In order to optimize symptom management, there must be a shift from fixed interventions "one size fits all" to adaptive interventions tailored to individual patients. Our multistaged interventions use the sequential multiple assignment randomized trial (SMART) design. This design will operationalize the decision rules for switching from one intervention to another for individual patients. Our team's work to date with breast and lung cancer patients has shown efficacy for two home-based symptom management interventions, reflexology and meditative practices, delivered by or with friend or family caregivers. The sustainability of use of these two evidence based therapies and improvements in symptom outcomes will be tested during weeks 5-8 and at the week 12 follow up of 331 patients based on power analysis, against a control group. By sequencing two evidence based interventions, the proposed research will impact research and practice by determining how to maximize the benefit of symptom management during cancer treatment.