The health outcomes of older Black adults with cancer are influenced by individual, familial, and contextual factors that highlight unexplored opportunities to better understand and support this population. Moreover, cancer is often just one of the significant health concerns facing Black families at any one time, adding complexity to caregiving within family systems. In light of this, three main questions guide this chapter. First, what are the experiences and needs of older Black adults across the cancer continuum, from cancer prevention through end-of-life? Second, how do Black families provide care for an older family member and cope with the challenges that cancer brings? Third, how might a family comorbidity lens, that recognizes the presence of concurrent morbidities within the family system, enhance our understanding of concepts and processes that contribute to the well-being of older Blacks with cancer and their family members? Existing research on family support after a cancer diagnosis overwhelmingly focuses on a single (i.e., primary) caregiver and spousal family caregivers. A broader focus on the role of family systems in providing cancer care highlights both the unique strengths and challenges facing Black families who provide care. In addition, a family comorbidity orientation underscores the need to better understand the nature and impact of concurrent health challenges within families and the possibility of new opportunities to address health issues interdependently. Ultimately, a family comorbidity perspective reflects the lived experiences of older Black adults and their families after a cancer diagnosis and has implications for future research and interventions.