Inclusion Criteria:  Age ≥ 18 years or older Patients with head and neck tumors, thoracic tumors, gynecological tumors, or melanoma Actively receiving systemic oncological treatment Worst fatigue over the last 7 days rated 4 or greater on (0-10 scale) Karnofsky score 60 or greater Life expectancy greater than six months English speaking  Exclusion Criteria:  Cognitive impairment that would preclude response to study assessments or require the use of Legally Authorized Representatives Unwilling to accept random assignment Concurrently enroll onto ongoing competing trials of integrative medicine interventions with symptom/toxicity as primary outcome. Note, however, patient will be allowed to enroll on other therapeutic protocols