Helping Patients Reduce Distress


The NCCN Distress Thermometer asks patients to circle a number that best describes their level of distress. The one-page assessment is accompanied by a yes/no checklist of distress problems.  (Reproduced with permission from the NCCN Clinical Practice Guidelines in
Oncology (NCCN® Guidelines) for Distress Management V.2.2014. ©2014 National Comprehensive Cancer Network, Inc. All rights reserved.)

Beginning this year, the American College of Surgeons is requiring the assessment of psychological distress as part of the vital signs process. The College’s actions recognize the powerful impact of mental and behavioral health on patients’ treatment decisions and outcomes. If patients have less distress, they tend to take a more active role in their care and can do better in treatment.

Fox Chase Cancer Center is going even beyond the College’s requirements to assess and treat patient distress. The Center’s new standards build on its own success in identifying and meeting patient needs through initiatives such as survivor support groups and case management. They also draw on the Distress Thermometer and Problem List of the National Comprehensive Cancer Network® (NCCN®), derived from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Distress Management.

At each visit, Fox Chase patients receive a one-page assessment to report on the kinds of distress they are experiencing—for example, physical, emotional, spiritual—and how much. The care team then refers the patient to resources, within or outside Fox Chase, such as social workers, specialist care in psychiatry or pain management, and financial assistance programs.

Fox Chase researchers and physicians serve as members of the NCCN Guidelines® Panel for Distress Management. As the Center implements its new standards, it is well positioned to help the NCCN Guidelines panel evaluate and revise its recommendations for assessing patient distress if necessary.


Karen Mechanic, MD

To learn more, please contact Karen Mechanic, MD, director of psychiatry, at