Working as a Cancer Information Nurse Specialist on the Macmillan Support Line

In 2024, the Macmillan Support Line supported on average more than 260 people affected by cancer every day. Many callers felt worried, isolated or unsure where to turn.

The Macmillan Support Line is open to anyone. The team is here to listen, answer questions and help people find the right support, whether that’s about diagnosis, treatment or everyday help.

Macmillan Digital Editor Ros spoke with Cancer Information Nurse Specialist (CNIS) Gemma Shaw about her role on the Support Line, the calls she handles, and what healthcare professionals (HCPs) should know.

What is different about being a CNIS on the Support Line?

Being a CNIS on the Macmillan Support Line is very different to any other nursing role I’ve done. You don’t know what kind of call or webchat will come through, so your brain is always ticking: what are they asking me about, what do I know, what do they need right now?

It draws on all the experiences I’ve had from oncology wards to chemotherapy units to being a specialist nurse. It’s like constantly flexing your muscle memory.

The calls are so varied. I might start the day web chatting with someone experiencing health anxiety, then move to a caller in the middle of an oncology emergency who needs to be told to ring an ambulance, and later speak to a man who has just lost his wife and is struggling with grief. No two days are the same.

Why do people usually call?

Many people ring after an appointment because they’ve gone home and can’t remember what was said. Their mind just shut down when they heard the word cancer. We can go over the information in a less medical way, helping them process it.

We’re also hearing more about communication issues. For example, people finding results on the NHS app before their clinician has spoken to them or feeling left in the dark about next steps.

We also get a lot of questions about palliative care support to help people live as well as they can with advanced cancer. Carers at home who aren’t prepared, don’t know what to expect, and are frightened.

And it’s not just people with cancer who call. Partners, carers, friends and sometimes they’re the ones who most need support.

We also hear from people waiting for investigations, who are caught in that horrible period of uncertainty and often spiralling because of what they’ve read online.

I’d say: you’ve got nothing to lose by calling. It doesn't matter if you don't have a specific question. Sometimes it’s easier to open up to a stranger than to friends or family. People can cry, say they’re frightened, or just talk freely without worrying how a loved one will react.

It doesn’t always have to be by phone, webchat works well for people on the go, or those who find typing easier than talking. Either way, people leave with more information and more support than they had before they reached out.

How does it complement NHS cancer care?

We complement NHS care by giving people more time and space to process what’s happening. Someone might have a 10-minute appointment with their consultant, then call us afterwards to go through it in detail.

We can send them questions to ask their team or link them to local services like support groups or exercise programmes. We’re also here evenings and weekends, or when someone feels too anxious to wait.

Sometimes callers end the conversation lighter, even joking, when they started out in despair. That’s priceless.

It’s not about replacing NHS care, we couldn’t do what we do without them, and vice versa. But together, we make sure people feel supported holistically, not just medically.