1.   Psychological distress is well known in patients undergoing oncological surgeries for gastro-intestinal, urological, head and neck, gynecological, neurological (CNS tumors) malignancies and other cancers like breast cancer, skin cancer like malignant melanoma. It adversely affects the quality of life and cancer care. Distress is associated with depression, anxiety, missed appointments, and adverse outcomes. The NCCN distress thermometer (DT) is a validated tool for its assessment. However, the same has not been documented much in Indian population. This study aims to fulfill the above paucity. The DT is a one-item,11-point Likert scale represented on a visual graphic of a thermometer that ranges from 0 (no distress) to 10 (extreme distress). Patients are asked to indicate the number that best describes how much distress they have experienced over the past week, on a scale of 0 to 10. Further patients are prompted to choose problems which are causing them distress from the NCCN Problem list depicted on the right side of the tool. The NCCN Problem List for patients is a 43 - item supplemental list of potential sources of distress including physical, emotional, practical, social problems as well as spiritual/religious concerns. The established cutoff score for further screening is a 4.  Patients with a score of 4 or more, needs to be referred for further evaluation and management. Referrals can include psychologists, religious counsellors, and social workers.