See validated screening tools mentioned in Principle 4 ‘Supportive care’.

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

• assistance for dealing with emotional and psychological issues, including body image concerns, fatigue, quitting smoking, traumatic experiences, existential anxiety, treatment phobias, anxiety/depression, interpersonal problems and sexuality concerns
• alteration in cognitive functioning, behaviour and personality, which are common with gliomas and are often unrecognised but can significantly affect normal activities and family and carer relationships
• assistance with activities of daily living and instrumental activities of daily living
• assistance with managing complex medication regimens, multiple medications (including oral chemotherapy), assessment of side effects and assistance with difficulties swallowing medications may be required (refer to a pharmacist if necessary; for patients with neurocognitive impairment, administration of medication may need daily supervision)
• potential isolation from normal support networks, particularly for rural patients who are staying away from home for treatment
• management of symptoms such as headaches and cognitive impairment or dementia, particularly in patients treated with postoperative irradiation
• swallowing and aspiration risk
• impact of corticosteroids on weight gain
• decline in mobility or functional status as a result of treatment
• assistance with beginning or resuming regular exercise with referral to an exercise physiologist or physiotherapist (COSA 2018; Hayes et al. 2019).

Early involvement of general practitioners may lead to improved cancer survivorship care following acute treatment. General practitioners can address many supportive care needs through good communication and clear guidance from the specialist team (Emery 2014).

Patients, carers and families may have these additional issues and needs:

• financial issues related to loss of income (through reduced capacity to work or loss of work) and additional expenses as a result of illness or treatment
• advance care planning, which may involve appointing a substitute decision-maker and completing an advance care directive
• legal issues (completing a will, care of dependent children) or making an insurance, superannuation or social security claim on the basis of terminal illness or permanent disability.

Cancer Council’s 13 11 20 information and support line can assist with information and referral to local support services.

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