This article provides oncology nurses with an overview of the incidence, diagnosis, and treatment of emotional distress in patients with cancer. Oncology nurses tend to focus more on the physical symptoms of their patients, and the assessment and treatment of distress in patients with cancer often are overlooked. A brief discussion of the National Comprehensive Cancer Network practice guidelines for distress management and signs and symptoms of distress are included, especially in the context of somatic symptoms. Barriers to nursing assessment of distress are included. Signs and symptoms are considered, especially in the context of patients' somatic symptoms.