Where cancer advances to a stage where cure is impossible or very unlikely, patients may have to consider whether further antitumor treatment is preferred or not. Few empirical data are available on the attitudes of cancer patients towards such decision-making during the course of the disease. In the Southwest region of the Netherlands, patients who suffered from breast, lung, colorectal, prostate or ovary cancer, which had recently progressed into an advanced stage were interviewed and asked to fill out a written questionnaire. Questions were asked about end-of-life decision-making and about the preferred aims of medical treatment (Quality Quantity Questionnaire, Stiggelbout, 1996). These questions were repeated after six months. Thus far, of 83 patients (mean age 63 yr (sd=10.8), 63% women) who participated at baseline, 57 also filled out the 6 months questionnaire, while 26 patients deceased within six months after inclusion. At baseline, 10% had filled out an advance directive and 12% had refused a potentially life-prolonging therapy. Of the patients, 21% had discussed their wishes concerning end-of-life treatment with their physician, 40% with a relative. No differences were found on these questions between patients who deceased within six months after inclusion and the people who survived longer. The baseline and six months scores of surviving patients were not different either, except for an increase in having discussed wishes concerning end-of-life treatment with a physician, increasing from 15% to 40%. Patient attitudes concerning trade-offs between quality of life and length of life did also not change after six months. We conclude that preferences of patients with advanced cancer concerning the aims of end-of-life treatment remain stable over time. Although the number of patients who had discussed the issue with their physician had grown over 6 months, the percentage of patients who want to discuss their wishes with their physician and/or relatives had remained unchanged, showing that the need to talk about these issues was still present.