This paper studies the interrelationships between the coping behaviours of cancer patients and perceived amount and adequacy of family support, as well as the issue of how these predict psychosocial adjustment to cancer. Based on questionnaire data from a sample of 169 patients with cancers of various sites, three questions were considered in detail: (1) How might cognitive and behavioural modes of coping with cancer affect perceptions of support provided by one's family in terms of the amount as well as adequacy of various supportive acts? (2) Are coping modes to be considered when explaining inter-individual differences in perceived support adequacy, or can these differences be reduced to differences in amount of support? (3) Can distinct patterns of family support and coping preferences be identified and, if so, how do these patterns differ in indicators of psychosocial adjustment to cancer? Results suggest that cognitive strategies of coping may be more effective in ‘mobilizing’ family support than behavioural strategies. Moreover, the perceived adequacy of various support modes proves to be influenced by cognitive coping preferences independent of perceived amount of support. Finally, results from cluster analyses point to a particular coping-support pattern identified as ‘highly risky’. This pattern is characterized by generalized support deficits, strong tendencies towards rumination, and weak tendencies towards minimizing disease-related threat. The findings are discussed from an interactional perspective on support processes and with regard to implications for psychological intervention in cancer patients.