As the numbers of cancer survivors grow, community-based primary care physicians are playing a larger role in their care. The goal of this pilot study was to begin to identify the problems and challenges faced by primary care physicians who treat patients with cancer histories. A mail survey was undertaken of 141 community-based primary care physicians in the Southeastern US that addressed physician characteristics, numbers and types of cancer patients treated, problems faced by these patients and challenges physicians face when caring for these patients. These physicians reported that on average 10% of their primary care patients had a history of cancer. The most frequent types of cancers seen by these physicians were skin, breast and prostate cancer, but there was a broad range of other cancers seen in their practices. They reported that patients and family members’ fears and emotional problems were frequently encountered problems. Side-effects of cancer and its treatments and limited access to supportive care services were also reported as frequent problems for the cancer patients they treated. The most challenging aspect of caring for patients with cancer histories they reported was promoting cancer-related risk reduction behaviours. Primary care physicians play a large and important role in the care of cancer survivors. They encounter a number of problems when providing this care, including patient fears and access to supportive care. These findings may be used to guide educational and policy initiatives aimed at improving the care of cancer survivors.