Advanced CancerNCT07133269
Care Coach-led Integrated Palliative Surgical Oncology and Rehabilitation Care Model for Advanced Cancer Patients
A study testing Care Coach-led Palliative Surgical Oncology (PSO) and Rehabilitation in people with Advanced Cancer, run by Singapore General Hospital at 2 sites in Singapore.
Trial summary
Advanced cancer is a life-limiting condition that can negatively impact quality of life and function. Patients often suffer from physical, emotional, social, spiritual, and decision-making issues. Read more about this study
- Who is it for?
- Ages 21 to 99 years
- Conditions the study is for
- Advanced Cancer
- What is being tested?
- Care Coach-led Palliative Surgical Oncology (PSO) and Rehabilitation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 770 participants
- Where
- 2 sitesSingapore
- Study dates
- 20 Aug 2025to Apr 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 99 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients:
- Aged 21 and above,
- Diagnosis of advanced cancer, i.e. stage 3 or 4 solid organ cancer or diagnosed with cancer that requires complex surgery,
- Planned for elective major surgery (Table of Surgical Procedures (TOSP) table code 4 or more or surgery involves more than one surgical discipline,
- Able to speak and read English or Chinese
- Caregivers:
Show all 12Show fewer
- Age 21 and above,
- Unpaid family or informal caregiver who takes direct care of the patient's day-to-day and healthcare needs, or ensures provision of care to meet the needs, or who is the decision maker with regard to the patient's needs and healthcare,
- Able to speak and read English or Chinese.
- Healthcare Providers (Qualitative interview only):
- Age 21 and above,
- Currently working as a Healthcare professional at SGH or NCCS and involved in this study.
Who cannot join
- Patients:
- Patient refusal,
- Have complex PC needs requiring specialty palliative care (SPC) intervention before surgery,
- Active mental illness or severe dementia and certified unfit to make medical decision by a specialist physician,
- Scheduled for Emergency surgery.
- Caregivers:
Show all 9Show fewer
- 1. Unwilling to participate in the study.
- Healthcare Providers (Qualitative interview only):
- 1. Unwilling to participate in the Qualitative interview.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Singapore2 sites, 2 recruiting
- Recruiting
National Cancer Centre Singapore
Singapore, 168583
Perlie Ng, +65 6306 1913, perlie.ng.x.y@nccs.com.sg
- Recruiting
Singapore General Hospital
Singapore, 169608
Perlie Ng, +65 6306 1913, perlie.ng.x.y@nccs.com.sg
About this study
Official title: Effectiveness of A Care Coach-led Integrated Palliative Surgical Oncology and Rehabilitation Care Model in Patients With Advanced Cancer Undergoing Major Surgery: A Randomized Controlled Trial
Advanced cancer is a life-limiting condition that can negatively impact quality of life and function. Patients often suffer from physical, emotional, social, spiritual, and decision-making issues. As such, most would benefit from basic palliative care (PC) which includes establishing goals of care through serious illness conversations (SIC), managing basic pain and other symptoms and addressing psychosocial needs, among others. Patients with advanced cancer are also at higher risk of functional decline due to receiving multiple concurrent treatments. Yet, among patients with advanced cancer undergoing major surgery, there has been little consideration of PC and functional needs.
The palliative surgical care model is a care model in which PC educated surgical oncology teams deliver basic PC, allowing sustainable PC provision to an increasing number of patients living with advanced cancer. In a local pilot palliative surgical care model, it was found that a care coach-led palliative surgical oncology (PSO) care model significantly increased palliative care delivery, ensuring more consistent and comprehensive support for patients. In addition, cancer rehabilitation delivered by rehabilitation professionals addresses functional impairments during the cancer journey, restoring and/or maintaining function and improving quality of life. It also plays a preventive role before surgery, a restorative role during treatment, and a supportive role during cancer progression.
Therefore, to address longitudinal PC and functional needs, an integrated care coach-led palliative surgical oncology rehabilitation (PSO+R) care model involving PC-trained care coaches, surgical oncology teams, rehabilitation professionals, supported by specialist palliative care (SPC) physicians who will provide PC and cancer rehabilitation throughout the patient's advanced cancer journey, is proposed.
Read the detailed description
Advanced cancer is a life-limiting condition that can negatively impact function, quality of life and exerts an excessive strain on caregivers. In Singapore, up to 60% of cancer patients suffer from advanced (stage 3 or 4) cancer at diagnosis and are recipients of resource-intensive and costly life-prolonging treatments including surgery, chemo-, radiation therapy, among others. In fact, approximately 80% of patients with advanced cancer undergo major surgery at some point of their cancer journey. Given their life-limiting cancer, these patients suffer from physical, emotional, social, spiritual, and decision-making issues that can arise near end-of-life. As such, most would benefit from basic palliative care (PC). This includes establishing goals of care through serious illness conversations (SIC), managing basic pain and other symptoms, and addressing psychosocial needs, among others. As they are often recipients of concurrent intensive multi-modality cancer treatments, patients with advanced cancer are also at higher risk of functional decline, and are ten times more likely to experience morbidity or mortality and have a six-fold increase in risks of 30-day emergency readmissions after major surgery as compared to patients without advanced disease. Yet, among patients with advanced cancer undergoing major surgery, there has been little consideration of PC and functional needs, leading to overall poor quality of life.
Palliative surgical care model is a care model in which PC educated surgical oncology teams deliver basic PC, allowing sustainable PC provision to an increasing number of patients diagnosed and living with advanced cancer. In a local pilot palliative surgical care model, it was found that longitudinal PC (as opposed to during the peri-operative period only) and functional needs during the advanced cancer journey were not well-addressed. Additionally, surgeon-led palliative surgical care was not feasible due to time constraints and competing clinical demands. However, it was found that a care coach-led palliative surgical oncology (PSO) care model significantly increased palliative care delivery, ensuring more consistent and comprehensive support for patients. Cancer rehabilitation delivered by rehabilitation professionals addresses functional impairments during the cancer journey and aims to restore and maintain function and improve quality of life. It plays a preventive role before surgery, restorative during adjuvant treatments, and is supportive during cancer progression.
To address longitudinal PC and functional needs, the investigators propose an integrated care coach-led palliative surgical oncology rehabilitation (PSO+R) care model involving PC-trained care coaches, surgical oncology teams, rehabilitation professionals, supported by specialist palliative care (SPC) physicians who will provide PC and cancer rehabilitation throughout the advanced cancer journey. Care coach-led PSO comprises of care coaches who will screen for PC needs, provide basic PC, and trigger referrals to SPC and surgical team when complex needs arise. The cancer rehabilitation team will screen for functional needs and institute tailored interventions. PSO+R care will be implemented before and up to 1 year after surgery. In contrast, usual care, though surgeons may be trained in PC, they are not supported by care coaches nor cancer rehabilitation or SPC teams. They provide standard peri-operative only care without consideration of the unique needs in advanced cancer. The objective of this proposal is to test the incremental effectiveness of care coach-led PSO+R vs PSO only vs usual care in improving health-related quality of life (HRQoL), functional capacity, and PC delivery and determine the cost-effectiveness of PSO+R over the next most costly intervention, among advanced cancer patients undergoing major surgery. To evaluate its effectiveness, the investigators conduct a 3-arm randomized controlled trial comparing outcomes at 6 months in patients receiving PSO+R vs PSO only vs usual care.
- Conditions
- Advanced Cancer
- Being tested
- Care Coach-led Palliative Surgical Oncology (PSO), Rehabilitation
- Keywords
- Palliative Care, Advancer cancer, Cancer rehabilitation, Surgical Oncology, Care coach, Quality of Life
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Care Coach-led Palliative Surgical Oncology (PSO)Other
- Patients will receive the current standard of care based on their surgeon's usual clinical practice.
- Additionally, patients will receive the Care Coach-led Palliative Surgical Oncology (PSO) intervention during all phases of their surgical journey.
- After pre-surgery consultations, care coaches will conduct Serious Illness Conversations (SIC) and focus on exploration of patients' hopes and worries, critical functions, social setup, and identification of a healthcare proxy. The SIC will also be conducted at 1, 3, 6, 9 and 12 months post-surgery.
- The Care coach will also screen for psychological and emotional needs using the Distress Thermometer and Problem List (pre-surgery and at 1, 3, 6, 9 \&12 months post-surgery). This will help to identify areas requiring palliative interventions such as symptom management or psychosocial support and for follow-up actions to be taken.
- ACP will also be offered at each timepoint to those who have yet to do so.
RehabilitationOther
- Patients will receive services from a dedicated rehabilitation service comprising of a Rehabilitation Physician, Physiotherapist, and Dietician.
- Pre-surgery: Patients will be triaged based on their frailty [Clinical Frailty Scale (CFS)], malnutrition risk [Malnutrition Universal Screening Tool (MUST)], and physical function [5-sit-to-stand (5-STS)] and will receive preventive rehabilitation interventions tailored to their functional needs.
- During surgical admission: The rehabilitation physician will review the progress of patients and refer them to a dietitian if needed. Patients may be followed-up by a rehabilitation physician one-month post-discharge and referred to a physiotherapist if required.
- Post-surgery: Patients will be screened by care coaches for health needs using the EQ-5D-5L at months 3, 6, 9 \& 12 post-surgery who will make referrals to a rehabilitation physician, nurse and psychologist, as needed.
| Study group | Role | What they receive |
|---|---|---|
| Usual Care | No intervention | Patients will receive the current standard of care based on their surgeon's usual clinical practice. [Note: All surgeons in the Division of Surgery \& Surgical Oncology (DSSO)- SGH and NCCS are required to attend a basic palliative care course.] |
| Care Coach-led Palliative Surgical Oncology (PSO) | Experimental | Patients will receive the current standard of care based on their surgeon's usual clinical practice and the Care Coach-led Palliative Surgical Oncology (PSO) intervention. Receives: Other: Care Coach-led Palliative Surgical Oncology (PSO) |
| Care Coach-led Palliative Surgical Oncology with Rehabilitation (PSO+R) | Experimental | Patients will receive the current standard of care based on their surgeon's usual clinical practice, PSO intervention and services from a dedicated rehabilitation service (PSO+R). Receives: Other: Care Coach-led Palliative Surgical Oncology (PSO); Other: Rehabilitation |
What is being measured
The primary outcome is the main question the study is designed to answer.
HRQoL in patients post-surgery (measured by FACT-G)
-The Functional Assessment of Cancer Therapy - General (FACT-G) is a well-validated HRQoL questionnaire that covers 4 domains - physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items) and functional well-being (7 items). Each item has response choices in a 5-point Likert-type scale, with a maximum value of 4 (being, "Very much") and a minimum value of 0 (being "Not at all"). Higher scores indicate a better quality of life.
Measured: Baseline, 6 months post-surgery
Secondary outcomes (12)
HRQoL in patients post-surgery (measured by FACT-G)
The Functional Assessment of Cancer Therapy - General (FACT-G) is a well-validated HRQoL questionnaire that covers 4 domains - physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items) and functional well-being (7 items). Each item has response choices in a 5-point Likert-type scale, with a maximum value of 4 (being, "Very much") and a minimum value of 0 (being "Not at all"). Higher scores indicate a better quality of life
Measured: Baseline, 1, 3, 9 and 12 months post-surgery
HRQoL in patients post-surgery (measured by EQ-5D-5L)
The 5-level EuroQol-5 Dimension instrument (EQ-5D-5L) is a HRQoL questionnaire with five domains (mobility, selfcare, usual activities, pain/discomfort, anxiety/depression) and has five levels for each domain. Scores from all five items will be used to derive a single utility score ranging from 0 to 1, with 0 representing the worst possible health to 1 representing perfect health. It also contains a health state component and a visual analog scale.
Measured: Baseline, 1, 3, 6, 9, 12 months post-surgery
Frailty in patients post-surgery
The Clinical Frailty Scale (CFS) is a well-validated scale to screen for frailty. It is a 9-point scale that quantifies the frailty of the individual based on his/her functioning. There is a minimum score of 1 (indicating "Very Fit) and 9 (indicating Terminally Ill). A higher score is indicative of greater frailty.
Measured: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Functional lower extremity strength, transitional movements, balance, and fall risk in patients post-surgery
The Five Times Sit-to-Stand (5-STS) test is a test to assess functional lower extremity strength, transitional movements, balance, and fall risk in patients. The patient is asked to sit against the back of a chair. The time taken to change from a seated position to a standing position five times is measured. A time of less than 12 seconds is linked to better functional lower extremity strength, transitional movements, balance, and reduced risk for falls.
Measured: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Malnutrition and risk for malnutrition in patients post-surgery
The Malnutrition Universal Screening Tool (MUST) is a tool to assess for malnutrition and the risk for malnutrition. It consists of five steps and assesses one's risk for malnutrition by evaluating one's Body Mass Index (BMI), rate of weight loss and presence of acute disease. A score of 0 indicates low risk of malnutrition, whereas a score of 2 or more indicates a high risk of malnutrition.
Measured: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Patient-surgeon relationship post-surgery
The Human Connection (THC) scale measures the therapeutic alliance between patients and their physicians. It consists of 16 questions. Each item has response choices in a 4-point Likert-type scale, with a maximum value of 4 and a minimum value of 1. Higher scores indicate a stronger patient-surgeon relationship.
Measured: Baseline, 1-month post-surgery
Documentation of Serious Illness Conversations (SIC) with patients pre-surgery
Serious Illness Conversations (SIC) (adapted from Ariadne Labs) enable Healthcare providers to understand patients' values and goals. This would be used as part of a palliative care delivery quality indicator.
Measured: Baseline (i.e pre-surgery)
Establishment of Advance Care Planning with patients
Advance Care Planning is a process of discussing one's values and future care preferences. This would be used as part of a palliative care delivery quality indicator.
Measured: Within 1-year post-surgery
Patients' receipt of specialist palliative care, when complex palliative care needs arise.
Patients with complex palliative care needs will be referred to specialist palliative care physicians, meeting the needs of patients and promoting HRQoL. This would be used as part of a palliative care delivery quality indicator.
Measured: Within 1-year post- surgery
Healthcare utilization of patients
Healthcare utilization will be determined by extracting the length of index hospitalization, all-cause emergency department visits, and total hospital days up to 1-year post-surgery.
Measured: Up to 1-year post-surgery
Cost of intervention(s)
Inpatient and outpatient billing records will be considered in total all-cause healthcare costs up to 1-year post-surgery.
Measured: Up to 1-year post-surgery
Cost-effectiveness of intervention(s)
The incremental cost-effectiveness of PSO and PSO+R will be quantified from the health system perspective.
Measured: Up to 1-year post-surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Aug 2025
- Study start20 Aug 2025
- Primary completionOct 2027 (estimated)
- Study completionApr 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Advanced CancerStudies of the same condition, open and under way.
- More trials run by Singapore General HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 770 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Singapore General Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Centre, Singapore, Duke-NUS Graduate Medical School
- Responsible party
- Sponsor
- Investigators
- Jolene Wong, MBBS, MMed (Surgery), MPH, Principal investigator, Singapore General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07133269
- Sponsor's protocol ID
- PHRGOC24jul-0008
- Status last verified
- Aug 2025
- First submitted
- 6 Aug 2025
- Last updated
- 12 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of A Care Coach-led Integrated Palliative Surgical Oncology and Rehabilitation Care Model in Patients With Advanced Cancer Undergoing Major Surgery: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07133269
- Acronym / sponsor ID
- PHRGOC24jul-0008
- Conditions
- Advanced Cancer
- Keywords
- Palliative Care, Advancer cancer, Cancer rehabilitation, Surgical Oncology, Care coach, Quality of Life
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 770 participants (estimated)
- Lead sponsor
- Singapore General HospitalUniversity, hospital or other
- Collaborators
- National Cancer Centre, Singapore, Duke-NUS Graduate Medical School
- Study start
- 20 Aug 2025 (actual)
- Primary completion
- Oct 2027 (estimated)
- Study completion
- Apr 2028 (estimated)
- First posted
- 21 Aug 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Advanced cancer is a life-limiting condition that can negatively impact quality of life and function. Patients often suffer from physical, emotional, social, spiritual, and decision-making issues. As such, most would benefit from basic palliative care (PC) which includes establishing goals of care through serious illness conversations (SIC), managing basic pain and other symptoms and addressing psychosocial needs, among others. Patients with advanced cancer are also at higher risk of functional decline due to receiving multiple concurrent treatments. Yet, among patients with advanced cancer undergoing major surgery, there has been little consideration of PC and functional needs.
The palliative surgical care model is a care model in which PC educated surgical oncology teams deliver basic PC, allowing sustainable PC provision to an increasing number of patients living with advanced cancer. In a local pilot palliative surgical care model, it was found that a care coach-led palliative surgical oncology (PSO) care model significantly increased palliative care delivery, ensuring more consistent and comprehensive support for patients. In addition, cancer rehabilitation delivered by rehabilitation professionals addresses functional impairments during the cancer journey, restoring and/or maintaining function and improving quality of life. It also plays a preventive role before surgery, a restorative role during treatment, and a supportive role during cancer progression.
Therefore, to address longitudinal PC and functional needs, an integrated care coach-led palliative surgical oncology rehabilitation (PSO+R) care model involving PC-trained care coaches, surgical oncology teams, rehabilitation professionals, supported by specialist palliative care (SPC) physicians who will provide PC and cancer rehabilitation throughout the patient's advanced cancer journey, is proposed.
Detailed description
Advanced cancer is a life-limiting condition that can negatively impact function, quality of life and exerts an excessive strain on caregivers. In Singapore, up to 60% of cancer patients suffer from advanced (stage 3 or 4) cancer at diagnosis and are recipients of resource-intensive and costly life-prolonging treatments including surgery, chemo-, radiation therapy, among others. In fact, approximately 80% of patients with advanced cancer undergo major surgery at some point of their cancer journey. Given their life-limiting cancer, these patients suffer from physical, emotional, social, spiritual, and decision-making issues that can arise near end-of-life. As such, most would benefit from basic palliative care (PC). This includes establishing goals of care through serious illness conversations (SIC), managing basic pain and other symptoms, and addressing psychosocial needs, among others. As they are often recipients of concurrent intensive multi-modality cancer treatments, patients with advanced cancer are also at higher risk of functional decline, and are ten times more likely to experience morbidity or mortality and have a six-fold increase in risks of 30-day emergency readmissions after major surgery as compared to patients without advanced disease. Yet, among patients with advanced cancer undergoing major surgery, there has been little consideration of PC and functional needs, leading to overall poor quality of life.
Palliative surgical care model is a care model in which PC educated surgical oncology teams deliver basic PC, allowing sustainable PC provision to an increasing number of patients diagnosed and living with advanced cancer. In a local pilot palliative surgical care model, it was found that longitudinal PC (as opposed to during the peri-operative period only) and functional needs during the advanced cancer journey were not well-addressed. Additionally, surgeon-led palliative surgical care was not feasible due to time constraints and competing clinical demands. However, it was found that a care coach-led palliative surgical oncology (PSO) care model significantly increased palliative care delivery, ensuring more consistent and comprehensive support for patients. Cancer rehabilitation delivered by rehabilitation professionals addresses functional impairments during the cancer journey and aims to restore and maintain function and improve quality of life. It plays a preventive role before surgery, restorative during adjuvant treatments, and is supportive during cancer progression.
To address longitudinal PC and functional needs, the investigators propose an integrated care coach-led palliative surgical oncology rehabilitation (PSO+R) care model involving PC-trained care coaches, surgical oncology teams, rehabilitation professionals, supported by specialist palliative care (SPC) physicians who will provide PC and cancer rehabilitation throughout the advanced cancer journey. Care coach-led PSO comprises of care coaches who will screen for PC needs, provide basic PC, and trigger referrals to SPC and surgical team when complex needs arise. The cancer rehabilitation team will screen for functional needs and institute tailored interventions. PSO+R care will be implemented before and up to 1 year after surgery. In contrast, usual care, though surgeons may be trained in PC, they are not supported by care coaches nor cancer rehabilitation or SPC teams. They provide standard peri-operative only care without consideration of the unique needs in advanced cancer. The objective of this proposal is to test the incremental effectiveness of care coach-led PSO+R vs PSO only vs usual care in improving health-related quality of life (HRQoL), functional capacity, and PC delivery and determine the cost-effectiveness of PSO+R over the next most costly intervention, among advanced cancer patients undergoing major surgery. To evaluate its effectiveness, the investigators conduct a 3-arm randomized controlled trial comparing outcomes at 6 months in patients receiving PSO+R vs PSO only vs usual care.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Usual Care | No intervention | –Patients will receive the current standard of care based on their surgeon's usual clinical practice. [Note: All surgeons in the Division of Surgery \& Surgical Oncology (DSSO)- SGH and NCCS are required to attend a basic palliative care course.] |
| Care Coach-led Palliative Surgical Oncology (PSO) | Experimental | Other: Care Coach-led Palliative Surgical Oncology (PSO)Patients will receive the current standard of care based on their surgeon's usual clinical practice and the Care Coach-led Palliative Surgical Oncology (PSO) intervention. |
| Care Coach-led Palliative Surgical Oncology with Rehabilitation (PSO+R) | Experimental | Other: Care Coach-led Palliative Surgical Oncology (PSO), Other: RehabilitationPatients will receive the current standard of care based on their surgeon's usual clinical practice, PSO intervention and services from a dedicated rehabilitation service (PSO+R). |
Who may qualify
- Ages
- 21 to 99 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Patients:
- Aged 21 and above,
- Diagnosis of advanced cancer, i.e. stage 3 or 4 solid organ cancer or diagnosed with cancer that requires complex surgery,
- Planned for elective major surgery (Table of Surgical Procedures (TOSP) table code 4 or more or surgery involves more than one surgical discipline,
- Able to speak and read English or Chinese
Key exclusion criteria (9 listed)
- Patients:
- Patient refusal,
- Have complex PC needs requiring specialty palliative care (SPC) intervention before surgery,
- Active mental illness or severe dementia and certified unfit to make medical decision by a specialist physician,
- Scheduled for Emergency surgery.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Care Coach-led Palliative Surgical Oncology (PSO)* Patients will receive the current standard of care based on their surgeon's usual clinical practice. * Additionally, patients will receive the Care Coach-led Palliative Surgical Oncology (PSO) intervention during all phases of their surgical journey. * After pre-surgery consultations, care coaches will conduct Serious Illness Conversations (SIC) and focus on exploration of patients' hopes and worries, critical functions, social setup, and identification of a healthcare proxy. The SIC will also be conducted at 1, 3, 6, 9 and 12 months post-surgery. * The Care coach will also screen for psychological and emotional needs using the Distress Thermometer and Problem List (pre-surgery and at 1, 3, 6, 9 \&12 months post-surgery). This will help to identify areas requiring palliative interventions such as symptom management or psychosocial support and for follow-up actions to be taken. * ACP will also be offered at each timepoint to those who have yet to do so. | Other | Care Coach-led Palliative Surgical Oncology (PSO), Care Coach-led Palliative Surgical Oncology with Rehabilitation (PSO+R) |
| Rehabilitation• Patients will receive services from a dedicated rehabilitation service comprising of a Rehabilitation Physician, Physiotherapist, and Dietician. * Pre-surgery: Patients will be triaged based on their frailty [Clinical Frailty Scale (CFS)], malnutrition risk [Malnutrition Universal Screening Tool (MUST)], and physical function [5-sit-to-stand (5-STS)] and will receive preventive rehabilitation interventions tailored to their functional needs. * During surgical admission: The rehabilitation physician will review the progress of patients and refer them to a dietitian if needed. Patients may be followed-up by a rehabilitation physician one-month post-discharge and referred to a physiotherapist if required. * Post-surgery: Patients will be screened by care coaches for health needs using the EQ-5D-5L at months 3, 6, 9 \& 12 post-surgery who will make referrals to a rehabilitation physician, nurse and psychologist, as needed. | Other | Care Coach-led Palliative Surgical Oncology with Rehabilitation (PSO+R) |
Primary outcome
HRQoL in patients post-surgery (measured by FACT-G)
Time frame: Baseline, 6 months post-surgery
-The Functional Assessment of Cancer Therapy - General (FACT-G) is a well-validated HRQoL questionnaire that covers 4 domains - physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items) and functional well-being (7 items). Each item has response choices in a 5-point Likert-type scale, with a maximum value of 4 (being, "Very much") and a minimum value of 0 (being "Not at all"). Higher scores indicate a better quality of life.
12 secondary outcomes
HRQoL in patients post-surgery (measured by FACT-G)
Time frame: Baseline, 1, 3, 9 and 12 months post-surgery
HRQoL in patients post-surgery (measured by EQ-5D-5L)
Time frame: Baseline, 1, 3, 6, 9, 12 months post-surgery
Frailty in patients post-surgery
Time frame: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Functional lower extremity strength, transitional movements, balance, and fall risk in patients post-surgery
Time frame: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Malnutrition and risk for malnutrition in patients post-surgery
Time frame: Baseline, 1, 3, 6, 9 & 12 months post- surgery
Patient-surgeon relationship post-surgery
Time frame: Baseline, 1-month post-surgery
Documentation of Serious Illness Conversations (SIC) with patients pre-surgery
Time frame: Baseline (i.e pre-surgery)
Establishment of Advance Care Planning with patients
Time frame: Within 1-year post-surgery
Patients' receipt of specialist palliative care, when complex palliative care needs arise.
Time frame: Within 1-year post- surgery
Healthcare utilization of patients
Time frame: Up to 1-year post-surgery
Cost of intervention(s)
Time frame: Up to 1-year post-surgery
Cost-effectiveness of intervention(s)
Time frame: Up to 1-year post-surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Feb 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jolene Wong, MBBS, MMed (Surgery), MPH principal investigator
Singapore General Hospital
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Care Coach-led Palliative Surgical Oncology (PSO) and Rehabilitation in people with Advanced Cancer, run by Singapore General Hospital at 2 sites in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 12 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 12 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Perlie Ng (+65 6306 1913, perlie.ng.x.y@nccs.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
HRQoL in patients post-surgery (measured by FACT-G) (time frame: Baseline, 6 months post-surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Feb 2026.