See validated screening tools mentioned in Principle 4 ‘Supportive care’. Additionally, the ‘Cancer Survivors Unmet Needs (CaSun)’ is another validated screening tool that may help health professionals to identify the unmet needs of patients during survivorship.

A number of specific challenges and needs may arise for cancer survivors:

• emotional distress arising from fear of disease recurrence, changes in body image, returning to work, anxiety/depression, interpersonal problems and sexuality concerns
• malnutrition following treatment due to ongoing treatment side effects (e.g. weight loss, reduced oral intake) – this requires monitoring and nutrition intervention where indicated
• decline in mobility or functional status as a result of treatment
• a need for increased community supports as patients recover from treatment
• financial and employment issues (e.g. loss of income and assistance with returning to work and the cost of treatment, travel and accommodation)
• appointing a substitute decision-maker and completing an advance care directive
• legal issues such as completing a will.

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