Inclusion Criteria:  Age ≥ 18 at time of consent Ability to provide written informed consent Metastatic cancer diagnosis referred to Radiation Oncology for palliative radiation therapy Patients, as assessed by the radiation oncologist, who present with symptoms secondary to cancer that can be palliated by radiation therapy Note: Patients who ultimately either choose to not receive radiation or not recommended to receive radiation will remain eligible  Note: Patients who ultimately do not complete prescribed radiation will remain eligible  Exclusion Criteria:  Patients who are unable to participate in follow up visits per investigator discretion (virtual/phone follow up is permitted) Patients receiving definitive/curative course of radiation therapy Patients who self-report as pregnant or nursing females are excluded from this study.