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Due to advances in detection and treatment, many more children survive childhood cancer in the 21st century compared with previous generations. How to best meet the needs of these survivors is a goal shared by many health care professionals. One area of complexity, however, involves the affective/emotional functioning of children who have experienced a cancer diagnosis. Although counterintuitive, a robust psychological literature has documented that the depression rate in childhood cancer patients tends to be equivalent or lower than the rate found in healthy peers. While various theoretical models have been offered that attempt to explain this phenomena, inadequate measurement remains one possible explanation for this anomaly. That is, mainstream self-report measures may not be sensitive enough to pick up on affective/emotional disturbance that truly exists. The present article is a focused case study examination of the assessment and treatment of affective/emotional disturbance in one childhood cancer patient. Of significance, actuarial projective assessment and parent report data indicated the presence of emotional disturbance, while self-report data did not. The mental health profession’s overreliance on self-report data is theoretically discussed, and both assessment and treatment recommendations are offered to mental health professionals who work with this growing segment of the population.