During the last decades health related quality of life (QoL) of cancer patients is considered as an important outcome of cancer treatment and a major goal of palliative care. In routine practice physicians rarely consider QoL in decision making. The work aimed to develop the new paradigm of palliative care in oncology based on QoL.The paradigm is based on the principle of balance of cancer treatment strategies. Treatment strategies are determined by the treatment goals. The possible goals of treatment are as follows:-To cure and to maintain QoL (in case we have chance to cure a patient)-To improve survival and QoL (in case we can’t cure a patient, but we have chance to improve patient life expectancy)-To improve quality of life (in case we have no a chance to improve patient life expectancy)-To test new methods of treatment or medications (clinical trials). Treatment approach is chosen depending on treatment goals. The goal and the approach are specified by the type and stage of cancer. It is worth mentioning that palliative care of cancer patients is to be started from the early stages with its proportion increasing with the disease progression. Taking into account cancer treatment goals it is seen that at any stage of the disease QoL of a patient is among the key issues to be analyzed and in doing so QoL is to be measured. In terminally ill patients symptom control and support of QoL might be effective if symptoms and QoL assessment are provided. The set of reliable measures is proposed. In conclusion, the paradigm gives grounds for the unified approach to cancer treatment and outlines the value of palliative care with the focus to patients’ quality of life. It might be used by physicians in their routine practice and in doing so improve quality of palliative care.