The importance of psychosocial factors in the cancer journey for both patients and their carers has been recognised in UK health policy. The aim of this paper is to consider– (1) which needs are regarded as important by patients and their carers; (2) which are the unmet needs of patients and their carers. The study focuses on the responses of 233paired cancer patients and their carers derived from a cross-sectional questionnaire survey in three health authorities in North West England. The majority of patient–carer pairs expressed the importance of having good relationships with health-care professionals and receiving good-quality information. These can be identified as ‘universal’ needs. A minority of patient–carer pairs expressed the importance of other kinds of needs. These items were mainly to do with managing daily life, emotions, and social identity and can be identified as ‘situational’ or ‘personal’ needs. Where there were discrepancies between patients and carers, patients were likely to identify more needs as important. In contrast, carers have more unmet needs, reflecting their comparative neglect. Broadly, ‘universal’ needs are being met, but ‘situational’ and ‘personal’ needs, particularly among carers, are relatively unmet and require greater attention on the part of nurses and primary care professionals.