The patient’s general practitioner should consider an individualised supportive care assessment where appropriate to identify the needs of an individual, their carer and family. Refer to appropriate support services as required. See validated screening tools mentioned in Principle 4 ‘Supportive care’.

A number of specific needs may arise for patients at this time:

• assistance for dealing with the emotional distress and/or anger of dealing with a potential cancer diagnosis, anxiety/depression, interpersonal problems and adjustment difficulties
• nutritional support and supplementation – some patients may need an enteral tube for feeding if oral intake is inadequate or significant malnutrition is present; refer to a dietitian for nutritional assessment and support as early as possible
• individualised assistance with physical decline
• encouragement and support to increase levels of exercise (Cormie et al. 2018; Hayes et al. 2019) – consider referral to an accredited practicing exercise physiologist or physiotherapist.

For more information refer to the National Institute for Health and Care Excellence 2015 guidelines, Suspected cancer: recognition and referral.

For additional information on supportive care and needs that may arise for different population groups, see Appendices A and B, and special population groups.