This chapter explores the critical task of delivering bad news in oncology, particularly within China’s unique cultural landscape. It emphasizes the impact of effective communication on patients’ well-being and examines barriers faced by healthcare professionals. Cultural nuances significantly influence how terminal diagnoses are disclosed, with a tension between traditional family views and individual preferences. The SPIKES protocol provides a foundation for delivering bad news, but adaptation to China’s context is essential. By mastering linguistic subtleties and fostering cultural competence, healthcare providers can navigate this delicate task with empathy, ensuring patients experience dignity and compassion throughout their cancer journey.