Patients with advanced cancer and chronic pain have problems that strain the resources of primary physicians and emergency room staff, frequently leading to unnecessary hospital admissions. The Supportive Care Program of the pain service at Memorial Sloan-Kettering Cancer Center (MSKCC), which concentrates on continuity of care, works to maintain these patients at home while improving the quality of their lives. It is also a source of expert information and a link between MSKCC and community health practitioners(1). Two nurses, a social worker, neurooncologist, psychiatrist, music therapist, and chaplain make up the team. Most of our patients have advanced cancer and intractable pain. Unlike hospice patients, many choose to continue active treatment, including experimental drugs, until shortly before death. The nurse, not the physician, is responsible for day-to-day pain management, symptom control and supportive care of the patient and family. The nurses hold master's degrees in nursing and have additional training in pain management, symptom control, and delivery of community services. Their backgrounds-in mental health, public health, and neuro-oncology-are complementary. Each nurse works with 12 to 15 patients and their families in collaboration with the patients' primary physicians and in consultation with the other team members. She follows patient and family through home visits, clinic visits, and hospital visits. Most intervention, however, is by telephone contact with the patient, family, or a community health worker (usually a visiting nurse but sometimes a private duty nurse, social worker, or physician). Telephone calls are extremely effective in monitoring symptoms, adjusting or initiating management approaches, anticipating problems, reducing anxiety, and in bereavement follow-up. While community health professionals help manage patients at home, the team nurse and social worker remain available to the patient, family and community health worker on a 24-hour basis. Since 1981, when the program started, 175 patients (ages 22 to 83) have been admitted based on one or