Somatic symptoms considered as unrelated to cancer or grossly out of p
roportion to the known pathology were systematically assessed in a gro
up of 98 consecutively referred cases. Subjects with prominent somatic
symptoms (somatisers) had depression (53%), anxiety (12%) and atypica
l somatoform disorder (27%). During follow-up, somatisers with depress
ion showed clinical improvement whereas those with atypical somatoform
disorder showed no improvement or deteriorated. Methods of distinguis
hing the cause of somatic symptoms in cancer patients are discussed.