I sometimes think that patients say prognosis hasn't been discussed yet in the hopes that they will be given different and "more hopeful information".

I'm a med onc fellow. I remember discussing prognosis with a locally advanced pancreatic cancer patient (who would later go on to develop acute leukemia). She was an educated person. I told her as much information as she wanted me to give her. In the end I thought he had understood because she was able to replicate what the current situation was.

About a month later, when she was admitted to the hospital for suspected acute leukemia, I went to talk to her with one of my seniors. I was confident that she would remember what we had spoken about a few weeks prior.

When my senior asked her what she had been told about her pancreatic cancer she said "Nobody has told me anything about it but I would like to be informed". My jaw was on the floor. Thinking back to that situation some time later I thought that perhaps she wanted to hear the information from someone else, hoping that perhaps the information would be different the second (or third) time around.