

Sometimes different opinion between GP and oncologist about treatment goals

Difficulties reaching center’s doctors, patient-empowerment as an option to get involved

Modes of GP-oncologist interaction on EOL-topics

Medical reports

Useful update about treatment options, lack of information about EOL-topics

Collaborative use of digital platforms

Not generally implemented

Phone calls

Difficulties reaching center’s doctors

Patient as intermediary

Complicated role for patient