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NCCN Guidelines for Patients



Distress, Version 1.2017


How distressed are you?



The field of nursing greatly varies. The nurse on your

cancer care team is likely an RN (





RNs have earned at least an associate’s degree or a

diploma from a hospital-based program. All RNs are

licensed to practice.

Some RNs go on to earn a master’s or doctoral

degree in nursing. They can also obtain certification

to become an expert in certain areas. Examples of

certification include oncology and psychiatry.

You may receive care from an NP (




racititioner). An NP has earned at least a master’s

degree in nursing, is licensed, and has passed

a national certification exam. NPs provide more

comprehensive care than RNs. In some states, they

can prescribe medicines.

Nurses are often the first to detect that a person is

distressed. They may be the one to screen you for

distress. They will also inform your cancer care team

of your state.

Nurses also provide a range of services for distress

treatment. They can help with practical matters,

provide counseling, and refer you to other experts.




A screening tool for distress is a brief survey

of your perceived distress. The Distress

Thermometer and Problem List were created by

NCCN experts to assess the level and nature of

your distress.



Distress screening that is paired with help for

related problems can be very helpful.



Your cancer care team can assess you for

distress at future visits and provide help for mild




Experts in distress have obtained education,

training, and credentials to conduct evaluations

and provide treatment. Depending on your

needs, you may be referred to a chaplain,

social worker, psychologist, psychiatrist,

psychiatric nurse, or other mental health


Cancer and my health situation have

given me a new perspective. For one

thing, I don’t take any day for granted.


Survivor, Multiple Myeloma