Background The integration of specialized palliative care (SPC) in pediatric oncology aims to minimize the significant suffering experienced by children and families. While early integration of SPC is recommended, barriers to integration of SPC exist and the ways to overcome those barriers are not entirely clear. Procedure We conducted semi-structured interviews of Candian healthcare providers (HCPs) in the fields of pediatric oncology and pediatric palliative care. We performed thematic analysis on the transcripts of those interviews to identify barriers to early SPC integration and solutions to overcome those barriers. Results Eight HCPs were interviewed (4 pediatric oncology and 4 palliative care providers). While the views of HCPs varied about the integration framework (universal, criteria-based, or unguided provider-initiated referrals), the importance of early SPC integration in patients with a high risk of mortality or high symptom burden was consistently described. We identified categories of barriers to early SPC integration including family perception, healthcare team-related, and process/systemic barriers. Common reported barriers include the association of palliative care with death or giving up and the perception that the family is “not ready” to meet SPC. Categories of solutions include improving communication with families, enhancing the collaboration between SPC and oncology teams, and optimizing the referral processes. Participants described strategies that often addressed several categories of barriers. Such strategies include skillful introduction of SPC to families and regular discussions amongst the pediatric oncology and SPC teams. Conclusion Barriers to early integration of SPC can be overcome through thoughtful discussions amongst HCPs. Those strategies should be considered when optimizing SPC integration with the goal of reducing the suffering of children and adolescents with cancer and their families.