Background: Diagnosis and treatment of cancer are highly stressful for patients. Everyday life is disrupted for the vast majority of patients and their relatives and the cancer experience often results in physical, psychological, social, practical, and spiritual concerns.25% to 40% of cancer survivors continue to suffer from distress.

Goal: To improve the referral to specific professionals.

Intervention: Implementation of the distress thermometer: for the future demand on healthcare, a National Cancer Control Program was developed. Two objectives are the availability and introduction of a validated screening instrument capable of indicating the need for specialized psychosocial assistance and the inclusion of screening for psychosocial problems in the national guidelines for oncologic care. These 2 objectives are in line with the American National Comprehensive Cancer Network (NCCN) practice guideline of distress management. This program introduced the Distress Thermometer (DT), an easily understood, self-reported measure of distress. Patients are asked to rate their overall distress on a visual analogue scale (a thermometer) from 0 (no distress) to 10 (extreme distress).

Implementation: Baseline measurements were done in 2008. In January 2009 we started using the distress thermometer at the orthopedic oncology outpatient clinic. The first results of the baseline measurements and the implementation so far will be presented during the EMSOS 2009.