Weekly Remote Symptom Monitoring Improves Symptom Control in Advanced Cancer

Patients receiving treatment for advanced cancer often struggle with uncontrolled symptoms and fragmented communication with clinicians. These gaps can impair daily function, increase emergency department use, and widen existing disparities in outcomes. Underserved groups, including patients with limited formal education, face particular barriers to timely symptom management. To help address this challenge, a new study shows that simple weekly electronic symptom check-ins with the care team can improve quality of life during treatment.

Alliance Foundation Trials (AFT) evaluated a remote symptom monitoring program that prompts patients to complete a brief weekly survey from home. The tool supports reporting by smartphone or computer, as well as through an automated telephone system to reduce barriers related to internet access. Severe or worsening symptoms trigger an alert to a nurse for timely follow-up.

The Patient-Reported Outcomes To Enhance Cancer Treatment (PRO-TECT; AFT-39) trial enrolled 1,191 adults with advanced cancer across 52 community oncology clinics in the United States. Participants were assigned to usual care or to weekly remote check-ins in addition to usual care, with outcomes assessed after three months.

Patients using the weekly check-ins showed significant improvements in overall symptom control and daily physical function compared with those receiving usual care alone. Benefits were especially pronounced among groups that often face higher distress or greater barriers to care, including women, adults younger than 65 years, Black patients, and individuals with a high school education or less. Among Black participants, improvements in symptom control eliminated a baseline gap by month three, and many reported greater control over their care and better communication with their teams. Use of the tool also reduced or delayed emergency department visits.

The findings were published in JCO Oncology Practice. Institutions represented in the study include Memorial Sloan Kettering Cancer Center, the University of North Carolina School of Medicine, and the UNC Lineberger Comprehensive Cancer Center. Investigators noted that routine remote check-ins may help close communication gaps that contribute to inequities in cancer care.

“When novel technologies are developed, there is a risk that they might leave historically underserved groups behind, widening rather than reducing health disparities. Here, we see that the opposite seems to be happening. Rather than exacerbating disparities, implementation of remote symptom monitoring is bridging an important communication gap and improving health care access for underserved groups,” said Victoria Blinder, M.D., breast medical oncologist at Memorial Sloan Kettering Cancer Center and senior author of the study.

“Our results suggest that remote monitoring may provide underserved cancer patients with a new avenue to communicate concerns that might go underrecognized in routine practice. Broad implementation of these systems may represent an effective and highly practical strategy to advance health equity. Future studies should test technology with more general patient audiences,” said Ethan Basch, M.D., M.Sc., study chair of AFT-39 and the Richard M. Goldberg Distinguished Professor of Medicine at the University of North Carolina School of Medicine.

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Alliance Foundation Trials