A report out yesterday calls on cancer specialists to identify and help patients deal with psychological and social issues that, if left unattended, can cause delays in treatment and lots of anxiety.

Oncologists and other cancer providers typically focus on getting patients tumor-fighting therapies such as chemotherapy, says the report by the Institute of Medicine.

But cancer doctors might overlook a host of problems such as depression, a lack of insurance or even difficulty getting to and from medical appointments, the report says.

The cost of not dealing with such psychological and social issues might be very high, says the institute, which appointed a panel of experts in cancer care to study the issue.

The report, "Cancer Care for the Whole Patient," says people who suffer from depression after getting a diagnosis might put off getting treatment, and that might allow the tumor to grow and become more deadly.

"People are often overwhelmed when they get a diagnosis of cancer," says panel member Lee Schwartzberg, who is director of the Memphis cancer center The West Clinic. "They have to learn how to live their life with cancer, and they often require some help."

The report calls for a new standard of care in which all oncologists routinely would screen patients for mental distress and other problems and then either refer them to or try to provide the appropriate services, says Nancy Adler, chairwoman of the panel and vice chairwoman of the psychiatry department at the University of California-San Francisco.

Patients, especially those in shock, might need help sorting through treatment options.

"They hear the word cancer, and they might not hear another word you say," says Patricia Ganz, an oncologist at the University of California-Los Angeles and a member of the panel.

Such patients might need information they can read at home and a friend or family member who can take notes in the meeting with the doctor, she says.

Other issues include the potential loss of a job, high medical bills, debilitating fatigue and inability to carry out daily chores without assistance.