Background: In a lower-middle-income country like India, where resources for basic needs are limited, many patients struggle with unmet supportive care needs, leading to unrelieved symptoms, heightened distress, financial difficulties and poor quality of life throughout their cancer journey, and these aspects are largely overlooked. The study aims to identify the most prevalent unmet supportive care needs among cancer patients receiving chemotherapy and to compare these needs across levels of psychological distress and gender differences.

Methods: This cross-sectional study used a purposive sampling technique to assess supportive care needs among newly registered chemotherapy patients (N = 245) in the day care unit of a single centre. The study used the Supportive Care Needs Survey - Short Form and the National Comprehensive Cancer Network Distress Thermometer as tools.

Results: The highest-ranked needs were psychological aspects and health-related information. Female patients reported higher psychological needs (M = 26.28, SD = 9.08) and greater psychological distress compared with males (M = 20.15, SD = 8.83), with the difference being statistically significant (t(243) = −4.97, p < 0.001). In contrast, no significant gender differences were observed in health system and information needs (p = 0.358) or physical and daily living needs (p = 0.169).

Conclusion: Female patients experience greater psychological burden, supportive care needs, sexuality-related concerns and overall distress compared with male patients. Screening all new patients - especially high-risk groups such as female patients - and providing psychological support and patient-centred interventions are essential.