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Health care providers will encounter bereaved individuals throughout their personal and professional lives.[1] Individual diversity, family and social networks, and micro- and macrocultural influences contribute to the way one experiences and expresses grief. The progression from advanced cancer to death is experienced in different ways by different people. Most people will experience common or normal grief and will, with time, adjust to the loss; others will experience more severe grief reactions such as prolonged or complicated grief and will benefit from treatment. Some may even find that the cancer experience, although it is difficult and trying, may lead to significant personal growth for the patient and others in the patient’s family and social network.

Multiple factors may influence how an individual or a social network adjusts to a death. How people grieve depends on the personality of the grieving individual and his or her relationship with the person who died. The following factors affect how a person will express grief externally and adjust to the loss internally:[2]

• The cancer experience.

• Manner of disease progression.

• Cultural and religious beliefs.

• Sociocultural structure in which the grieving process occurs.

• Coping skills.

• Psychiatric history.

• Availability of support systems.

• Socioeconomic status.

Even the sense of a relationship’s completeness can influence the grieving process.[2] The effect of grief on the patients themselves and on the loss of their future should also be considered by providers and patients’ social networks.

This summary first defines the constructs of grief, mourning, and bereavement. It then distinguishes the grief reactions of anticipatory grief, prolonged complicated grief, normal or common grief, models of normal grief, and complicated or prolonged grief. Psychosocial and pharmacological treatments are explained. The important developmental issues of children and grief are presented, and a section on cross-cultural responses to grief and mourning concludes the summary.

The following information combines theoretical and empirical reviews of the general literature on grief, bereavement, and mourning [3-6] and is not specific to loss via cancer. Where available, studies that have focused on cancer are emphasized.

In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.

PDQ (Physician Data Query) Cancer Information Summaries: The PDQ health professional cancer information summaries are part of the comprehensive, evidence-based, up-to-date cancer content made available as a public service of the NCI. The summaries are written by Editorial Boards of cancer experts and provide the strength of the evidence for specific interventions. The summaries are fully referenced with links to published literature.

PDQ (Physician Data Query) Cancer Information Summaries: The PDQ health professional cancer information summaries are part of the comprehensive, evidence-based, up-to-date cancer content made available as a public service of the NCI. The summaries are written by Editorial Boards of cancer experts and provide the strength of the evidence for specific interventions. The summaries are fully referenced with links to published literature.