Theranostics Survey

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Adrenal Gland/Adrenocortical Basket Trials (Multiple Types)Biliary Tract/Gall Bladder/Cholangiocarcinoma (GI)Bladder/Urothelial (GU)Bone Metastases Brain and Central Nervous System (CNS)Breast Cervical (GYN)Colon/Rectal/Anal (GI)Endocrine Cancers Endocrine Neoplasia Esophageal (GI)Gastric/Stomach (GI)Gastrointestinal (GI) (Multiple Types)General Solid Tumors (Multiple Types)GenitoUrinary (GU) (Multiple Types)GEP-NET (NEC)GI Stromal Tumor (GIST)Gynecologic (GYN) (Multiple Types)Head and Neck Cancers Hematological Malignancies Hepatocellular/Liver (GI)Hodgkins Lymphoma Insulinoma Kidney/Renal Cell Carcinoma (GU)Leukemias Lung Lymphomas Melanoma/Skin Cancers Mesothelioma Multiple Myeloma NeuroBlastoma NeuroEndocrine (NEC) (Multiple Types)NeuroEndocrine Carcinoma (NEC)Orbital Neoplasms Osteosarcoma Ovarian Ovarian/Primary Peritoneal (GYN)Pancreatic (GI)Paraganglioma (NEC)Penile (GU)Pheochromocytoma (NEC)Pituitary Prostate (GU)Salivary Gland Sarcoma Synovial Carcinoma Testicular (GU)Thymoma Thyroid Unknown Primary Cancers Uterine (GYN)Vulvar (GYN)

1. What is the likelihood that you consider a Clinical Trial as a Treatment Option for your Cancer?

Not Likely Likely

2. Have you participated in a Clinical Trial for your Cancer in the Past?

Yes No

3. What best describes you?

Patient Care Giver Physician Other

4. Gender

Male Female Other

5. Age

<18 18-54 55-74 >74

6. Race

Black/African American White Native American/Native Alaskan Asian Pacific Islander Hispanic Other

7. Residence

Urban Suburban Rural

8. Household Income

<15,000 15-24,999 25-34,999 35-49,999 50-74,999 75-99,999 100-200,000 >200,000

9. Highest Level of Education Completed

Did Not Complete High School/GED High School/GED College Post Graduate

10. Insurance Coverage

No Insurance Medicaid Medicare Private/Employer Insurance Other

11. Internet Access

No Internet Access Use of Internet is Infrequent Commonly Use Internet

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