Silence and cancer: why do families and patients fail to communicate?

Health Commun. 2003;15(4):415-29. doi: 10.1207/S15327027HC1504_03.


This study examined the phenomenon of avoidance of family communication about cancer. Thirty-seven Stage III or IV lung cancer patients and 40 caregivers, including 24 primary and 16 secondary caregivers, were interviewed; a total of 26 families were studied. The interviews were audiotaped and transcribed. Analysis of the interviews indicated that two thirds of the families (65%) experienced communication problems. The avoidance of family communication was associated with several underlying thought processes: avoidance of psychological distress; desire for "mutual protection;" and belief in positive thinking. Family communication was further hindered by the increasing difficulty of issues inherent to late-stage cancer. The adverse impact of communication avoidance and the implications of our findings are discussed.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Cancer Care Facilities / statistics & numerical data
  • Caregivers / psychology*
  • Communication*
  • Family Relations*
  • Female
  • Humans
  • Interpersonal Relations*
  • Interviews as Topic
  • Lung Neoplasms / classification
  • Lung Neoplasms / psychology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Ohio
  • Sick Role
  • Stress, Psychological / psychology