Over 15 years ago extrapolating from cancer data it was estimated that of those who die from non malignant diseases in england and wales each year over 71 000 people may need specialist palliative care7 recent reports from germany and australia indicate that non cancer patients are still in the minority within specialised inpatient palliative care institutions2 3 it is only now as palliative medicine is expanding into non malignant diseases that a picture is emerging and symptom . The challenges of uncertainty and interprofessional collaboration in palliative care for non cancer patients in the community a systematic review of views from patients carers and health care professionals o ai oishi and fliss em murtagh palliative medicine 201428910811098. The two patients were sle one had coexistent pulmonary alveolar hemorrhage and presented with dyspnea and psychological anxiety and the other had coexistent skin ulcers and presented with pain insomnia and psychological anxietydiscussion there were still few requests for palliative care in non cancer patients in japan. The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer few non cancer patients