Palliative care
Early integrated palliative care in cancer (Temel, ENABLE III, ASCO 2024), referral triggers, prognostic tools, anticancer treatment near the end of life, Australian services and funding, advance care planning and voluntary assisted dying laws, and culturally safe care for Aboriginal and Torres Strait Islander and Māori people.
Tier 1Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Palliative care improves quality of life for people with life-limiting illness and their families through early identification, assessment and treatment of physical, psychosocial and spiritual problems. It is not limited to the last days, and it runs alongside anticancer treatment.
- Early integration works. Temel 2010 improved quality of life and mood, and median survival was longer (a secondary outcome). In ENABLE III, quality of life, symptom impact and mood did not differ between early and delayed (3 months later) palliative care, but 1-year survival was higher (63% vs 48%). The ASCO 2024 update recommends specialist interdisciplinary palliative care for all patients with advanced solid or haematological cancers, early and alongside active treatment.
- In Australia, most palliative care is delivered by GPs, oncologists and aged care staff (primary palliative care), with specialist services for complex need. Needs, not prognosis, should trigger referral.
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Sources
- Therapeutic Guidelines: Palliative Care, version 5AU/NZTherapeutic Guidelines Ltd, 2024
- National Palliative Care Standards for specialist palliative care services (5th edition), and National Palliative Care Standards for all health professionals and aged care servicesAU/NZPalliative Care Australia, 2018 and 2022
- National Consensus Statement: Essential elements for safe and high-quality end-of-life care (2nd edition)AU/NZAustralian Commission on Safety and Quality in Health Care, 2023
- Sanders JJ et al. Palliative care for patients with cancer: ASCO guideline update. J Clin Oncol 2024;42:2336-57American Society of Clinical Oncology, 2024 (current, November 2026)
- Temel JS et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733-42New England Journal of Medicine, 2010
- Christakis NA, Lamont EB. Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study. BMJ 2000;320:469-72BMJ, 2000
- Glare P et al. A systematic review of physicians' survival predictions in terminally ill cancer patients. BMJ 2003;327:195-8BMJ, 2003
- Earle CC et al. Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol 2004;22:315-21American Society of Clinical Oncology, 2004
- Bakitas MA et al. Early versus delayed initiation of concurrent palliative oncology care: the ENABLE III randomized controlled trial. J Clin Oncol 2015;33:1438-45Journal of Clinical Oncology, 2015
- Palliative Care Outcomes Collaboration (PCOC): phase, AKPS and symptom assessment toolsAU/NZUniversity of Wollongong
- Timely Palliative Care: A Practical Framework (oncology and haematology CPD)AU/NZPalliative Care Australia and ANZSPM, 2026
- Te Ara Whakapiri: Principles and guidance for the last days of life (2nd edition)AU/NZTe Whatu Ora / Ministry of Health New Zealand, 2017
- Indigenous Program of Experience in the Palliative Approach (IPEPA)AU/NZProgram of Experience in the Palliative Approach, Australian Government funded
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback