Palliative care has evolved over the past decade, but for some it still carries connotations associated with end-of-life care when the benefits of introducing it earlier are being realised.
This is the premise behind Care Plus Extend, part of the VCCC Alliance Equity program and led by Prof Jennifer Philip and Prof Brian Le.
Prof Le explains it from the perspective of a patient who benefited – let’s call her Mary. Mary accessed the program as part of her standard pathway of care at the time of her brain tumour diagnosis. This was an 'early' referral, in that Mary really did not have any significant physical symptoms. She was coming to terms with her diagnosis and was needing support, perhaps even just someone to talk to, who understood what she was going through. Over a series of appointments, she and her palliative care physician got to know each other and bonded over a shared interest in cricket and travel. A trusting therapeutic relationship formed.
Unfortunately, Prof Le says, Mary’s tumour recurred soon after she had completed radiation therapy. She experienced increasing physical symptoms such as nausea and fatigue. Because of the early support offered and the relationships formed, her care was seamless, without any need to transfer between settings or clinics. She was able to continue care with clinicians who already knew her, and who could rapidly identify the changes occurring.
Care Plus Extend
Patients with sarcoma, lung and colon cancer across regional Victoria and metropolitan Melbourne can access high quality palliative care at an earlier stage, with the extension of a pilot palliative care program.
Care Plus Extend is the second phase of a study which introduces palliative care at earlier timepoints for these patients and incorporates telehealth, then evaluates the clinical and cost benefits.
Funded by the Victorian Government under the VCCC Alliance Equity program, Care Plus Extend is now available to patients with sarcoma, lung and colon cancer at Latrobe Regional Health in Gippsland, Mildura Base Public Hospital, along with Peter MacCallum Cancer Centre, Royal Melbourne Hospital and St Vincent’s Hospital Melbourne.
Referrals from metropolitan sites started in August 2025 and regional sites from November 2025. The study is co-led by lead Professor Jennifer Philip, University of Melbourne and St Vincent’s Hospital, and Professor Brian Le, Director of the Parkville Integrated Palliative Care Service at Peter MacCallum Cancer Centre and Royal Melbourne Hospital.
Prof Le said palliative care had evolved over the past 12 years to an understanding it could be beneficial when introduced earlier.
“Studies show people can have high levels of symptoms and needs, that we may not have been aware of before,” he said.
For those in the study, Care Plus – an enhanced supportive and palliative care model of care, is introduced early, at agreed timepoints for all those with advanced cancer Prof Le said.
Palliative care goes beyond physical support for symptoms like pain, nausea, vomiting and constipation to include nursing, psychological, psychiatric and spiritual support, he said.
“Our job is to address symptoms early so people can live good lives while having cancer treatment and beyond,” Prof Le said. “Yes, we look after people at end of life but it is helpful for people well before.”
How does it work?
Care Plus is delivered in outpatient settings and involves three medical assessment appointments with specialist supportive care clinicians alongside cancer treatment.
Patients living in regional areas where outpatient palliative care is not universally available are able to attend telehealth appointments delivered via Peter Mac.
The aim of telehealth is to evaluate the patients’ supportive care needs and connect them with local services such as GPs, community palliative care and other practical support services.
For more information about the Care Program, contact Program Manager Care Plus Extend David Marco or Prof Brian Le on 03 8559 7960.
Prof Brian Le is speaking about the Care Plus Extend program at the Advancing Equity in Cancer Outcomes Symposium, March 11, which will be co-chaired by Prof Jennifer Philip and Prof Jacinta Elston. Learn more and register
