Telephone-based symptom monitoring by trained community health workers reduced emergency department visits and hospitalizations by 28% among adults over 65 with cancer, according to a randomized controlled trial involving 613 participants. The intervention used structured weekly calls to assess symptoms like pain, nausea, and fatigue, with protocols for when to recommend medical attention. This represents a significant advancement in cancer care delivery, particularly for older adults who face complex treatment regimens and heightened vulnerability to treatment complications. The approach addresses a critical gap in oncology care—the period between clinic visits when symptoms can escalate undetected. Previous telemedicine studies have shown promise, but this research demonstrates that non-clinical personnel can effectively bridge care gaps when equipped with proper protocols. The intervention's success suggests potential for scalable, cost-effective cancer support programs that could be particularly valuable in underserved areas lacking specialized oncology resources. However, the study's focus on older adults may limit generalizability to younger cancer populations, and longer-term outcomes beyond acute care utilization remain to be evaluated. The findings support integrating structured symptom surveillance into standard cancer care protocols.