For patients with a diagnosis of terminal cancer, spirituality may be helpful as they live through their final days.

In addition to providing medical information, physicians can discuss spirituality in the context of the patient’s treatment and care, while providing emotional support.

 

Majority of people are spiritual

A terminal cancer diagnosis leaves patients feeling a myriad of emotions. Many feel depressed, hopeless, scared, and worried about the future. Spirituality may help some patients feel more in control of their lives and give them a sense of security. It may also help them come to terms with their diagnosis.

There have been ongoing discussions on how to address religion and health from a healthcare professional’s (HCP’s) standpoint, reflecting the realization that a large number of people have spiritual and religious needs and beliefs.

According to a study done by the Pew Research Center, about 75% of US adults considered themselves spiritual.

Lipka M, Gecewicz C. More Americans now say they’re spiritual but not religious. Pew Research Center. September 6, 2017.

Somewhat fewer (54%) thought of themselves as religious, while 48% of adults in this study said they were both spiritual and religious.

 

An article published by Happier Human defined religious people as members of an institution who share the same set of beliefs, while spiritual people had a personal set of beliefs and practices.

Scott S. Spirituality vs religion: 4 differences you should consider. Happier Human. January 13, 2023.

 

 

Positive outcomes linked to spirituality

Research has linked patient spirituality with positive health outcomes such as increased mental and psychological health. An article in Fierce Healthcare discussed several studies on this topic that were published in Cancer, the journal of the American Cancer Society.

MacDonald l. How spirituality and religion impact patient outcomes. Fierce Healthcare. August 14, 2015.

 

One of the Cancer studies found that patients with cancer who view themselves as more religious or spiritual can function better on a day-to-day basis, feeling fewer of the symptoms from their illness and its treatment.

Jim HSL, Pustejovsky JE, Park CL, et al. Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer. 2015;121(21):3760–3768.

 

Another Cancer study showed better mental health in patients with higher religiosity.

Salsman JM, Pustejovsky JE, Jim HSL, et al. A meta-analytic approach to examining the correlation between religion/spirituality and mental health in cancer. Cancer. 2015;121(21): 3769–3778.

 

Allen Sherman, PhD, was lead author of a Cancer study on social health.

Sherman AC, Merluzzi TV, Pustejovsky JE, et al. A meta-analytic review of religious or spiritual involvement and social health among cancer patients. Cancer. 2015;121(21):3779–3788.

He told Fierce Healthcare, “When we took a closer look, we found that patients with stronger spiritual well-being, more benign images of God (such as perceptions of a benevolent rather than an angry or distant God), or stronger beliefs (such as convictions that a personal God can be called upon for assistance) reported better social health. In contrast, those who struggled with their faith fared more poorly.”

 

 

Having the conversation

Discussing a patient’s spirituality has previously been considered taboo, but for patients—especially those with terminal cancer—it could make a real difference to their quality of life.

In an article published by University of Washington Medicine, the late Thomas R. McCormick, DMin, who was a professor of medical ethics, offered insights on how to approach this conversation and take a patient’s “spiritual history.”

McCormick TR. Spirituality and medicine. University of Washington Medicine. April 2014.

 

As physicians (or as physicians-in-training), we have discovered that many of our patients have spiritual or religious beliefs that have a bearing on their perceptions of illness and their preferred modes of treatment.

McCormick suggested that if a patient is open to discussing their illness in terms of their beliefs, the physician can use follow-up questions to learn additional information about them. If they are not open to such discussions, it’s a signal to move on to another subject.

However, it can be valuable to ask if the patient’s family members have spiritual beliefs or practice a specific religion, to better anticipate any concerns that the family may have.

Having this conversation with patients can help them through the acceptance process while enabling the clinician to serve as an advocate for addressing their spiritual needs, which is a component of compassionate care.