Abstract
Family members of a cancer patient should be recognized as "second-order patients," because the diagnosis of cancer in a family member presents a frightening crisis to the whole family and all of the family members react in their characteristic ways. Nevertheless, most of Japanese medical oncologists seem to take it for granted that the family would be available as an extended agent of patient care and the important cancer information is often varied, according to family members. Moreover, in trying to protect themselves and the patient, many families reduce the communication process and create a "conspiracy of silence," which has already been well documented in the past Western literature. There are no such family intervention programs in today's Japan that have any evidence to improve family functioning of cancer patients. In this article, we review the available literature referring to family issues in cancer care with a view to clarifying the central role of the family and developing a comprehensive approach to family intervention. Also, we refer to effective skills of communication with cancer patients and their family members.
