Background Optimal matching theory posits that the effects of social support are enhanced when its provision is matched with need for support. We hypothesized that matching received social support with the needs of persons with cancer, and cancer survivors would be related to better psychosocial adjustment than a mismatched condition. Method In a cross‐sectional design, sample 1, consisting of 171 cancer patients, and sample 2, consisting of 118 cancer survivors, completed measures of emotional and instrumental received support, physical debilitation, and psychological distress. Results The optimal matching theory model was confirmed; those needing support (i.e., greater physical debilitation), who did not receive it, experienced more distress than those who needed support and received it. Patients in treatment benefited from the matching of need and provision for both emotional and instrumental support, whereas survivors only benefited from the matching of emotional support. Conclusions The results suggest that social support is contextualized by the degree of physical impairment and may be somewhat different for cancer patients in treatment compared with cancer survivors. The transition to cancer survivorship may involve a transformation in the need for as well as the type and amount of received social support. Copyright © 2015 John Wiley & Sons, Ltd.