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

In addition to the common issues outlined in the Appendix, specific issues that may arise include the following.

Physical needs

• Patients may require treatment for ongoing/new 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).
• Assistance with managing complex medication regimens, multiple medications, assessing side effects and assistance with difficulties swallowing medications may be required. Refer to a pharmacist if necessary.

Psychological needs

• Emotional and psychological distress may result from fear of death, complications of chemotherapy, existential concerns, anticipatory grief, communicating wishes to loved ones, interpersonal problems and sexuality concerns.

Social/practical needs

• Ensure the patient attends appointments.
• Patients may experience isolation from their normal support networks, particularly for rural patients who are staying away from home for treatment.
• Financial issues may result from disease recurrence (patients may need early access to superannuation and insurance).
• Help with legal issues may be required including for advance care planning, appointing a power of attorney, completing a will and making an insurance, superannuation or social security claim on the basis of terminal illness or permanent disability.

Information needs

• Provide appropriate information for people from culturally and linguistically diverse backgrounds.

Spiritual needs

• Multidisciplinary teams should have access to suitably qualified, authorised and appointed spiritual caregivers who can act as a resource for patients, carers and staff.
• Patients with cancer and their families should have access to spiritual support that is appropriate to their needs throughout the cancer journey.