Most people with cancer are able to deal with the mental turmoil with support from ordinary health care, family and friends. However, by themselves or by attentive health-care workers some patients are referred to specialists within the psychosocial field, foremost social workers and psychologists. This paper deals with patients’ motives for seeing a psychologist. Methods: The case books for all patients who had met with the psychologist at a department of oncology in Sweden during a 10-year period were read through and categorised according to what the patients wanted to talk about. Results: The most commonly found motives were in sliding order: coping with anxiety and worries caused by the disease; dealing with relational problems in life outside the disease; dealing with relational problems actualised by the disease; living with a malignant diseasedespair in a new life situation; and finally dealing with a particular problem. Conclusion: Patients seeing a psychologist in oncology do not just ask for help to come to terms with anxiety and worries. More than a third of the patients wanted to talk about distressing relationships, which were not connected to, or only remotely connected to the cancer disease. Patients have different needs and competence in different psychological treatment perspectives is therefore important. The found diversity of motives bears impact on the external validity of screening instruments for distress and randomised controlled intervention studies