There is growing evidence that a cancer diagnosis profoundly affects not only the person with the disease, but also their spouse and the dyad formed by the couple. The quality of support within the relationship also plays a determining role in the couple’s adaptation to cancer. Limited knowledge exists on the support needs of couples dealing with cancer. Furthermore, limited data is available that would make it possible to determine the extent to which these couples perceive that their needs are met (or not) by the Quebec health and social services system. In order to improve support for these couples, it is necessary to have a better understanding of their needs, as well as the responses to these needs by oncology services. This article presents the results of a mixed descriptive study conducted among couples, professionals and managers in two administrative regions of Quebec. The purpose of this study is to draw a picture of the priority needs of couples affected by cancer and the services intended for them. The results indicate that couples experience a diversity of needs of a psychosocial nature but it is perceived that the health and social services system’s response to these needs is not as good as for needs of a medical nature. The results reveal the importance of achieving a better integration of couple-specific psychosocial services in the service offer. Finally, the knowledge resulting from this study provides indications for the implementation of services better adapted to these couples’ needs.