Patients with advanced cancer experience many distressing symptoms [6]. The symptoms are principally disease related but may also be related to morbidity and toxicity from past treatment – surgery, chemotherapy, and radiation [7]. The most common symptoms are lack of appetite, fatigue, sleepiness, pain, nausea, dry mouth, constipation, dyspnea, anxiety, and depression [6]. In addition, patients with colorectal malignancies often present typical challenges related to tumours in the bowels, liver, or peritoneum, such as cachexia with weight loss and muscle wasting, abdominal or pelvic pain, ascites, jaundice, or bowel obstruction [5]. The pain may be difficult to relieve due to neuropathic components caused by pelvic tumour infiltration into the lumbosacral nerve plexi. Further, distant metastases to the bones, lungs, and brain may give rise to bone pain, dyspnea, neurological deficits, or cognitive failure. The picture is often complex and becomes additionally complicated by social, occupational, and economic challenges and problems of a psychological, spiritual, and existential nature. Indeed, the last phase of the colorectal cancer trajectory may be the most challenging and demanding of all.

Palliative care is the active, total care of patients with advanced, incurable disease and short life expectancy [8]. However, palliative care should not be withheld until all treatment alternatives for the underlying disease have been exhausted. The palliative care approach should be included in treatment and care from the time the patient is diagnosed with an incurable illness, regardless of prognosis. Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual [9]. This approach is also applicable early in the course of cancer in conjunction with other therapies that are intended to prolong life, such as surgery, chemotherapy, and radiation therapy. Palliative care may also include investigations that are required to better understand and manage distressing clinical complications [9].

Living with advanced cancer affects so many aspects of life; therefore, it is rarely, if ever, possible for any one professional to meet all of the needs of a patient or family. Consequently, teamwork is an inherent feature of palliative care [8].

The palliative care team is found in any setting providing specialist palliative care [10]. The core members may vary between countries and settings but usually include nurses, doctors, a physiotherapist, social worker, and chaplain. Other professions may be included in the team as needed. The typical palliative care team is the hospital consult team serving the hospital wards and possibly the nearby communities. The team may also staff an in-patient specialist palliative care unit, in which case the team assumes full responsibility for the patients admitted to the unit. The palliative care consult team seeks to influence and improve patient care by giving advice to the health professionals in charge of the care. The consult team members work alongside the hospital ward teams, giving advice on symptom control and psychosocial and spiritual issues, and supporting relatives and staff in difficult decisions. The team has an important role in assessing the needs and priorities of patients and families and helping to set goals and lay out plans for care [11]. The consult team must have an overview of all relevant services regardless of whether the hospital team also has outreach programmes or liaises with community teams. Important functions of the team are discharge planning and facilitating care transitions.