The objective of this phase 2 study is to evaluate the feasibility of an early palliative care intervention for metastatic cancer patients. Feasibility will be assessed in terms of percentage of patients that accept the proposal of the early palliative care intervention and that effectively start to be followed in the palliative care out-patient clinic. The study will be performed in a consecutive series of newly diagnosed patients affected by lung cancer (NSCLC or SCLC, stage IIIb, IV), mesothelioma (stage II, IV), pancreas (stage IV), stomach (stage IIIb-IV).

Inclusion Criteria:

• patients within 8 weeks of cancer diagnosis confirmed by histology or cytology
• lung cancer (NSCLC or SCLC) stage IIIb-IV OR mesothelioma stage III-IV OR pancreas cancer stage IV, OR gastric cancer stage IIIb-IV
• age more than 18 years
• performance status (ECOG) ≤ 2;
• ability to read, understand and fill-in the questionnaires
• written informed consent to the study

Exclusion Criteria:

• any chemotherapy, radiotherapy or ormonotherapy for any tumour in the past 12 months