Lung cancer and family-centered concerns

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Genetic and environmental interactions predispose certain groups to lung cancer, including families. Families or caregiving units experience the disease interdependently. We have previously evaluated the concerns and preferences of patients in addressing the lung cancer experience and cancer risks in their families. This qualitative study evaluates the concerns and preferences of family members and caregivers of patients with lung cancer in the lung cancer experience and familial cancer risks.


We held focus groups to discuss the format and timing of addressing these preferences and concerns. Qualitative data generated was analyzed using a grounded theory approach.


Five focus groups totaling 19 participants were conducted. Seven themes were identified: (1) journey to lung cancer diagnosis has core dimensions for patient and family, (2) importance of communication between patients, families, and providers, (3) challenges for caregivers and family, (4) mixed perceptions of lung cancer causation among relatives, (5) discussion of cancer risk with relatives has complex dynamics, (6) impact of diagnosis on family health behaviors and screening, (7) role of genetic counseling.


Family members of patients with lung cancer are interested in discussing risk factors, prevention, and diagnoses and also would like access to other supportive services do learn about and cope with some of the stresses and barriers they experience in the family lung cancer journey. The diagnosis represents a potential teachable moment with the opportunity to reduce the risk of LC development or improve early detection in LC patient’s family members.

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  1. 1.

    Illingworth N, Forbat L, Hubbard G, Kearney N (2010) The importance of relationships in the experience of cancer: a re-working of the policy ideal of the whole-systems approach. Eur J Oncol Nurs 14(1):23–28

  2. 2.

    Kalanithi P (2016) When breath becomes air(First edition.). New York: Random House

  3. 3.

    Bouazza YB, Chiairi I, el Kharbouchi O, de Backer L, Vanhoutte G, Janssens A, van Meerbeeck JP (2017) Patient-reported outcome measures (PROMs) in the management of lung cancer: a systematic review. Lung Cancer 113:140–151

  4. 4.

    Kotronoulas G, Kearney N, Maguire R, Harrow A, di Domenico D, Croy S, MacGillivray S (2014) What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. J Clin Oncol 32(14):1480–1510

  5. 5.

    Mascaux C et al (2017) Personalised medicine for nonsmall cell lung cancer. Eur Respir Rev 26(146):170066

  6. 6.

    Van Ryn M et al (2011) Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue? Psycho-Oncology 20(1):44–52

  7. 7.

    Litzelman K et al (2016) How does caregiver well-being relate to perceived quality of care in patients with cancer? Exploring associations and pathways. J Clin Oncol 34(29):3554

  8. 8.

    Butler KM, et al. (2017) Association of smoking in the home with lung cancer worry, perceived risk, and synergistic risk. In Oncology nursing forum. NIH Public Access. 44(2):E55–E63

  9. 9.

    Shaffer KM, Jacobs JM, Nipp RD, Carr A, Jackson VA, Park ER, Pirl WF, el-Jawahri A, Gallagher ER, Greer JA, Temel JS (2017) Mental and physical health correlates among family caregivers of patients with newly-diagnosed incurable cancer: a hierarchical linear regression analysis. Support Care Cancer 25(3):965–971

  10. 10.

    Wittenberg E et al (2017) Cancer communication and family caregiver quality of life. Behav Sci 7(1):12

  11. 11.

    Hamann HA, Lee J, Schiller JH, Horn L, Cleeland CS, Manola J, Wagner LI, Chang VT, Fisch M (2010) Clinician perceptions of care difficulty and quality of life for lung cancer patients: results from the ECOG SOAPP study (E2Z02). J Clin Oncol 28(15_suppl):9102–9102

  12. 12.

    Grant M, et al. 2013 Family caregiver burden, skills preparedness, and quality of life in non-small-cell lung cancer. In Oncology nursing forum. 40(4):337-46

  13. 13.

    Hamann HA et al (2013) Clinician perceptions of care difficulty, quality of life, and symptom reports for lung cancer patients: an analysis from the symptom outcomes and practice patterns (SOAPP) study. J Thorac Oncol 8(12):1474–1483

  14. 14.

    Musolf AM et al (2017) Familial lung cancer: a brief history from the earliest work to the most recent studies. Genes 8(1):36

  15. 15.

    Schnoll RA, Wileyto EP, Leone FT, Langer C, Lackman R, Evans T (2013) Is a cancer diagnosis a teachable moment for the patient’s relative who smokes? Cancer Causes Control 24(7):1339–1346

  16. 16.

    Tammemagi MC, Schmidt H, Martel S, McWilliams A, Goffin JR, Johnston MR, Nicholas G, Tremblay A, Bhatia R, Liu G, Soghrati K, Yasufuku K, Hwang DM, Laberge F, Gingras M, Pasian S, Couture C, Mayo JR, Nasute Fauerbach PV, Atkar-Khattra S, Peacock SJ, Cressman S, Ionescu D, English JC, Finley RJ, Yee J, Puksa S, Stewart L, Tsai S, Haider E, Boylan C, Cutz JC, Manos D, Xu Z, Goss GD, Seely JM, Amjadi K, Sekhon HS, Burrowes P, MacEachern P, Urbanski S, Sin DD, Tan WC, Leighl NB, Shepherd FA, Evans WK, Tsao MS, Lam S (2017) Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study. The Lancet Oncol 18(11):1523–1531

  17. 17.

    Koca D, Oztop I, Yilmaz U (2013) Evaluation of changes in the attitudes and behaviors of relatives of lung cancer patients toward cancer prevention and screening. Indian J Cancer 50(3):233

  18. 18.

    Jacobson FL et al (2012) Development of the American Association for Thoracic Surgery guidelines for low-dose computed tomography scans to screen for lung cancer in North America: recommendations of the American Association for Thoracic Surgery Task Force for Lung Cancer Screening and Surveillance. J Thorac Cardiovasc Surg 144(1):25–32

  19. 19.

    Zlot A et al (2012) The effect of chronic disease family history on healthcare provider practice and patient behavior among Oregonians. Public Health Genomics 15(3–4):189–200

  20. 20.

    Prichard I, Lee A, Hutchinson AD, Wilson C (2015) Familial risk for lifestyle-related chronic diseases: can family health history be used as a motivational tool to promote health behaviour in young adults? Health Promot J Australia 26(2):122–128

  21. 21.

    Feliciano J et al (2018) Lung cancer and family-centered patient concerns. Support Care Cancer:1–7

  22. 22.

    Strauss A, Corbin J (1994) Grounded theory methodology. Handbook of qualitative research 17:273–285

  23. 23.

    Diefenbach M et al (2009) Cancer and patient–physician communication. J Health Commun 14(1):57–65

  24. 24.

    Mazor KM et al (2013) Assessing patient-centered communication in cancer care: stakeholder perspectives. J Oncol Pract (9, 5):186–193

  25. 25.

    Gray DJP et al (2018) Continuity of care with doctors—a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open 8(6):021161

  26. 26.

    Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, Werner C, Gerger H (2017) Trust in the health care professional and health outcome: a meta-analysis. PLoS One 12(2):0170988

  27. 27.

    Hann KE et al (2017) Awareness, knowledge, perceptions, and attitudes towards genetic testing for cancer risk among ethnic minority groups: a systematic review. BMC Public Health 17(1):503

  28. 28.

    Patterson F, Wileyto EP, Segal J, Kurz J, Glanz K, Hanlon A (2010) Intention to quit smoking: role of personal and family member cancer diagnosis. Health Educ Res 25(5):792–802

  29. 29.

    Wells M et al (2017) Barriers and facilitators to smoking cessation in a cancer context: a qualitative study of patient, family and professional views. BMC Cancer 17(1):348

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The authors would like to offer a special thank you to the staff and patients who have helped to make this project possible.

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Correspondence to Josephine Feliciano.

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Feliciano, J., Chang, A., Venkatraman, D. et al. Lung cancer and family-centered concerns. Support Care Cancer 28, 497–505 (2020) doi:10.1007/s00520-019-04839-5

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  • Family
  • Lung cancer
  • Focus groups