The concept of palliative care has evolved over the past few decades, transitioning from a focus on end-of-life planning to providing comprehensive psychosocial support and symptom management for those with serious chronic illnesses such as cancer.¹ As the evidence base supporting palliative care for people with cancer grows, there are ever-increasing calls for its earlier integration alongside so-called standard oncologic treatment as a way to improve quality and quantity of life.² There is also an important extension of palliative care to caregivers of people living with cancer, as these 鈥渟econd patients鈥� have levels of unmet needs and distress that match and at times exceed those of the person with cancer.³ The potential for palliative care is particularly significant for patients with advanced head and neck cancer (HNC), as they continue to face a stubbornly poor prognosis and high symptom burden. These debilitating symptoms, which are often exacerbated in end-of-life situations, include common cancer toxicities, such as pain and fatigue, but also unique toxicities of HNC relating to airway obstruction, dysphagia, malodorous wounds near the face, aesthetic disfigurement, and risk of major bleeding.^2,4