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, keeping in mind the long duration with which patients live with low- grade lymphomas. 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 (this should include assessment of existing coping strategies and abilities to identify the needs for the patient, their carer and family)
• management of physical symptoms including pain, nausea and fatigue
• encouragement and support to increase levels of exercise (Cormie et 2018; Hayes et al. 2019)
• assessment of health literacy for self-care early in the diagnosis
• identifying impairments and providing targeted interventions to improve the patient’s function level (Silver & Baima 2013)
• an integrated and structured approach to self-care enquiry – identifying Social Health, Exercise, Education, Diet and Sleep Hygiene (SEEDS) is one such practical tool (Arden 2015)
• psycho-oncology support to improve their knowledge and motivation towards healthy self-care care behaviours and to emotionally regulate throughout the course of the disease and treatments (this is particularly the case in patients on a ‘watch and wait’ approach, which can be associated with significant stress and anxiety)
• reviewing the patient’s medication to ensure optimisation and to improve adherence to medicine used for comorbid conditions
• nutritional assessment and

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

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, B and C.

The general practitioner is responsible for:

• providing patients with information that clearly describes to whom they are being referred, the reason for referral and the expected timeframes for appointments
• requesting that patients notify them if the specialist has not been in contact within the expected timeframe
• considering referral options for patients living rurally or remotely
• supporting the patient while waiting for the specialist appointment (Cancer Council 13 11 20, Leukaemia Foundation 1800 620 420 and Lymphoma Australia 1800 953 081 are available to act as a point of information and reassurance during the anxious period of awaiting further diagnostic information).

More information

Refer to Principle 6 ‘Communication’ for communication skills training programs and resources.