Beyond the Patient: Family-Level Consequences of Cancer on Quality of Life, Productivity, and Economic Stability

A Literature Review

Abstract

Background: Cancer imposes a substantial global health burden, with consequences extending beyond the individual patient to affect family members who serve as primary caregivers throughout the disease trajectory. Despite growing recognition of caregiver burden, the multidimensional impacts on family quality of life, productivity, and economic stability remain insufficiently addressed in clinical practice and health policy. Objective: This narrative review aims to synthesize current evidence on the impact of cancer on family caregivers, particularly regarding quality of life, psychological well-being, work productivity, and financial stability. Methods: A literature search was conducted using PubMed, ScienceDirect, Springer Nature, Oxford Academic, and Google Scholar for articles published between 2020 and 2026 in English or Indonesian. A combination of Boolean operators (AND, OR) was applied with keywords including cancer, family, caregiver, quality of life, productivity, and financial toxicity. Following title, abstract, and full-text screening, 24 studies met the inclusion criteria and were analyzed using a comparative-critical synthesis approach. Results: The synthesis revealed that caregiving burden is a major determinant of reduced family quality of life, particularly in physical, emotional, and social domains. Psychological distress including anxiety, depression, and fatigue served as a significant mediator between caregiving burden and reduced well-being. Financial toxicity resulting from treatment costs and loss of work productivity further exacerbated these effects, especially in low- and middle-income countries. Conversely, protective factors including family resilience, perceived social support, and high-quality interpersonal relationships were consistently associated with lower perceived burden and better quality of life. Conclusion: Cancer caregiving generates cascading consequences on family well-being, mediated by psychological distress and economic strain. A family-centered care approach that integrates routine caregiver screening, psychosocial support, resilience-building interventions, and financial protection policies is urgently needed to improve outcomes for both patients and their families.