We tell patients that though they are the ones with the actual diagnosis of breast cancer, everyone who loves them and is involved with them intimately is also experiencing this disease and its treatment.

Studies that have examined the impact of a cancer diagnosis on patients' loved ones confirm that this impact is significant. The studies identified four key issues faced by family members and caregivers:

1. Family members are substantially distressed when a relative has cancer. (Remember your mother's reaction when you had to tell her you were diagnosed? She was probably devastated.)

2. Family members do not know, understand, or respond supportively to the expressed thoughts or feelings of other family members about the cancer diagnosis. (Were you angry with your sister for not being as distressed as you were with the news that your baby sister was just diagnosed?)

3. Families try to cope with both the impact of the cancer and the tension in the family caused by cancer. ("No one picked up the children from school, dinner is late, the phone is ringing, and I just had chemo and don't feel like doing anything but lying down in a quiet room.")

4. Family members struggle to fulfill their core functions when one of them is a long-term survivor. ("I feel like I don't have time to be a parent. I'm too busy washing clothes and running errands to be both mother and father while my wife is ill from chemo.")

Interest is growing not just in acknowledging these family issues but also in doing something about them by providing support to family members and teaching them coping skills that can help the entire family through this ordeal.

There's also a need to look at these family dynamics over the long term, because when a woman finishes breast cancer treatment, her life and that of her family will not necessarily return to normal. This is a life-altering experience for her, and most likely for others around her, too. She also could be dealing with side effects of treatment for many years.

If you or a family member is asked to participate in research studies related to these issues, I hope you'll consider saying yes so that we can better understand how to help women and their families deal with a diagnosis of breast cancer. And if you know someone whose loved one is battling breast cancer, think of how you can lend a hand and support the entire family.