Cancer and the Family Life Cycle A Practitioner s Guide

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Cancer and the Family Life Cycle A Practitioner s Guide
1st Edition Theresa A. Veach Digital Instant Download
Author(s): Theresa A. Veach; Donald R. Nicholas; Marci A. Barton
ISBN(s): 9781134941780, 1134941781
Edition: 1
File Details: PDF, 13.19 MB
Year: 2002
Language: english
 CANCER AND
THE FAMILY LIFE CYCLE
CANCER AND
THE FAMILY
LIFE CYCLE
A Practitioner's Guide

Theresa A. Veach, Ph.D.

Donald R. Nicholas, Ph.D.
Marci A. Barton, Ph.D.
 USA Publishing Office: BRUNNER-ROUTLEDGE
A Member of the Taylor & Francis Group
29 West 35th Street
New York, NY 10001
Tel: (212) 216-7800
Fax: (212) 564-7854

Distribution Center: BRUNNER-ROUTLEDGE

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CANCER AND THE FAMILY LIFE CYCLE: A Practitioner's Guide

Copyright © 2002 Taylor & Francis. All rights reserved. Printed in the United States of
America. Except as permitted under the United States Copyright Act of 1976, no part of
this publication may be reproduced or distributed in any form or by any means, or stored
in a database or retrieval system, without the prior written permission of the publisher.

1234567890

Printed by Edwards Brothers, Lillington, NC, 2002.

Cover design by Nancy Abbott.

A CIP catalog record for this book is available from the British Library.
The paper in this publication meets the requirements of the ANSI Standard
Z39.48-1984 (Permanence of Paper).

Library of Congress Cataloging-in-Publication Data is available from the publisher.

ISBN 1-58391-016-6
 This book is dedicated
to Elaine Nicholas Underhill,
August 18, 1943, to January 3, 1996
 CONTENTS

Preface xi
Acknowledgments xiii

Chapter 1 Introduction and Purpose

Cancer Basics
The Clinical Course of Cancer and Its Phases 4
Cancer and the Family System 11
Cancer and the Family Life Cycle 17
Summary 23
References 26

Chapter 2 Diagnosis and the Family Life Cycle: The Existential Crisis 29
Diagnosis and Psychosocial Considerations: The Existential Crisis 34
The Six Family Life Cycles during the Diagnostic Phase:
The Importance of Assessment 41
The Single Young Adult during the Diagnostic Phase 41
The Newly Forming Couple during the Diagnostic Phase 51
The Family with Young Children during the Diagnostic Phase 58
The Family with Adolescents during the Diagnostic Phase 64
The Family Launching Children during the Diagnostic Phase 69
The Family in Later Life during the Diagnostic Phase 75
Summary 79
References 80

Chapter 3 Treatment and the Family Life Cycle: The Long Haul 83
Medical Variables during the Treatment Phase 83
Treatment and Psychosocial Considerations: The Long Haul 88
The Six Family Life Cycles during the Treatment Phase:
The Importance of Flexibility 94
The Single Young Adult during Treatment 95
The Newly Forming Couple during Treatment 98
The Family with Young Children during Treatment 102
The Family with Adolescents during Treatment 107
The Family Launching Children during Treatment 109

VII
VIII Contents

The Family in Later Life during Treatment 113

Summary 115
References 115

Chapter 4 Rehabilitation and the Family Life Cycle: Living in Limbo 118
Medical Variables during the Rehabilitation Phase 118
Rehabilitation and Psychosocial Considerations: Living in Limbo 128
The Six Family Life Cycles during the Rehabilitation Phase:
The Importance of Transformation and Reorganization 135
The Single Young Adult during Rehabilitation 135
The Newly Forming Couple during Rehabilitation 137
The Family with Young Children during Rehabilitation 139
The Family with Adolescents during Rehabilitation 142
The Family Launching Children during Rehabilitation 145
The Family in Later Life during Rehabilitation 147
Summary 149
References 149

Chapter 5 Survival and the Family Life Cycle:

Living under the Sword of Damocles 152
Definition and Meaning of Survival 152
Survivorship and Psychosocial Considerations:
Living under the Sword of Damocles 155
The Six Family Life Cycles during Survivorship:
The Importance of Rituals 159
The Single Young Adult during Survivorship 160
The Newly Forming Couple during Survivorship 161
The Family with Young Children during Survivorship 166
The Family with Adolescents during Survivorship 167
The Family Launching Children during Survivorship 169
The Family in Later Life and Survivorship 170
Summary 171
References 172

Chapter 6 Recurrence/Advanced Disease and the Family Life Cycle:

Life in the Balance 174
Medical Variables during the Recurrent Phase 174
Recurrence/ Advanced Disease and Psychosocial Considerations:
Life in the Balance 179
The Six Family Life Cycles during the Recurrence Phase:
The Importance of Balance 185
The Single Young Adult during Recurrence 185
The Newly Forming Couple during Recurrence 190
The Family with Young Children during Recurrence 193
The Family with Adolescents during Recurrence 197
 Contents IX

The Family Launching Children during Recurrence 199

The Family in Later Life during Recurrence 202
Summary 204
References 204

Chapter 7 Terminal Illness and the Family Life Cycle: In a Strange Land 208
Medical Variables during the Terminal Illness Phase 208
Passive Euthanasia: Withholding and Withdrawing Treatment 213
Terminal Illness and Psychosocial Considerations: In a Strange Land 215
The Six Family Life Cycles during the Terminal Illness Phase:
The Importance of Caregiving and Grieving 223
The Single Young Adult during Terminal Illness 224
The Newly Forming Couple during Terminal Illness 229
The Family with Young Children during Terminal Illness 231
The Family with Adolescents during Terminal Illness 233
The Family Launching Children during Terminal Illness 235
The Family in Later Life during Terminal Illness 237
Summary 238
References 239

Index 243
 PREFACE

It is 4:00 p.m. on a busy Friday afternoon. Tired after a full week, I receive a
psychooncology consult for yet another family recently diagnosed with cancer. I
start to think defeating thoughts about my work in the mental health field: What
can I possibly say to help this family? What can I do to make things better for them? How are
they going to respond to me, a total stranger, when I approach them about this life threatening
illness? I feel like an intruder on most sensitive and private ground.
We understand that this book, Cancer and the Family Life Cycle: A Practitioner's Guide,
cannot replace genuine human compassion, empathy, and superior listening skills,
but it does provide a conceptual "road map" for helping patients and their families
adapt to one of the most ubiquitous of life threatening illnesses, cancer.
Cancer affects more than 30% of the individuals in Western societies alone. From
a broader perspective, not only does cancer have an impact on the individual pa-
tient, but also on the entire family system. It has been estimated that three out of
four families will suffer from some form of cancer during the course of a lifetime
(American Cancer Society [ACS], 1998). Cancer can thus be regarded as a "disease
of the family system." This book integrates the current literature on families of
adult cancer patients and places it within the rich context of family systems theory
to provide a guide for working with cancer patients and their families.
Increasing numbers of professionals from many specialties are being called upon
to help families adapt to the immediate and long-term effects of cancer. Due to
advances in cancer treatment, the focus of practice and research has shifted from
one of coping with loss and bereavement to one of adapting to prolonged life with
cancer. Rather than concentrating solely on quantity of life concerns, quality of life
now has become important. Thus, more and more families are in need of therapeu-
tic assistance in coping with long-term treatment regimens, treatment side effects,
cancer rehabilitation, and survival concerns. The growing subspecialty of
psychooncology is addressing these needs via empirical research and clinical ac-
counts of family adaptation to cancer.
This book is an integration of much of the current psychosocial literature on
families of adult cancer patients. It has been written to assist psychologists, mar-
riage and family therapists, counselors, social workers, clergy, oncology nurses,
and all other professionals who are helping to facilitate family adaptation to can-
cer. This book is a synthesis of two broad frameworks: the clinical course of cancer
(i.e., diagnosis, treatment, rehabilitation, survivorship, recurrence, and the termi-
nal phase) and the family life cycle (i.e., single young adults, newly forming couples,
families with young children, families with adolescents, families launching chil-

XI
XII Preface

dren, and families in later life). The six phases of the clinical course of cancer and
their specific effects on each of the six family life cycles are highlighted in the
individual chapters.
The first section of each chapter focuses on specific medical variables. For ex-
ample, during the diagnostic phase, pertinent medical information includes (l)
symptoms and "lagtime," (2) the diagnostic workup, (3) cancer severity continua,
and (4) treatment decision making. The second section of each chapter is an inte-
gration of the psychosocial literature on families of adult cancer patients. Again,
this information is specific to each phase of the clinical course of cancer. For ex-
ample, during the diagnostic phase, specific psychosocial information includes (l)
the existential crisis, (2) the patient's search for meaning, (3) predictors of indi-
vidual distress during the existential crisis, (4) predictors of distress in the family
system, and (5) family assessment during the diagnostic phase. The final section of
each chapter constitutes the application of both the medical variables and the psy-
chosocial information via the use of case studies. Suggestions for therapeutic inter-
ventions are included.
Six families are followed as they progress from the existential crisis of the diag-
nostic phase, through the daily long haul of the treatment phase, and into the
rehabilitation and survivorship phases of the illness. Other families from each of
the six life cycles are introduced in the last chapter. These case studies illustrate
family systems as they face cancer recurrence, advancing disease, cancer metasta-
sis, and the terminal phase of the illness.
This book can be used as both a general guide for professionals working with
multiple families throughout all phases of the clinical course of cancer, or it can be
used as a quick reference for professionals working with a particular family dur-
ing a specific phase of the clinical course of cancer. For example, when working
with a cancer patient who has adolescent children and is currently undergoing
cancer treatment, chapter three, "Treatment and the Family Life Cycle: The Long
Haul," is the most pertinent chapter. Thus, much of the current literature regarding
families of adult cancer patients has been organized to provide a framework for
facilitating healthier family adaptation to cancer. It is hoped that by organizing the
literature and by providing a solid theoretical foundation, increased therapeutic
assistance, comfort, and care can be given to families in any life cycle, during any
phase of the clinical course of cancer.

D Reference
American Cancer Society (ACS). ( 1998). Cancer Facts and Figures-1998. New York: Author.
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 Criminology - Field Notes
Summer 2023 - Department

Prepared by: Researcher Jones

Date: August 12, 2025

Lesson 1: Interdisciplinary approaches

Learning Objective 1: Best practices and recommendations
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Learning Objective 2: Literature review and discussion
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 3: Case studies and real-world applications
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 4: Fundamental concepts and principles
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Learning Objective 5: Historical development and evolution
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 5: Diagram/Chart/Graph]
Note: Literature review and discussion
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 6: Diagram/Chart/Graph]
Definition: Ethical considerations and implications
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 7: Research findings and conclusions
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Problem-solving strategies and techniques
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 9: Ethical considerations and implications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Results 2: Statistical analysis and interpretation
Important: Fundamental concepts and principles
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Theoretical framework and methodology
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Best practices and recommendations
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Assessment criteria and rubrics
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Learning outcomes and objectives
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Study tips and learning strategies
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Key terms and definitions
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Literature review and discussion
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Research findings and conclusions
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 19: Fundamental concepts and principles
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Review 3: Best practices and recommendations
Practice Problem 20: Interdisciplinary approaches
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 21: Diagram/Chart/Graph]
Remember: Experimental procedures and results
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Key terms and definitions
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 23: Study tips and learning strategies
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 24: Assessment criteria and rubrics
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Remember: Interdisciplinary approaches
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 26: Ethical considerations and implications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Problem-solving strategies and techniques
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Problem-solving strategies and techniques
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 29: Fundamental concepts and principles
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Background 4: Critical analysis and evaluation
Definition: Research findings and conclusions
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Problem-solving strategies and techniques
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 32: Learning outcomes and objectives
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Experimental procedures and results
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 34: Comparative analysis and synthesis
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Case studies and real-world applications
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 36: Diagram/Chart/Graph]
Definition: Literature review and discussion
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 37: Theoretical framework and methodology
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Important: Study tips and learning strategies
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Learning outcomes and objectives
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Appendix 5: Learning outcomes and objectives
Example 40: Case studies and real-world applications
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 41: Diagram/Chart/Graph]
Note: Study tips and learning strategies
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 42: Research findings and conclusions
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Ethical considerations and implications
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Key terms and definitions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 45: Diagram/Chart/Graph]
Note: Practical applications and examples
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Comparative analysis and synthesis
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Assessment criteria and rubrics
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Comparative analysis and synthesis
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 49: Diagram/Chart/Graph]
Definition: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Exercise 6: Learning outcomes and objectives
Practice Problem 50: Theoretical framework and methodology
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Practical applications and examples
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Statistical analysis and interpretation
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Literature review and discussion
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 54: Comparative analysis and synthesis
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Theoretical framework and methodology
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 56: Current trends and future directions
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Learning outcomes and objectives
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Learning outcomes and objectives
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 59: Diagram/Chart/Graph]
Example 59: Fundamental concepts and principles
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Appendix 7: Practical applications and examples
Practice Problem 60: Case studies and real-world applications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
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