Fifteen lung cancer patients and their spouses were interviewed in order to determine the effects of the diagnosis of lung cancer on family relationships. The major areas of investigation were: 1) the immediate impact of the diagnosis of lung cancer, 2) changes in family relationships since the diagnosis of illness, 3) intrapsychic changes since the diagnosis of the illness, and 4) changes in relationships outside the nuclear family since the diagnosis. The salient findings were: 1) most spouses reported not sharing their fears with the patients and talking less often to the patients than their mates reported; 2) nine out of 15 couples reported a discrepancy in the degree of closeness perceived in the marital relationship; 3) more spouses than patients reported signs of stress and feeling alone; and 4) seven of the 15 couples reported difficulty or disappointment with others outside the nuclear family. These findings suggest that the physical and emotional well being of the cancer patient and of his or her family may be markedly affected by the alert and responsive actions of the nurse.