Updated
Original VAYEMA symptom and impact self-check – not a validated scale
Cancer-related distress
Answer the symptom statements below to see which experiences and areas of daily life you report as most affected. These are original VAYEMA questions, not a validated diagnostic scale. No clinical severity or probability score is calculated.
Answers are processed only in this page by this assessment. They are not submitted, monitored or automatically saved. No name, email or account is required. Use a private device and clear your answers when finished.
For adults aged 18 and over. This self-check cannot diagnose or rule out a condition. Concerns about a child require an age-appropriate professional assessment.
Thinking about the past four weeks, how well does each statement describe your experience?
Additional context – not included in any questionnaire score
These are original VAYEMA questions, not a diagnostic instrument or a validated severity scale. They summarise the experiences you select and do not predict a diagnosis or future harm. Background condition information; this source does not endorse this self-check.
Understand the purpose of distress screening
In cancer care, screening can help identify concerns that might otherwise go unspoken and prompt a fuller discussion. Distress can involve physical symptoms, emotional difficulties, practical problems or spiritual questions. A high score on a suitable measure is not by itself a psychiatric diagnosis, and a low score should not override a specific concern you need help with. The NCI describes screening as a starting point for evaluation and support. [1]
This page does not reproduce a validated distress instrument. Its prompts organise observations and questions without a numerical result. You can use them selectively or speak directly with your care team. The aim is access to appropriate support, not a pass mark or proof that your experience fits a standard emotional response to cancer.
Begin with your current stage of care and priorities
The questions that matter at diagnosis may differ from those during treatment, remission, recurrence or a change in treatment goals. Explain where you are in care and what has become difficult recently. A person may feel relatively settled during active treatment and more anxious afterwards, or need additional support at another transition. The NCI describes these changing adjustment needs. [1]
You do not need to retell the whole medical history before your main concern is heard. A brief summary and a question can begin the conversation. The understanding guide provides background, but the assessment should respond to your present priorities rather than presume every person with the same cancer has the same emotional needs.
Describe feelings without judging whether they are normal enough
You may notice fear, numbness, anger, sadness, guilt or difficulty finding pleasure in ordinary things. Explain how often these experiences occur and what they affect. Emotional reactions vary and can change quickly. The NCI’s emotions resource encourages people to recognise their own experience rather than compare it with the way others appear to cope. [2]
You can also say that you do not know how to name the feeling. A clinician can ask further questions. The assessment should not require a polished account or a consistently positive outlook. It should help distinguish understandable distress, a need for practical support and any mental-health condition that merits specific treatment, without using one label to explain every difficulty.
Discuss depression and anxiety alongside physical symptoms
Fatigue, poor sleep, appetite changes and concentration difficulties may relate to cancer, treatment, depression or several factors together. The clinician should consider mood, enjoyment, thoughts and daily functioning alongside these overlapping symptoms. NCI guidance describes reviewing both medical and psychological information when depression is suspected in someone with cancer. [3]
Tell the professional about persistent hopelessness, severe anxiety or thoughts of self-harm directly rather than assume a total score communicates them. The PHQ-9 information page explains a separate optional screener, but it does not replace assessment in the oncology context. Immediate danger or inability to remain safe requires urgent local help rather than another questionnaire.
Bring medication and symptom changes to the medical team
New agitation, confusion, sleep changes or marked emotional shifts can sometimes involve medication effects or medical complications. The oncology team needs to know about relevant changes and their timing. A psychological assessment should not automatically treat every symptom as a reaction to diagnosis or assume that medical review has already happened. [1,3]
Bring an accurate medication list where useful, including non-prescribed products. Do not adjust treatment yourself to make symptoms easier to interpret. Ask who will communicate with the oncology team if psychiatric input is proposed. The goal is a connected plan, not separate recommendations that leave you responsible for identifying interactions or deciding which clinician’s advice should take priority.
Include practical, financial and family concerns
Distress may be driven partly by transport, work, childcare, treatment costs or difficulty understanding appointments. These concerns may need social work, patient navigation or another practical service rather than psychotherapy alone. The NCI describes distress assessment as extending beyond emotional symptoms to relationships, work and finances. A useful response identifies the type of help needed instead of treating every barrier as a mental-health disorder. [1]
Explain the task that is becoming difficult and what assistance would make a difference. Care coordination can support agreed arrangements where appropriate. Relatives may help, but they should not automatically take over decisions or receive private information. You can accept practical assistance while keeping selected conversations confidential.
Make room for body image, intimacy and meaning
Cancer-related concerns can include changes in appearance, sexuality, fertility, identity or beliefs about the future. These may feel difficult to mention in a short medical consultation. You can ask for a private discussion or a professional with suitable expertise. The NCI recognises that emotional support needs extend beyond one symptom category and can change throughout care. [2]
The assessment should not assume what matters to you based on age, relationship status or the type of treatment. Explain which concern you would like addressed and how much you want to discuss now. You may prefer a later appointment for a sensitive topic. Being able to choose a manageable pace is different from being expected to disclose everything before support can begin.
Agree information preferences and supporter involvement
Some people want detailed written information; others need smaller explanations and time to revisit them. Tell the team what helps you understand and remember decisions. A short question list or trusted person may be useful, with your agreement. The NCI communication guidance recommends expressing these preferences and asking for clarification about diagnosis, options and practical arrangements. [4]
Clarify what can be shared with family and existing professionals. Family support can address relatives’ own needs without granting access to all of your therapy. You can ask for private time even when somebody accompanies you. The purpose of involvement is to support your voice and choices, not replace them because the situation is emotionally difficult.
Ask how the assessment will change the support plan
A useful outcome explains the needs identified, any uncertainty and the next action. Options may include counselling, treatment for depression or anxiety, practical assistance or a specialist psycho-oncology referral. Symptom-management or palliative-care input may also be relevant alongside cancer treatment. [5] Ask what each service is meant to contribute and who will arrange the next contact.
The treatment and support guide explains these roles. Discuss professional expertise, appointment burden, fees and review arrangements before agreeing to care. A screening result should not automatically allocate you to an intensive programme or be used to promise a particular cancer outcome. Support needs to fit your medical circumstances and preferences.
Keep urgent symptoms and online notes separate
Follow your oncology team’s urgent-contact instructions for new symptoms or sudden deterioration during treatment. Do not use a distress worksheet to decide that a physical change is only anxiety. Immediate danger from self-harm also needs direct urgent support. Routine website inquiries are not monitored medical or crisis services, and the tool cannot assess whether waiting is safe.
For planned care, VAYEMA’s private assessment pathway can discuss relevant psychological support and coordination, with scope confirmed individually. Your notes stay in the page while you use it. You may deliberately download a summary and share it through an agreed clinical channel, keeping the file private. Completing the worksheet is optional and does not book an appointment or submit information to the clinic.
Frequently asked questions about cancer distress assessment
Is this a cancer screening or recurrence test?
No. The page concerns emotional and practical support in cancer care. It does not diagnose cancer, estimate recurrence or assess new medical symptoms. Follow the oncology team’s investigation and symptom-reporting plan. The original prompts here are unscored and intended only for appointment preparation.
Does a distress score diagnose depression?
Not by itself. Screening can identify concerns worth discussing, but diagnosis needs symptoms, duration, functioning, medical context and clinical judgement. The worksheet here does not produce a score at all. You can seek help without reaching a threshold or completing another questionnaire.
What if my biggest concern is money or transport?
Say so. Practical difficulties can contribute substantially to distress and may need a different service from psychotherapy. A good assessment helps identify relevant support rather than treating every problem as a disorder. Emotional and practical help can also be combined where both would be useful.
Can I ask for support after cancer treatment has ended?
Yes. Fear of recurrence, changed roles and reduced contact with the treatment team can create continuing needs. The appropriate assessment should consider your current experience rather than assume support is only relevant at diagnosis or during active treatment.
Do I need to involve my partner or family?
Not automatically. You can discuss whether their involvement would help, what may be shared and what remains private. A trusted person can assist with appointments without receiving all clinical information. Relatives may also seek separate support for their own concerns.
Will an urgent concern typed here alert a clinician?
No. Nothing entered in the worksheet is transmitted or monitored. Use your oncology team’s direct contact arrangements or appropriate emergency services when help is urgent. A downloaded summary is only a file you choose to keep and discuss later through an agreed clinical channel.
Resources and references
[1] NCI: Distress screening and adjustment to cancer
[3] NCI: Assessing depression during cancer care