Printed in Great Britain Families, Cancer and Dying

Cancer involves change in individuals and families. Family practitioners are in a unique position to meet the needs of families where cancer is present. By coordinating differing therapeutic interventions and developing therapeutic support within the community the physical, psychological, social and spiritual needs of those who are dying, and the needs of their families, can be met. This paper focuses on the management of termi-nal illness in the context of the family. It is inten-ded as a discussion document and as a description of the author's practice. Several important issues are raised. First is a consideration of who is a family member. Second is the consideration of critical junctures in the process of dying. Third is a discussion of the way in which community pro-fessionals can coordinate their practice. A feature of working with the terminally ill is that there are various individual and relational problems which have to be resolved and accom-modated. The family has to adapt to the process of losing a loved one, and then life continuing without that person. The overriding emphasis in this paper is on assisting families to use their own resources to accommodate change. However, they are helped in this by a network of com-munity support and professional expertise. A COMMUNITY APPROACH TO CANCER IN FAMILIES This approach attempts to integrate the physical, psychological, spiritual and social dimensions of a person's life. The concept of whole person med-icine is a part of general medical practice already,1 but the community approach offers beyond that, first, a way of working with people to encourage their own innate healing properties, and, secondly, the involvement of those persons with whom they live in the management of the process of dying. The focus of the work is on the quality of life for the patients and their family. Patients are regarded as active partners in healt