• symptoms and symptom management

Although the world is full of suffering, it is also full of the overcoming of it.

Helen Keller

Having begun my surgical training in 1970, I was not introduced to the concept of ‘surgical palliative care (SPC)’—the term did not exist. I was aware of the seminal work of Dame Cicely Saunders and the hospice movement, but the term ‘palliative care’ was not yet used in the medical vernacular until Dr Balfour Mount,1 2 a retired urological surgeon and the Eric M Flanders Emeritus Professor of Palliative Care at McGill University, introduced the term in 1975 while I was in the fourth year of my surgical residency. As a budding surgeon, I was taught that there was a role for ‘palliative surgery’ to relieve the patient from malodorous wounds, extremity pain and intestinal obstruction, but my colleagues and I served an entirely technical role without having a more overarching view relating to global management in alleviating suffering. My basic instinct as a young medical student and surgical trainee—to make the patient well and free of their surgical malady—was destined to be redirected, questioned and probed over the next 40 years of general surgery and surgical oncology practice. I eventually learnt that palliative care was not hospice care! Over the years, it has become vitally important that ongoing educational initiatives, clinical practice guidelines and clinical professional society recommendations shed light on the difference between palliative and hospice care in order to inform surgeons, other healthcare workers and the public that palliative care should be viewed as ‘supportive concurrent care’ to disease-directed care for all seriously ill and injured surgical patients with palliative care needs.3

Although the term ‘surgical palliative care’ has been defined in a variety of ways, it is the treatment of suffering and the promotion of quality …