The Disruption of the Consumer Life Cycle By Serious Illness: the Case of Breast Cancer

Marlys Mason, University of Utah
Teresa Pavia, University of Utah
ABSTRACT - Illness, death, divorce, or natural disaster may suddenly disrupt a person’s life and dramatically affect the consumer life cycle. An illness such as breast cancer with a high level of sustained uncertainty challenges a woman’s self-identity and alters her consumer behavior. We explore the effect breast cancer diagnosis and the subsequent stages of survival have on women’s consumption patterns. Our analysis suggests that at diagnosis women consume cancer-related goods, indulgences, and "new persona" possessions. As the threat of death subsides, women adopt more conservative consumption patterns, but demonstrate higher awareness of their consumption patterns and increased interest in doing over having.
[ to cite ]:
Marlys Mason and Teresa Pavia (1998) ,"The Disruption of the Consumer Life Cycle By Serious Illness: the Case of Breast Cancer", in NA - Advances in Consumer Research Volume 25, eds. Joseph W. Alba & J. Wesley Hutchinson, Provo, UT : Association for Consumer Research, Pages: 416-420.

Advances in Consumer Research Volume 25, 1998      Pages 416-420


Marlys Mason, University of Utah

Teresa Pavia, University of Utah


Illness, death, divorce, or natural disaster may suddenly disrupt a person’s life and dramatically affect the consumer life cycle. An illness such as breast cancer with a high level of sustained uncertainty challenges a woman’s self-identity and alters her consumer behavior. We explore the effect breast cancer diagnosis and the subsequent stages of survival have on women’s consumption patterns. Our analysis suggests that at diagnosis women consume cancer-related goods, indulgences, and "new persona" possessions. As the threat of death subsides, women adopt more conservative consumption patterns, but demonstrate higher awareness of their consumption patterns and increased interest in doing over having.

I hate having to change my life. I feel incredibly angry about this interruption.

- Lois Tschetter Hjelmstad

Disruption in the form of illness, death, divorce, or natural disaster can strike without warning at any point in one’s life. Its impact may be extreme and may alter an individual’s perception of self and their attachment to possessions. A person’s possessions including their body, attitude, personal relationships, and material goods represent their self-identity (Belk 1988). Furthermore, material possessions are an important means by which a person creates, maintains, and preserves who they are throughout their life cycle (Gentry, Baker, and Kraft 1995).

This concept of defining self through possessions has been widely studied in the consumer behavior literature (Joy et al. 1995; Richins 1994; Schultz Kleine, Kleine, and Allen 1995; Wallendorf and Arnould 1988). However, an area that has been less researched is the notion of disruption-defined as a major disturbance or interruption befalling one’s life. The focus of this paper is to explore the ways disruption from illness can occur in a person’s life, how it might affect their self-identity, and its potential influence on their consumption and behavioral patterns.


For several decades, the consumer life cycle concept has been used to characterize consumption patterns. In a traditional life cycle model (Wells and Gubar 1966), disruption’s impact can be seen through the death of a spouse. This disruption moves the individual into a new stage of the cycle with different consumption behaviors. A more recent version of the life cycle model (Murphy and Staples 1979) adds the disruption of divorce to create a new stage which further explains consumption changes. Other consumer behavior studies (Andreasen 1984; Schaninger and Danko 1993; Wilkes 1995) further suggest that disruptive events create changes in consumption patterns which justify separate stages within the life cycle. This research points to a connection between disruption and an alteration in consumer behavior.

Based on the consumer behavior literature, we classify disruption as three types: 1) external crises such as fire, earthquakes and other natural disasters; 2) personal crises such as divorce and job loss; and 3) life crises such as potentially terminal illness and death of closely related people. A recent study (Sayre and Horne 1996) explored the impact of fire on people’s consumption and the potential for them to re-define themselves through their new possessions. In this study, after the external crises, many people viewed specific possessions as less important and described objects with detachment. They purchased different items rather than replacing the cherished items that were lost. The study also revealed that some disaster victims changed their consumption patterns by making significant impulse purchases. These individuals justified the purchase as a reward for surviving the disruption to their life.

Another study (Fellerman and Debevec 1992) examined the disruption of a divorce on consumer behavior. After the divorce, they purchased different types of possessions and many bought fewer goods. Although some of this change may be attributed to lower household income, the research suggests that it is also linked with increased stress and coping behavior. In addition, some people exhibited more impulse shopping purchases, as did the disaster victims.

When a person is faced with the loss of health and life, their perception of self is challenged which may affect their attitude towards possessions. One study (Pavia 1993) looked at people with late stage HIV infection and its impact on self-identity. The dispossession of health and both involuntary and voluntary loss of possessions threatened this group’s perception of self.

Another study (Gentry, Baker, and Kraft 1995) explored the meaning of possessions to a person’s identity over their life time and when faced with the threat of death. They posit that a person’s material possessions help them to express who they are in relation to past experiences, to others, and to the future. When the threat of death srikes through illness, the person’s identity becomes very central and possessions take on new, important meanings. A person who is in the youth stage becomes present-time oriented rather than future-time oriented. Because of the threat of a shortened life, they seek possessions which provide instant gratification, rather than looking to the future. People in the mainstream years faced with death tended to place less importance on material possessions. What was important was the loss of one’s ability to generate possessions and to care for one’s family. In the elderly stage of life, a person experiences a return to the importance of material possessions. Tangible objects take on a deep meaning because they are a means by which to be remembered.


In recent years, the leading causes of death in the United States have been cardiovascular disease, cancer, and accidents (U.S. Bureau of the Census 1995). We have elected to explore the effect of serious illness on consumer behavior within the context of cancer for several reasons. Unlike automobile accidents, a diagnosis of cancer provides a window during which the person may be living with heightened uncertainty. Unlike cardiovascular disease, cancer strikes an alarming number of people who are still in the workforce, still forming households, and, at least prior to diagnosis, consuming in a fashion that reflects an expectation of many more years as a consumer.

Some cancers kill quickly. Some tumors are fairly benign and are rarely fatal. We sought a form of cancer that was not uniformly terminal but which was not benign. This type of illness leaves the person unclear as to his/her long term survival for a sustained period of time. Within this window of uncertainty, we hoped to be able to understand better the impact of disruption due to illness on consumer behavior.

In 1993, 183,000 cases of breast cancer were diagnosed in the United States. Deaths from breast cancer have been holding at around 44,000 people per year (U.S. Bureau of the Census 1995). An individual has a variable chance of survival depending on whether the tumor was detected early, the aggressiveness of the cancer, and the stage of the tumor. Most individuals diagnosed with breast cancer are women, approximately 98.5%. For our purposes, we have not explored the problem of the male breast cancer patient because the data is much more abundant for women.

These above statistics suggest that, each year, approximately 140,000 people are entered into the pool of people living with breast cancer or living with the threat of recurrent breast cancer. For women with aggressive tumors, recurrence will usually happen within five years; less aggressive tumors may recur as far as ten to fifteen years from the original diagnosis. If we use the five-year-to-recurrence figure, this suggests that at a minimum there are 700,000 people (mostly women) who are living with heightened uncertainty due to their diagnosis of breast cancer. During this time of uncertainty, they may appear "the same" on the surface, but changes may occur within. In addition, many people with breast cancer are able to maintain their source of revenue and the sense of self that the role brings. This continued revenue enables a woman to afford new possessions, which was not the case with many of the HIV infected individuals previously studied (Pavia 1993).

Our approach began with a review of the literature in psycho-social oncology and HIV, family dynamics, and consumer behavior. We then read the extant "life stories" of breast cancer survivors from books and the popular press. This literature provides a milieu within which the breast cancer patient may try to understand her disease and its meaning. We treated these texts as informants and looked for consistent themes. Then, we conducted open-ended, depth interviews with breast cancer survivors in order to supplement our analysis. Themes from the text re-eerged in the interviews. The publications helped us to understand the themes while the interviews provided vibrancy and personified the analysis.

Because we are relying heavily on publications, our analysis may be limited. Authors may tend to be financially well-off and relatively highly educated. Thus, we may not be getting a clear picture of the effect of breast cancer on lower income and lesser educated women.


The woman diagnosed with breast cancer will go through different stages which may significantly impact consumer behavior. Leigh (1994) discusses the following three stages that cancer survivors go through as: 1) acute, 2) extended, and 3) permanent.

The Acute Stage

This stage starts with a person’s diagnosis of cancer and continues through their initial courses of treatments. During this time, a person is focused on physical survival and medical treatment. Many women shed their passive medical information consumption behaviors and become aggressive in their pursuit of medical information and alternative therapies. They are assertive in selecting their physicians and participating in treatment decisions. Women use both advanced technologies (e.g., the Internet, NCI’s Cancerfax system) and face-to-face communication (e.g., support groups, cancer workshops) to gather the latest information.

By conducting this information search, not only are the women attempting to prevent the loss of their life, but they are helping to preserve a sense of self in a time of fear and uncertainty. As a woman becomes more aggressive in her battle with cancer and more assertive in treatment decisions, her self-identity may take on a fighter metaphor. One of tool that many women employ to gain control is nutrition / nutritional supplements.

But now, I feel, I am under serious attack, and when the Scud missiles are raining on your head, you don’t have time to get on the phone with your girlfriends and say you are terribly depressed. (Wadler 1992)

Informant 3: I was always a good shopper for vitamins, now I’m a serious shopper for vitamins. I buy, like, hundreds of dollars worth at a time, where I didn’t before...I’m more conscious of my eating, like broccoli is a really good cancer fighter.

Informant 5: I remember going to a store to buy bandages after the biopsy. I just became totally poverty stricken. I thought, I couldn’t even afford Band Aids... I mean here is someone who has multiple assets and resources and I was so freaked out. Once I got over the immediate fears and upset, then things were okay. I did spend about $12,000 the first year on alternative healthcare therapies, counseling therapies and alternative stuff.

Even in the earliest stage of cancer, one’s self-identity begins to change. To gain a sense of control and a sense of self, the woman may go shopping for possessions and make uncharacteristic, impulsive purchases. In the following passages, the women display this impulse buying behavior and an urgency for having possessions now rather than in the future:

...I am living on borrowed time. So, I borrow. I want the bedroom ceiling, which is shedding paint like agruesome skin disease, fixed and painted. I want the threadbare carpet on the stairs replaced. I want new casement windows and a roof that doesn’t leak. I want voice mail, a printer for my computer. I want the couch re-upholstered. I want all these things now. The virtue of waiting has evaporated. (Middlebrook 1996)

I take my expensive medical book back to Barnes & Noble and ask if I can get my $129 back...Then I hit Daffy’s, a discount clothing store, across the street. (Wadler 1992)

This impulsive buying behavior and sense of urgency for owning material possessions was also exhibited by the informants during the personal interviews. Similar to people facing death in their youth, these women take on a present-time oriented mind set, rather than future-time oriented. The sudden realization that death may be in the not-so-distant future drives them to seek instant gratification, rather than looking to their ambiguous future.

Informant 1: I remember going out, when I knew I would lose my hair, and just picking out all the scarves that I wanted and picking out a nice wig. That was the beginning of it. Rather than buy one scarf and one ugly wig, I bought a nice wig and some really pretty scarves. From there on it was a lot easier to want things, to look at things in stores and want them. Whereas, before [breast cancer] I would look at them but I wouldn’t let myself want them...I don’t know how many tomorrows I have so I'd better enjoy it today because all this 'save save save’ stuff is for the birds if I might not have a retirement to save for.

Informant 2: When I received my initial diagnosis, I was in the outpatient room and the surgeon had come to tell me that I had a malignancy. To help pass the time while I was in the waiting room I frivolously bought Vogue magazine-a total escape, fantasy. While I was looking through the magazine, I spotted a very flashy pair of Western cowboy boots. The first thought that came to mind after I was given the bad news was I’m going to buy those cowboy boots. So I contacted Vogue magazine for a buyer’s guide. The store in our area didn’t have them so I contacted the store in San Francisco and they shipped the boots out...That was my retail therapy beginnings.

A common stereotypical response to the threat of death is for a person to recognize that "the best things in life can’t be bought." However, running counterpoint to this view is the "eat, drink, and be merry" sentiment reflected above. The interesting feature of breast cancer is that these two aspects appear simultaneously in most women.

Extended Stage

A woman moves into this stage once her breast cancer has responded to the medical interventions. She has either finished her initial treatments or is receiving maintenance treatments in order to "control" her cancer. According to Leigh (1994), in this stage a woman is in limbo-somewhere between heaven and hell. The initial battle with cancer has been won, but what lies ahead is the unknown and fear that the cancer may recur. Furthermore, less contact with the health professionals who helped her win the first battle may now expose the woman to greater vulnerability and a sense of aloneness (Auchincloss 1995).

During this time, a woman must come to terms with the physical and emotional effects of the breast cancer disruption. In reassessing her perception of self, she may cling to possessions that offer comfort and provide a sense of safety. Familia possessions, such as one’s home and pets, may bring feelings of comfort and protection from the unknown.

I wanted to wrap my dear house around me like a blanket. How could I endure what the cancer therapies were doing to me without my house? (Middlebrook 1996)

[Laura] Evans [a survivor of a very advanced breast cancer tumor] said the new house in Ketchum is their "final" home...She needs to nest. "And besides, [the house] is right by the Ketchum cemetery," she said with a laugh. I cried and Buster [her new dog] licked the tears off my face. In the early years of my illness, I thought if anything happened to Buster, I could not go on. It sounds silly, but he became closely connected with my wellness (Forsberg 1996)

I thought, well, I want something warm and fuzzy that wags its tail when I walk in the door. I got a dog, I need some life in my house. (LaTour 1993)

Informant 1: I had decided I wanted a house. We lived in a condo...I was scared of spending the money. Again, it was well what if I die...then I thought, well, where else would I rather die? Not in the condo... I got the bird [a parrot] 10 months after my diagnosis. I’d been off chemo about 5 months...And he’s been great...he’s a sweetheart. He’s a real loving little favorite thing to do is to wake up next to my husband, in my bed, with my bird in the bedroom.

Women also use diversion to help cope with the breast cancer and escape the uncertainty of their future. One common diversionary stratagem was travel. By getting away, one may be able to temporarily "leave" the cancer behind and focus on living, rather than medical treatments and the unknown. In traveling, some women select peaceful destinations where they can relax. They want to get away so they rest and heal their bodies and minds. Other women want an adventurous vacation with high risk challenges which they can overcome. They may project the strength to face and conquer an obstacle such as climbing a mountain or running white water rapids onto their ability to face and defeat their cancer. Whichever type of vacation is chosen, the overall reason for traveling is to achieve some diversion as reflected by the women below:

After two mastectomies and six months of chemotherapy, I headed for Alaska in my simple van camper. I had painted my living motto of "Destination Unknown" on the van’s tire cover. The focus of my life has to be on here and now, and not wherever I end up. Now is all I really figures big in my diversionary tactics. (Cross 1997)

Doctors, hospitals, anesthesia, smells, and uncertainty. I’m counterphobic in an attempt to reassure myself. Last summer we climbed the Grand Teton; this summer we’re going river running. We just got back from mountain biking the Moab slickrock trail. My poor son finally asked why we couldn’t have "normal" vacations like other people. -Peggy Hatch (Hollister & Company 1996)

Informant 4: In January [my husband] had a conference in Washington DC and we just decided to go. We just thought we’re not going to worry about if it’s convenient or if we can really afford it. We’re just going to do it. And that’s a difference [from before diagnosis].

Putting structure back in one’s life was important in dealing with the disruption of cancer. They stived to re-gain their self-identity by returning to the things that will give them purpose and structure such as performing household duties, going back to work, starting a business, and fulfilling vital family roles.

Being at work was a great relief. It gave some shape and semblance of normalcy to my days...In the weeks following my diagnosis, it was the constant distraction and hubbub of the newsroom that had kept me sane. The worst days I endured were in the week following surgery when I was confined to the house. (Wittman 1993)

During the extended stage, another important theme for women was building and improving their relationships. Many women viewed their family and friends as more important than material possessions. They want to build better relationships so that if they did succumb to the cancer, their loved ones would have good memories of them. In doing this, they would pass on a part of themselves and could achieve some immortality. The women talk about working at their relationships and building memories in the following:

I’ve learned to use it [a new-found sketching skill] to develop an illuminated journal of my journeys and wilderness peak experiences. I applied it to developing a personal history sketch book...and now my as-yet-unborn grandchildren will have a novel way indeed to know their grandmother! (Cross 1997)

Informant 2: improved the relationship I had with my mom because my mom and I always struggled. So, I tried to improve that relationship and spend more time with my mother and my daughter, the three of us together. Those kind of memories I thought were important, time shared with other people.

Permanent Stage

Survivors enter the permanent or long-term stage of cancer survival when they make the gradual process of moving from surviving to thriving (Leigh 1994). They are in a state of "cure" or sustained remission and the chances of the cancer recurring is significantly diminished. However, the experience of breast cancer is never forgotten and may permanently impact their outlook on life. Some women still retain their desire to have possessions now rather than wait for the future, while other women put less emphasis on material possessions and more emphasis on doing over owning, on taking risks and enjoying life.

I’ve gone into a different plane, a different way of observing things, a different way of feeling about things, definitely a different sense of priorities, a different attitude to people, a loss of materialism. (Hilton 1993)

Informant 1: I have a new appreciation of things which is really strange because I’ve never been terribly materialistic. I’ll just want to go into a gallery and look at art, a furniture store and look at furniture, or a bird shop and lok at birds. Its just that I like things. I’m fascinated by things and I enjoy them. I like touching them. And it’s not that I didn’t before, it’s that I notice them more.

Women who enter the permanent survival stage frequently feel the need to give something back. They feel fortunate for surviving and for the people who have helped them and now they want to do something in return to help others. This desire to become involved may not be thought of as survivor guilt but rather as survivor responsibility (Sullivan 1996). Whether it be volunteering, educating through writing a book and public speaking, or being a breast cancer activist, the following women feel the need to reach out:

I submitted two thousand signatures, along with a sketch drawn by my good friend Martha Kelly of a woman looking over her right shoulder, a pink ribbon attached to the sketch. That sketch is now depicted on the official Breast Cancer Awareness Stamp, issued in June 1996. It happened! -Betty R. Pittman (Hollister & Co. 1996)

Informant 1: [I] was very active on Prodigy for a very long time. I think that long time was 3 1/2 years [from diagnosis], and by active I mean I would get on almost every night. [I would] get on the bulletin board and see who’s newly diagnosed, see who’s going through chemo, and give them all that support.

Informant 2: I want to volunteer. I want to help. I want to do something. Because so many people have been so kind and generous to me. I want to give something back. That’s a main reason that I’m now in the kind of profession that I’m in...


These women experienced many changes as they struggled to overcome breast cancer. Throughout the process their perception of self and consumer behavior changed. For those women who lived to reach the permanent stage of survival, some believe that their attitudes and self-identity have been permanently transformed. But a question remains as to how this perceived change will manifest over time. In our initial interviews we heard women shifting back to the consumer behaviors that they had prior to the disruption of breast cancer. When women pass the magic mark at which they have determined the cancer will not recur, they feel that they must 'get on’ with their life. They are no longer are driven by the possibility of recurrence and the fear of its uncertainty. Sometimes, women return to their previous consumer behavior such as putting things off for the future and denying themselves the things that they would like:

Infomant 1: The farther out I am [from the occurrence of breast cancer] I’m going back to my old habits where I’ll think twice about buying something again. I remember picking up a bar of scented soap, which is one of my weaknesses. I picked it up and it smelled so good. I looked at the price, it was $5.95 or $6.95 and I put it down. So, the old me is coming back...if I felt that I was actually going to die tomorrow I would have bought the bar of soap.

On the other hand, many women trace permanent changes in their behavior to their cancer diagnosis. The process of defining their self during this time has resulted in a higher level of self confidence for many women. A clearer sense of self may not be related to higher or lower consumption patterns per se, but may be related to greater satisfaction with and awareness of one’s consumer behavior. Our analysis suggests that at the moment of diagnosis the woman enters a new phase of her consumer life cycle. Many women spend more money at this time on cancer related goods, indulgences, and "new persona" possessions. As the immediacy of the threat of death subsides, women may adopt somewhat more conservative spending patterns, but seem to do this with a higher level of awareness and increased interest in doing over having.


Andreasen, Alan R. (1984), "Life Status Changes and Changes in Consumer Preferences and Satisfaction," Journal of Consumer Research, 11 (December), 784-794.

Auchincloss, Sarah (1995), "After Treatment," Cancer, 76 (November), 2117-2124.

Belk, Russell W. (1988), "Possessions and the Extended Self," Journal of Consumer Research, 15 (September), 139-168.

Cross, Laura (1997), "Diversionary Tactics for Coping With Cancer," Coping, (March/April), 10-11.

Fellerman, Ritha and Kathleen Debevec (1992), "Till Death Do We Part: Family Dissolution, Transition, and Consumer Behavior," in Advances in Consumer Research, Vol. 19, ed. John F. Sherry and Brian Sternthal, Provo, UT: Association for Consumer Research, 514-521.

Forsberg, Helen (1996), "The Climb of Her Life," Salt Lake City Tribune, (April 21), J1.

Gentry, Jim, Stacey Menzel Baker, and Frederic B. Kraft (1995), The Role of Possessions in creating, Maintaining, and Preserving One’s Identity: Variation Over the Life Course," in Advances in Consumer Research, Vol. 22, ed. Frank R. Kardes and Mita Sujan, Provo, UT: Association for Consumer Research, 413-418.

Hilton, B. Ann (1993), "Issues, Problems, and Challenges for Families Coping With Breast Cancer," Seminars in Oncology Nursing, Vol. 9 (May), 88-100.

Hollister & Company (1996), Our Gift of Love: Personal Stories of Breast Cancer Courage, Salt Lake City, UT: Gibbs-Smith Publisher.

Joy, Annamma, Michael Hui, Chankon Kim, and Michel Laroche (1995), "The Cultural Past in the Present: The Meaning of Home and Objects in the Homes of Working-Class Italian Immigrants in Montreal," in Marketing in a Multicultural World, ed. Janeen Arnold Costa and Gary Bamossy, Beverly Hills, CA: SAGE Publications, 145-179.

LaTour, Kthy (1993), The Breast Cancer Companion: From Diagnosis Through Treatment to Recovery: Everything You Need to Know for Every Step Along the Way, New York: Avon Books.

Leigh, Susan (1994), "Cancer Survivorship: A Consumer Movement," Seminars in Oncology, Vol. 21 (December), 783-786.

Middlebrook, Christina, (1996), Seeing the Crab: A Memoir of Dying, New York: BasicBooks.

Murphy, Patrick E. and William A. Staples (1979), "A Modernized Family Life Cycle," Journal of Consumer Research, 6 (June), 12-22.

Pavia, Teresa (1993), "Dispossession and Perceptions of Self in Late Stage HIV Infection," in Advances in Consumer Research, Vol. 20, ed. Leigh McAlister and Michael L. Rothschild, Provo, UT: Association for Consumer Research, 425-428.

Richins, Marsha L.(1994), "Special Possessions and the Expression of Material Values," Journal of Consumer Research, 21 (December), 522-533.

Sayre, Shay and David Horne (1996), "I Shop, Therefore I Am: The Role of Possessions for Self Definition," in Advances in Consumer Research, Vol. 23, ed. Kim P. Corfman and John G. Lynch Jr., Provo, UT: Association for Consumer Research, 323-328.

Schaninger, Charles M and William D. Danko (1993), "A Conceptual and Empirical Comparison of Alternative Household Life Cycle Models," Journal of Consumer Research, 19 (March), 580-594.

Schultz Kleine, Susan, Robert E. Kleine III, and Chris T. Allen (1995), "How Is a Possession Me or Not Me:? Characterizing Types and an Antecedent of Material Possession Attachment," Journal of Consumer Research, 22 (December), 327-343.

Stanley, Laura (1995), "Nature Cure," Travel Holiday, (May) 75-84.

Sullivan, Andrew (1996), "When Plagues End: Notes on the Twilight of an Epidemic," The New York Times Magazine, (November 10), Section B, 58-84.

Tschetter Hjelmstad, Lois (1993), Fine Black Lines: Reflections on Facing Cancer, Fear and Loneliness, Denver, CO: Mulberry Hill Press.

U.S. Bureau of the Census (1995), Statistical Abstract of the United States: 1995 (115th ed.), Washington, DC: U.S. Government Printing Office.

Wadler, Joyce (1992), My Breast: One Woman’s Cancer Story, Reading, MA: Addison Wesley Publishing.

Wallendorf, Melanie and Eric J. Arnould (1988), "My Favorite Things: A Cross-Cultural Inquiry into Object Attachment, Possessiveness, and Social Linkage," Journal of Consumer Research, 14 (March), 531-547.

Wells, William D. and George Gubar, "Life-Cycle Concepts in Marketing Research," Journal of Marketing Research, 3 (November), 355-63.

Wilkes, Robert E. (1995), "Household Life-Cycle Stages, Transitions, and Product Expenditures," Journal of Consumer Research, 22 (June), 27-42.

Wittman, Juliet (1993), Breast Cancer Journal: A Century of Petals, Golden, CO: Fulcrum Publishing.