Focus: quality of life, symptoms, and management of children with advanced cancer. The aims are to: 1. Evaluate the quality of life (QOL) (physical, emotional, social, spiritual, and daily activity level). 2. Examine the self-reported symptom data in relation to type of cancer, treatment (chemotherapy, surgery, or radiation) and Common Toxicity Criteria (CTC). 3. Explore commonly occurring clusters of symptoms reported by the child. 4. Examine strategies used by child, parent(s), and health care personnel to manage self-reported symptoms. 5. Analyze the trajectory of the symptoms, management effectiveness, and QOL during a 5-month period. 6. Test the fit of a preliminary sequential model of ethnicity, age, type of cancer, treatment, symptoms, management, & QOL. 7. Compare and contrast symptoms, management and QOL experienced by Latino and White children. A mixed method will be used to examine the prospective, multi-site data from a sample of 80 children, 6 through 17 years, English or Spanish speaking, with advanced cancer. Data will be collected in the hospital, clinic, or home every 2 weeks for five months (10 data points) or until end of life. Self-report data will be collected from the child for the QOL, symptoms, and management using appropriate tools. Additional management information will be obtained from the parent, chart, or nurse. Data analysis will include descriptive and inferential statistics. Additionally, the CTC and self-report data will be examined for correlation; clusters of symptoms will be examined by graphic displays, factor analysis and hierarchical cluster analysis; the trajectory of QOL, symptoms, and management effectiveness, will be analyzed by growth curves; the fit of a preliminary sequential model will be examined by multiple regression and structural equation modeling. Significance: The results of this study are imperative in providing knowledge regarding QOL, symptoms and management for evidence-based practice by nurses and other health care professionals caring for children with advanced cancer.