Patients with advanced cancer

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Patient and caregiver understanding of treatment goals are influenced by differing clinical and socio-demographic features. Psychological morbidity was not associated with differing patient perception of the goals of treatment. Caregivers are confirmed as the third arm in the triad of care and a carefully described epidemiology profile assists to highlight the role of adult daughters as well as gender factors in spousal caregiving. The specialist was overwhelmingly the most important source of information in regard to illness for everyone, but a number of others provide information for supportive care. While household knowledge of community and health services was high, pathways of knowledge were varied. Our findings point to the need for health providers to acknowledge the triad of care as the unit of care in the advanced cancer setting and design services accordingly. There should be comprehensive, multidisciplinary units across tertiaryand primary health who are sufficiently responsive to the needs of patients and their families thatearly contact with the palliative care team in a "shared care" arrangement ensures smooth continuity of care to death.