Successful symptom control in palliative care patients presents a particular challenge to the primary healthcare team. The goals of palliative care include quality of life, good symptom management, adjustment to the situation and a dignified death. Patients are less likely to volunteer symptoms that have a lower likelihood of being successfully treated, and volunteer symptoms may go completely undetected unless specifically asked for. Problematic respiratory symptoms are common in patients with advanced cancer. As patients become weaker and more debilitated, they are at increased risk of mouth problems and they also become less capable of preventing these problems themselves. The causes are often multifactorial, and the symptoms affect patients with many different types of cancer. Intractable vomiting causes carers to feel helpless and gives rise to feelings of isolation and shame in patients. In some patients, problems with delayed gastric emptying are either a prelude to or part of a more problematic picture of full obstruction.