This is a case study of a 58-year-old lady with metastatic nasopharyngeal carcinoma (NPC) who suffered a left neck of femur fracture. Unfortunately, there was an unexpected and rapid cancer progression, requiring her goals of care to transit from rehabilitation after her fracture to palliation. The case brings to light the need for family physicians to be poised to manage cancer patients at the end of life in the community, and work together with other stakeholders to deliver compassionate and supportive care.