Most physicians, with the possible exception of residents, have considerable experience with cancer patients of terminal stage. In the majority of cases, a psychiatrist is not consulted. When a psychiatric consultation is requested, it usually reflects a significant problem. The clinical diagnoses most commonly associated with consultation in the patients are depression and delirium. Personality disorder, treatment-resistant continuous pain, despondency, anxiety, or denial are less frequently encountered. Occasionally, the patient is identified as having the problem, but investigation reveals that it is often the family or significant other that is having substantial difficulty.