Planning and delivering appropriate cancer care for older people can present a number of challenges. This could also be true for frail people or those experiencing comorbidities. Effective communication between oncology and geriatrics departments will help facilitate best practice care, which takes into account physiological age, complex comorbidities, risk of adverse events and drug interactions,…

The transition from active treatment to post-treatment care is critical to long-term health. In some cases, people will need ongoing, hospital-based care, and in other cases a shared follow-up care arrangement with their general practitioner may be appropriate. This will vary depending on the type and stage of cancer and needs to be planned. Shared…

Early referral to palliative care can improve the quality of life for people with cancer and in some cases may be associated with survival benefits (Haines 2011; Temel et al. 2010; Zimmermann et al. 2014). The treatment team should emphasise the value of palliative care in improving symptom management and quality of life to patients…

Advance care planning is important for all patients with a cancer diagnosis but especially those with advanced or relapsed disease. Patients should be encouraged to think and talk about their healthcare values and preferences with family or carers, appoint a substitute decision-maker and consider developing an advance care directive to convey their preferences for future…

If there is an indication that a patient’s cancer has returned, care should be provided under the guidance of a treating specialist. Each patient should be evaluated to determine if referral to the original multidisciplinary team is necessary. Often referral back to the original multidisciplinary team will not be necessary unless there are obvious aspects…

If the treatment team does not include a palliative care member, the lead clinician should consider referring the patient to palliative care services, with the general practitioner’s engagement. This may include inpatient palliative unit access (as required). The multidisciplinary team may consider seeking additional expertise from these professionals: clinical psychologist clinical nurse specialist or practitioner…

Treatment will depend on the location, extent of recurrent or residual disease, previous management and the patient’s preferences. In managing people with Hodgkin lymphoma and DLBCL, treatment may include these options: conventional-dose salvage chemotherapy high-dose chemotherapy with autologous stem cell transplantation palliative chemotherapy allogeneic stem cell transplantation (see section 6.4.1) radiation therapy immunological or targeted…

Clinical trials may help improve palliative care and in managing a patient’s symptoms of advanced cancer (Cancer Council Victoria 2019). The treatment team should support the patient to participate in research and clinical trials where available and appropriate. For more information visit the Cancer Australia website. See ’Resource list’ for additional clinical trial databases.

Managing recurrent or residual disease is complex and should therefore involve all the appropriate specialties in a multidisciplinary team including palliative care where appropriate. Some instances of recurrent or residual disease remain potentially curable with intensive therapies, and clear documentation of the patient’s wishes of the goals of treatment are a fundamental element of this…