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Palliative Care and Symptom Management
Specialist palliative care optimising quality of life, managing cancer-related symptoms, and providing psychological, social, and spiritual support for patients and families throughout the cancer journey.
Overview
Overview
Palliative Care and Symptom Management is a specialist medical approach focused on improving the quality of life of patients and their families facing a life-threatening illness by providing expert prevention and relief from pain and other distressing physical, psychological, social, and spiritual symptoms. It is provided from the point of cancer diagnosis alongside active treatment and is not limited to end-of-life care. A multidisciplinary palliative care team including palliative physicians, specialist nurses, social workers, physiotherapists, and chaplains coordinates care across hospital, community, and hospice settings. Early integration of palliative care with oncological treatment is proven to improve both quality of life and survival outcomes.
Types of Palliative Care and Symptom Management
- Specialist inpatient palliative care — for complex symptom management requiring hospital-level assessment, investigation, and treatment adjustment
- Outpatient palliative care clinic — regular review appointments for ongoing complex symptom management alongside active oncological treatment
- Community palliative care — home visits and telephone support from specialist palliative care nurses for patients managed at home
- Hospice day services — structured therapeutic, social, and complementary programmes for patients with advanced illness
- End-of-life care — compassionate holistic management of the final days and hours of life with comfort as the primary goal
Risk Factors of Palliative Care and Symptom Management
- Advanced or metastatic cancer with a significant symptom burden significantly affecting daily function and quality of life
- Complex pain not adequately controlled by standard analgesic prescribing requiring specialist opioid titration or interventional pain management
- Refractory breathlessness, nausea, or other distressing symptoms unresponsive to first-line treatments
- Significant psychological, social, or spiritual distress impacting wellbeing and engagement with treatment
- Family or carer distress and exhaustion requiring professional support, guidance, and respite planning
- Requirement for advance care planning including preferred place of care, resuscitation decisions, and goals of care documentation
Symptoms of Palliative Care and Symptom Management
- Persistent severe pain at the primary tumour site or from metastatic deposits not controlled by regular oral analgesics
- Breathlessness at rest or on minimal exertion causing significant functional limitation and anxiety
- Intractable nausea and vomiting preventing adequate oral fluid and medication intake
- Profound fatigue and weakness making all daily activities and self-care extremely difficult or impossible
- Anxiety, depression, and existential distress related to the cancer diagnosis, treatment burden, and prognosis
- Anorexia and significant unintentional weight loss from cancer cachexia and treatment-related side effects
- Confusion and delirium related to metabolic disturbance, medications, infection, or disease progression in the brain
- Constipation and bowel obstruction from opioid use, abdominal tumour, or peritoneal disease requiring specialist management
Key Benefits
Discover the advantages of choosing our palliative care and symptom management services.
Expert symptom management dramatically improves quality of life at every stage of the cancer journey
Early palliative care alongside active oncology treatment improves both quality of life and survival
WHO analgesic ladder achieves adequate pain control in over 80% of cancer pain patients when correctly applied
Advance care planning ensures patients receive care consistent with their values and preferences
Coordinated community palliative care enables preferred place of death to be achieved for most patients
Clinical Features
The technology, techniques and clinical approach behind our palliative care and symptom management.
Edmonton Symptom Assessment Scale at every appointment providing objective symptom severity tracking
WHO analgesic ladder followed systematically with documented reason for each step change
Laxatives prescribed prophylactically alongside every opioid -- constipation is universal and preventable
Goals of care discussions documented and shared across all care settings
Psychological and spiritual distress screening at every palliative care appointment
Preparation Instructions
A referral to palliative care is not a sign that active treatment has ended -- it is a specialist service for symptom optimisation at any stage of the cancer journey. Bring a list of all current symptoms with their severity. A trusted family member or carer is welcome and encouraged to attend.
The Procedure
Step-by-step guide to what you can expect during your palliative care and symptom management procedure.
Comprehensive Symptom Assessment
All symptoms are systematically assessed using the Edmonton Symptom Assessment Scale scoring pain breathlessness nausea fatigue anxiety depression appetite and wellbeing from 0 to 10 -- providing the objective baseline driving all symptom management interventions.
Pain Management Optimisation
Analgesic therapy follows the WHO analgesic ladder -- paracetamol and NSAIDs for mild pain weak opioids for moderate pain and strong opioids for severe pain. Neuropathic pain requires specific agents including pregabalin duloxetine or ketamine.
Breathlessness Management
Low-dose oral or nebulised morphine is the most evidence-based pharmacological treatment for cancer-related breathlessness. Non-pharmacological interventions including a hand-held fan breathing techniques and positioning are taught alongside medication.
Nausea and Bowel Symptom Management
The specific cause of nausea guides anti-emetic selection. Laxatives are prescribed prophylactically alongside every opioid prescription -- opioid-induced constipation is universal and preventable.
Psychological and Spiritual Support
Psychological distress is assessed and managed with supportive counselling CBT approaches chaplaincy referral and psychiatric consultation when indicated. Existential distress is specifically addressed rather than avoided.
Advance Care Planning and Goals of Care
Goals of care discussions explore the patient's values priorities and preferences for future care including preferred place of care CPR preference and the overall balance between life prolongation and quality of life.
What to Expect
The palliative care team conducts a comprehensive assessment of all symptoms and their impact on daily life. A personalised symptom management plan is developed using medications, non-pharmacological therapies, psychological support, and social care interventions. The plan is communicated to you, your family, your GP, and the oncology team.
Recovery
Contact the palliative care team or 24-hour advice line if symptoms become difficult to manage between appointments. Medicines prescribed by the palliative care team are in addition to your oncology medications -- take all as prescribed and do not stop without advice. A community palliative care nurse can visit at home if attending clinic is difficult.
Frequently Asked Questions
Common questions about palliative care and symptom management.
Related Services
Explore other services in our Oncology department.
Chemotherapy Administration
Radiation Therapy
Cancer Staging and Tumour Marker Assessment
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
