title: The psychosocial impact of recurrence on cancer survivors and family members: a narrative review.
abstract: OBJECTIVE
  This paper is a report of a review undertaken to identify, critically analyse and synthesize the psychosocial experience of cancer recurrence for survivors and family members.
  
  
  BACKGROUND
  Recurrence of cancer is an event after which life changes for families. Individuals move from being short- or long-term survivors of cancer to being patients once more. Families move from a state of fear of recurrence to one of uncertainty and distress as a result of the new crisis.
  
  
  METHODS
  MEDLINE, CINAHL and CancerLit databases were searched for the period January 1980-2007. Reference lists of papers were conducted for relevant studies. The search terms recurrence, recurrent cancer, experience, survivor and family were searched for separately and in combination.
  
  
  METHODS
  A narrative review was conducted. Data were categorized in terms of issues during survivorship and concerns after recurrence.
  
  
  RESULTS
  Three main categories were identified that explained survivors' and families' experiences of recurrent cancer: (1) fear of recurrence during survivorship, (2) when cancer recurs: families facing new challenges and (3) distress because of recurrence.
  
  
  CONCLUSIONS
  Recurrence is a distressing experience for survivors and families because they have to face again psychosocial effects of cancer, such as uncertainty, distress and concerns about death. Care should not be addressed simply to survivors, but should include the general well-being of families beyond their survivorship and support to manage better psychosocial issues occurring when a member has a recurrence of cancer.
authors.affiliation: Department of Community Nursing and Maternal & Child Health Care, School of Nursing, University of Navarra, Spain. cgarvivar@unav.es
authors.forename: Cristina G
authors.initials: CG
authors.lastname: Vivar
authors.forename: Navidad
authors.initials: N
authors.lastname: Canga
authors.forename: Ana D
authors.initials: AD
authors.lastname: Canga
authors.forename: Maria
authors.initials: M
authors.lastname: Arantzamendi
mesh_terms: D000223:Adaptation, Psychological; D002986:Clinical Trials as Topic; D005190:Family / Q000523:psychology*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009369:Neoplasms / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*