The study took place at the Princess Margaret Cancer Centre ( Toronto , ON , Canada ) , between Dec 1 , 2006 , and Feb 28 , 2011.24 medical oncology clinics were cluster randomised ( in a 1:1 ratio , using a computer-generated sequence , stratified by clinic size and tumour site [ four lung , eight gastrointestinal , four genitourinary , six breast , two gynaecological ] ) , to consultation and follow-up ( at least monthly ) by a palliative care team or to standard cancer care .