The purpose of this study is to develop an accurate and useful way of measuring patients' thoughts and feelings about hope and hopelessness as they relate to their illness. Doctors and psychologists from Memorial Sloan-Kettering Cancer Center, Calvary Hospital, the Peter MacCallum Cancer Centre, and Fordham University are working together to design a new measure. Findings from this research will help us study the nature of illness and develop improved methods of diagnosis and treatment. We hope what we learn from you will help us learn more about how to care better for patients with cancer and other severe illnesses.

Inclusion Criteria:

• 18 years of age or older.
• Patients who are able to understand verbal and written English.
• Diagnosis of cancer.
• Patients with advanced cancer receiving ambulatory or inpatient care at Memorial Sloan-Kettering Cancer Center in New York City. Patients at Calvary Hospital and Peter MacCallum Cancer Centre admitted for palliative care will also be eligible for participation in this study

Exclusion Criteria:

• The presence of a psychotic mental disorder (e.g., Bipolar Disorder, Schizophrenia, Schizo-affective illness, psychosis due to substance abuse) as indicated in medical chart.
• Cognitive impairment so severe (i.e., Mini-Mental State exam score of less than 20) that, in the opinion of the Principal Investigator or Project Coordinator, would interfere with a patient's ability to give informed consent for research.

Subjects will be recruited in equal numbers from Memorial Hospital and Calvary Hospital or Peter MacCallum Cancer Centre at each stage of data collection.