Screening with a validated screening tool (for example, the National Comprehensive Cancer Network Distress Thermometer and Problem Checklist), assessment and referral to appropriate health professionals or organisations is required to meet the identified needs of an individual, their carer and family.

In addition to the other common issues outlined in the Appendix, specific needs that may arise at this time include the following.

Physical

• Change in functional abilities – patients may benefit from referral to occupational therapy, physiotherapy and/or exercise physiology.
• Patient may need treatment for other physical symptoms such as pain, fatigue and musculoskeletal dysfunction.
• Patients require ongoing nutritional screening, assessment and management. Reduced oral intake and/or swallowing difficulties and weight loss require referral to a dietitian and speech pathologist (for swallowing difficulties).

Psychological

• Patients may require help with psychological and emotional distress while adjusting to the diagnosis, treatment phobias, existential concerns, stress, difficulties making treatment decisions, anxiety/depression, psychosexual issues such as potential loss of fertility, loss of previous life roles and interpersonal problems.

Social/practical

• Patients may need support to attend appointments.
• Provide guidance about financial and employment issues (such as loss of income and having to deal with travel and accommodation requirements for rural patients and caring arrangements for other family members).

Information

• Discuss fertility options with the patient and/or family (where appropriate) before beginning treatment.
• Provide appropriate information for people from culturally and linguistically diverse backgrounds.

Spiritual needs

• Patients and their families should have access to spiritual support that is appropriate to their needs throughout the cancer journey.