Patients with advanced head and neck cancer constitute a special care entity in hospice and palliative care. They account for roughly 7% of the hospice patients in our earlier study at Changhua Christian Hospital (CCH). Active problems such as recalcitrant pain, smelly fungating wound, repetitive local soft tissue infection or osteomyelitis, unpredictable massive tumor hemorrhage, upper airway obstruction, swallowing difficulty, impaired verbal communication, and body image change continue to challenge the palliative care team striving to provide quality of hospice care. Personal arguments against the administration of permanent tracheostomy, feeding jejunostomy, or prophylactic transcatheter arterial embolization to stop future tumor bleed contradict the hospice's prerequisite that hospice affirms life. Only through the judicious advice on chossing the respective procedure and gaining an informed consent and a consensus via a family meeting can we solve these problems with no regrets. In addition to literature review, methods of care and know-how gained from the team care experience at Doctor Jean Landsborough Memorial Ward of CCH are discussed and presented in this review article.