The National Comprehensive Cancer Network (NCCN)—an alliance of leading cancer centers in the United States—today announced the NCCN Distress Thermometer has been translated into 46 languages. This free resource helps providers worldwide identify and address the multifactorial aspects of distress cancer patients can experience.

NCCN defines “distress” as an unpleasant experience of a mental, physical, social, or spiritual nature that can affect the way people think, feel, or act. Distress may make it harder to cope with having cancer, its symptoms, or its treatment. Using a tool like the NCCN Distress Thermometer normalizes and encourages discussion without any stigma that can cause some patients to avoid talking about psychological or deeply personal issues.

“The NCCN Distress Thermometer acknowledges that undergoing treatment for cancer is distressing for everybody. This simple chart gives patients an easy way to let their doctor know how well they’re coping,” explained Robert W. Carlson, MD, Chief Executive Officer, NCCN. “We’ve found that a score of four or higher is an indication for further evaluation and possible intervention. The thermometer includes a corresponding list of problems to help health care providers determine if a patient’s distress stems from practical problems, family problems, emotional problems, spiritual/religious concerns, physical problems, or a combination thereof.”

The NCCN Distress Thermometer was first created in 1997 by psycho-oncology pioneer Jimmie C. Holland, MD. The late Dr. Holland was Founding Chair of the NCCN Guidelines Panel for Distress Management and Founding President of the American Psychosocial Oncology Society. Her goal was to make discussion of distress a routine part of oncology patient visits in order to improve both the psychosocial and physical well-being of people with cancer.

“Managing a patient’s emotional distress as well as physical pain is an essential part of medical treatment,” said Sonali Johnson, PhD, Head, Knowledge, Advocacy and Policy, Union for International Cancer Control, the world’s largest international cancer-fighting organization, also behind World Cancer Day held every February 4th. “Cancer patients are particularly vulnerable to anxiety and depression, as well as stress at work and at home, all of which can affect their recovery and quality of life. The NCCN Distress Thermometer provides patients and caregivers with a valuable tool in addressing the psychological impact of illness.”

The NCCN Distress Thermometer translations are part of ongoing efforts by the NCCN Global Team to make NCCN Guidelines and derivative products more accessible to non-English speakers. More than 100 new translations have published this year alone, including clinical guidelines and patient-friendly versions. NCCN also provides NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework) and NCCN Harmonized Guidelines with optimal recommendations alongside pragmatic approaches to improve treatment in resource-constrained settings, such as low- and middle-income countries. Visit and join the conversation online with the hashtag #NCCNGlobal.

The translated NCCN Distress Thermometer can be found at Recently-updated NCCN Guidelines for Patients: Distress are also available at

This announcement was originally published on July 13, 2020, on the National Comprehensive Cancer Network website.