To advance a social work model for working with patients with diagnoses of cancer in diverse global contexts, this paper draws from qualitative research with clients diagnosed with cancer, and their social workers, in Lithuania. As in many countries, Lithuanian social work is a new profession, finding its way to helping people through many life stressors in a unique cultural context. The threat cancer presents – of dying from a protracted and painful illness – requires social work strategies, especially because many countries lack Hospice supports. Key aspects of the findings are the life crisis that a diagnosis of cancer presents, with great fear, anguish, and shifts in personal identity. Clients and social workers describe physical and emotional suffering and alienation from others. While some aspects of clients’ suffering cannot be alleviated by social workers, alienation can be, so here we focus on that possibility. The data from clients and social workers are used to revise crisis intervention theories to suit this unique type of crisis, and an alternative concept of “accompaniment” is offered to capture how social workers can reduce alienation. Drawing from the work of Farmer, Watkins, and O’Donoghue, accompaniment is compatible with strengths-based and wholistic approaches to practice and is adaptable for those with any belief system.