DESCRIPTION (provided by applicant): Charles F. von Gunten, MD, PhD is seeking support as an established investigator in palliative care, part of National Cancer Institute's prevention and control program. Palliative care can be summarized as the prevention and relief of suffering. As an established investigator with a track record of funded research, peer-reviewed publications and mentoring, he is now in a unique position to foster further development of the field as called for in the recent reports by the Institute of Medicine and National Cancer Policy Board. In roles as Director of the Center for Palliative Studies at San Diego Hospice & Palliative Care, a teaching and research affiliate of the University of California San Diego School of Medicine, member of the NCI-designated University of California San Diego Moores Comprehensive Cancer Center, Co-Principal of the EPEC Project, Senior Associate Editor of the Journal of Palliative Medicine and Chairman, American Board of Hospice and Palliative Medicine, the NCI is able to protect his abilities to conduct palliative care research and mentor trainees and leaders in the field. He has pursued research objectives to understand education (particularly physicians) and symptom control (particularly neuropathic pain) and as well as broad advocacy and leadership objectives to achieve his goals. Scientifically supported approaches to the prevention and relief of suffering are as important to the overall care of patients with cancer and their families as are approaches to the treatment of cancer itself. He needs protected time to continue a vital research program in the creation and dissemination of palliative care knowledge and reentering new physician scientists in the field. He is responsible for the educational and research developments in the largest department of subspecialist palliative medicine physicians in the USA. In addition, he is responsible for nurturing and developing nurse practitioners, nurses, social workers, and chaplains in a similar way. His personal research plan addresses the question "How is palliative care best taught?" This K05 will permit him to conduct educational research for resident physicians, physician fellows, nurses, social workers and chaplains. This K05 will permit him to mentor junior investigators in projects to test the ability of infusional lidocaine to relieve severe refractory pain, to understand patient, family, staff communication in terminal illness, and to test the ability of acupuncture to relieve distress in patients with terminal illness. All reentered investigators are seeking NCI funding and have the potential to become independent investigators.