Background/rationale: The island of Guam is a U.S. territory in the Western Pacific located 11,000 km west of the U.S. mainland and 2,500 km east of the Philippines. While Guam has two general hospitals and a number of medical clinics, there is a significant shortage of medical specialists in several subfields, including oncology. Nevertheless, oncology services have improved in recent years. In the past, a cancer diagnosis almost always led to a referral off-island, but today, surgery, chemotherapy, and radiation are all available locally. Despite advances in the availability of cancer treatment on Guam, access to psycho-oncology care has nevertheless been limited. Methods: In 2024, the authors created a psycho-oncology program for the Guam community called “Circle of Care Cancer Support and Psycho-Oncology Services.” Circle of Care offers cancer support groups, individual and family psycho-oncology counseling, integrative oncology health and wellness services, and psycho-oncology care for children and adolescents. Service delivery includes in-person and online programming, as well as outreach support through hospital and home visits. Impact on practice: The program was designed to help patients cope with cancer symptoms, make treatment decisions, manage treatment side effects, and learn to cope with the emotional stress of living with cancer. Yet program participants seemed to yearn for something deeper—a sense of meaning and purpose, and the belief that happiness is still possible as they face the implications of their diagnosis. Thus, Circle of Care also provides specialized programming focused on meeting patients’ existential needs. Discussion: Within its first year, Circle of Care has become an established part of the island's cancer care community, fostering support, hope, and resilience as participants navigate their cancer journey.