C
ancer affects not just those who have the
disease but also their caregivers and
families. Very few studies have exam-
ined the effects of long-term cancer sur-
vivorship on the family. Most studies
that have addressed this topic have focused on
breast cancer survivors and are limited to three
years after diagnosis. This article will examine the
strengths and limitations of the current literature on
families and cancer survivorship and suggest direc-
tions for future research that is needed in this field.
Family is defined broadly, to include biological or
blended families and opposite- and same-sex part-
nerships with or without children. Studies of chil-
dren diagnosed with cancer are excluded because
this topic constitutes a separate body of literature
and deserves its own analysis.
STUDIES ON FAMILIES WITH CANCER
Four generations of studies have focused on cancer
and its effects on families and caregivers. The first
generation of studies appeared as clinical papers
and included recommendations on how to minimize
disruption to the patient and spouse. However,
these studies lacked data and were based on clinical
impressions. The second generation of studies
emerged in the 1970s and 1980s and primarily
The Effects of Cancer Survivorship
on Families and Caregivers
More research is needed on long-term survivors.
By Frances Marcus Lewis, PhD, RN, FAAN
State of the Science
20
AJN t March 2006 t Vol. 106, No. 3 Supplement
http://www.nursingcenter.com/ajncancersurvivors
Frances Marcus Lewis is professor of family and child nursing and the
Elizabeth Sterling Soule Professor of Nursing and Health Promotion at
the University of Washington in Seattle. Contact author: fmlewis@
u.washington.edu. Research reported in this article was sponsored by
grants from the National Institutes of Health (National Center for
Nursing Research RO1-NR-01000; Division of Nursing RO1-NU-
01000; National Institute of Nursing Research RO1-NR-01435; and
the National Cancer Institute RO1-CA-55347); the American Cancer
Society; the intramural