Cancer is a life threatening and hope inhibiting disease. Furthermore, as in the case of breast cancer and the concomitant loss of an intimate body part, it is an identity threatening disease. The disease, the mastectomy, as well as the treatment place high demands on the process of hope for the whole family. In various ways, the family is constantly busy constructing a hopeful story for the future. Hope develops from a conjunction of a rich variety of factors that consciously or unconsciously have an influence on the process of hope. For the Christian, faith is first and foremost anchored in God and his Word. Our hope grows, in various ways, when our own story becomes one with God’s Story of Hope. Many people with cancer experience spiritual growth, a transformation of faith narratives, and get to know God in a way that would not have been possible in any other conditions. However, hope is not only spiritual hope. Hope also grows in relationships in a social constructionist process. The woman who had undergone a mastectomy and experiences unconditional acceptance in various ways of support by family members and friends, can, as a result, construct a hopeful story for the future. Acceptance of the inevitable that is happening to her, as well as the consequential self-acceptance, helps her to establish a new identity. The ability to experience loss as only a small part of one’s self-identity is crucial for the process of emotional healing. During this process of healing, hope prospers. Positivism and hope are closely related and realism is always coupled with positivism. Hope is ingrained in reality. Positive, realistic people are able to make choices that will result in hope. In this freedom of choice lies the potential to transform a personal tragedy into a triumph. A viable system of belief with regard to the purpose of life of human existence, helps in creating a foundation of hope in a person’s life. The belief that a person’s existence is purposeful, despite the inevitable tragedies of life, equips the human being to live to the full, amidst tragedies. The return of a sense of humor is one of the most secure signs of a healthy recovery. Hope is stimulated within ourselves and others when we are able to laugh at ourselves and with others, amidst sad conditions. Reconstruction can be regarded as an aid in the process of growth of hope concerning the woman’s body image, providing her with feelings of balance and completeness, and enhancing her feeling of being a woman. Shared hope is one of the strongest sources of hope for people with cancer. To be able to talk to someone who had personally suffered from and outlived breast cancer has more value than merely taking note of the statistics of survivors. People suffering from cancer also experience oases of hope in things like a book that is significant to their situation, relationships, an unexpected meeting with a breast cancer survivor, or her work. Hope also becomes manifest in nature as a symbol of life and hope, in participation in research studies, in a reliable doctor. Even more hope will be established if all women have the privilege of having breast examinations performed at breast clinics where professional and sympathetic people can announce the diagnosis in cases where cancer is indeed diagnosed. Various treatment options can be discussed. Time can be made available to prepare the entire household and provide peace of mind for the children. / Thesis (PhD (Pastoral Family Therapy))--University of Pretoria, 2005. / Practical Theology / unrestricted