PRIMARY OBJECTIVES:~I. To determine feasibility of embedding a palliative care (PC) physician within the James Thoracic Oncology Clinic.~II. To assess patient and caregiver outcomes over a 12-month period within an embedded onco-palliative care clinic model.~III. To evaluate and describe clinician attitudes and beliefs regarding utilization of embedded palliative care as well as symptoms of provider burnout.~IV. To analyze health care utilization among participants receiving embedded onco-palliative care.~OUTLINE:~Participants and caregivers undergo embedded palliative care comprising symptom management (physical and psychological), advanced directives and goals of care discussion, caregiver support, and referral for adjunctive supportive services as needed at each clinic visit.~After completion of study, patients are followed for up to 1 year.
This trial studies how well embedded palliative care works in managing symptoms in participants with stage III-IV thoracic malignancies that has come back and their caregivers. Embedded palliative care may improve distress and anxiety in participants and caregivers.