Pharmacogenomic Testing to Personalize Supportive Oncology

Inclusion Criteria * Written informed consent and HIPAA authorization for release of personal health information. * Completion of ESAS at initial palliative medicine clinic visit, presenting with moderate to high pain (≥ 4/10) and/or depression (≥ 3/10). * New patients ≥ 18 years of age who have had an initial visit in the Department of Supportive Oncology's palliative medicine clinic with hematologic malignancy or any stage solid tumor malignancy according to the provider. * Agree to at least one additional palliative medicine clinic visit per protocol. * Able to provide a buccal sample for PGx testing. Exclusion Criteria * Psychiatric illness, social situations, or active/recent (within 30 days) history of illicit substance (e.g. cocaine, heroin) abuse that would limit compliance with study requirements (e.g. clinic visits, medication compliance, etc.) as determined by the Investigator. * Patients who have had prior multiple visits in palliative medicine clinic.