A cancer diagnosis has a profound effect on the affected family, and some experience increased distress. As cancer incidence and survival rates rise, the number of people living with cancer will increase significantly, but little is known about the psycho-social impact upon the family of surviving cancer. 23 self-defined families (total number participants = 23) of cancer survivors (12 more than 3-years post-diagnosis) were recruited through Australian media and participated in a family interview covering long-term outcomes. Interviews were recorded, transcribed verbatim, then thematically-analysed. Participants noted various long-term outcomes of a cancer diagnosis within their families. Many reported challenges in managing changes in their working life and their geographical location. Some noted that the physical effects of cancer and treatment had changed what they could do as a family. For some, relationships with external family members were problematic due to disagreements regarding familial choices. Families spoke of difficulties in managing their own or others’ emotions, or in adjusting to changes of personality or priorities exhibited by the cancer patient. Finally, several families raised management of risk factors as problematic: views about the importance and consequences of behavioural change to manage risk varied, and could cause on-going tension. These (relatively high-functioning) families faced ongoing psycho-social challenges long after diagnosis. Cancer changed the present circumstances and the future possibilities resulting in changed behaviour, and related to issues around identity. This required, but did not always result in, adjustment within and without the family. Some families may benefit by psycho-therapeutic family-centred interventions to address these issues.