Background Patients with advanced gynaecological cancers have high symptom burden and supportive care needs and have traditionally had little and delayed involvement with specialist palliative care.

Aim This qualitative study explores the views and experiences of consultant gynaecological-oncologists and their trainees in managing advanced gynaecological cancers, providing generalist palliative care (with a specific focus on symptom profile and end of life care), as well as reflecting on their interactions with palliative care services in an Australian healthcare setting.

Methodology All gynaecological-oncology specialists and fellows working and training in the state of Victoria, Australia between November 2022 and July 2023 were approached to participate in semi-structured, face-to-face interviews. A reflexive thematic analysis approach guided the data analysis.

Results Fifteen clinicians participated in the study. Four themes were derived from the qualitative data set – the evolution of the role of gynaecological-oncologist in advanced cancer from a more ‘holistic’ care provider to being ‘the surgical person or assessment decision maker’; the challenges of symptom management; the importance and challenges of difficult communication tasks, and how different models of care influenced the involvement of palliative care services.

Conclusion Both gynaecological-oncology specialists and fellows described a role for palliative care involvement in symptom management. They highlighted personal and institutional preferences for the management of all patients approaching end of life to be undertaken by specialist palliative care teams. Participants discussed the many communication tasks they undertook and how specific training could improve their skillset in this area. Palliative care integration with gynaecological-oncology care is service dependent, which has implications for future service planning.