Despite significant therapeutic advances, many people continue to die from cancer or its complications. In the setting of advanced cancer, palliative care has been demonstrated to improve physical and psychological symptoms, reduce hospitalisations, emergency department presentations and escalation of treatment at the end of life, and is associated with improved family caregiver outcomes both during the illness and in bereavement. Yet palliative care referrals are frequently late or not at all, with health care professionals’ fear of destroying hope an oft cited reason. 

The transition to palliative care is an important yet complex clinical task. Successful transition requires attention to a series of factors including: the organisation and integration of services; the definition and recognition of transition points; and sensitive communication with patients and their families, as well as with professional colleagues. When such factors are effectively addressed, the concept of transition from one form of care to another is replaced by integrated care throughout the illness course.