A prospective national cohort study assessed the development of health-related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ-C30 version 3.0 questionnaire monthly for 4 months. Changes over time and between-group comparisons were examined. Of 58 patients included in the study, 47% completed the questionnaire four times. Functioning was generally high, and improved social functioning was observed after 1 and 2 months. The highest symptom score was for fatigue followed by pain and nausea/vomiting. A high score for financial problems remained unchanged during the entire period. Patients with higher income had reduced pain intensity (p =.03) and diarrhoea (p =.05) than patients with income below the poverty line. After 1 month, reduction in pain intensity was observed for Nuuk citizens compared with non-Nuuk citizens (p =.05). After 2 months, non-Nuuk citizens reported improved social functioning compared with Nuuk citizens (p =.05). After 3 months, Global Health in Nuuk citizens was improved compared with non-Nuuk citizens (p =.05). An important clinical finding was that patients’ needs for support are related to social status, and geographical factors should be taken into account when planning palliative care.