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Any expression of suicidal ideation in cancer care warrants structured assessment of risk and protective factors. Using a validated tool (e.g., Columbia-Suicide Severity Rating Scale) helps stratify ideation, intent, plan, and means. Immediate actions include developing a safety plan (warning signs, coping strategies, crisis contacts), restricting access to lethal means (medications, firearms), and arranging urgent mental-health evaluation—same day if moderate risk, emergently if high risk or intent is present. Engage supportive others with the patient’s permission; ensure 24/7 crisis resources are provided. Pharmacotherapy alone without evaluation (Option C) is insufficient acutely. Reassurance and delay (Option A) risk harm. Involuntary hospitalization (Option D) is reserved for imminent danger when the patient refuses help; most can be managed collaboratively. APRNs should document the assessment, notify the oncology team, consider contributory factors (uncontrolled pain, delirium, depression), and address them in parallel. Regularly revisit safety, and coordinate with palliative care and psycho-oncology to integrate symptom control and counseling.