E-MOSAIC Electronic Tool to Monitor Symptoms

DISEASE CHARACTERISTICS:

* Diagnosis of advanced incurable cancer
* Symptomatic disease, defined as meeting ≥ 1 of the following criteria:

  * Pain Visual Analogue Scale (VAS) ≥ 3/10 and/or morphine equivalent daily dose of ≥ 10 mg for ≥ 3 days
  * Anorexia VAS ≥ 3/10 and/or weight loss of ≥ 2% in 2 months or ≥ 5% in 6 months
  * Fatigue VAS ≥ 3/10 and/or Karnofsky performance status \< 70%
  * Depression or anxiety VAS ≥ 3/10 and/or treatment with antidepressants for ≥ 5 days and planned for ≥ 1 month
* Receiving continuously, weekly, or biweekly palliative anticancer treatment meeting 1 of the following criteria:

  * At least 1 first-line treatment for any of the following:

    * Metastatic melanoma
    * Renal cell cancer
    * Pancreatic cancer
    * Biliary tract cancer
    * Mesothelioma
    * Prostate cancer (chemotherapy)
    * Advanced glioblastoma
  * At least 1 second-line treatment for any of the following:

    * Extensive stage small cell lung cancer
    * Stage IV non-small cell lung cancer
    * Colorectal cancer
    * Gastric cancer
    * Esophageal cancer
    * Bladder cancer
    * Sarcoma
    * Carcinoma of unknown primary
  * At least 1 third-line chemotherapy regimen for any of the following:

    * Metastatic breast cancer
    * Ovarian cancer
* Anticancer treatment must be given in an outpatient setting, not within a clinical trial, with weekly monitoring, and expected tumor response rate ≤ 20% according to the literature
* No testicular cancer
* No hematological malignancies
* No primary brain tumors other than glioblastoma
* Physician characteristics:

  * No change to standard of care for symptom assessment or to major communication skills strategies within the past 3 months
  * Experienced in medical oncology (i.e., worked ≥ 50% in clinical oncology within the past 24 months)
  * Likely to stay in the participating institution for the time required to treat ≥ 5 study patients
  * Able to independently communicate with the patient about all aspects of cancer care
  * Able to independently perform immediate changes of interventions in patient care without the institutional requirement to counsel another colleague before prescribing (i.e., for symptom control)
  * Completed a basic communication skills course or equivalent training (i.e., familiar with communication skills)

PATIENT CHARACTERISTICS:

* Able to understand assessment instrument language
* Able to understand physician communication without difficulty (i.e., due to culture, language, speech)

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* No concurrent participation in another clinical trial