Spirituality in Cancer Care (PDQ®)
Topics in This Section
- General Information About Spirituality
- Spirituality and Quality of Life
- Spiritual Assessment
- Meeting the Patient's Spiritual and Religious Needs
- Current Clinical Trials
- Changes to This Summary (05/18/2015)
- About This PDQ Summary
- About PDQ
- Purpose of This Summary
- Reviewers and Updates
- Clinical Trial Information
- Permission to Use This Summary
- Contact Us
- Questions or Comments About This Summary
- Get More Information From NCI
Studies have shown that religious and spiritual values are important to Americans. Most American adults say that they believe in God and that their religious beliefs affect how they live their lives. However, people have different ideas about life after death, belief in miracles, and other religious beliefs. Such beliefs may be based on gender, education, and ethnic background.
Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping. Many caregivers also rely on spiritual coping. Each person may have different spiritual needs, depending on cultural and religious traditions. For some seriously ill patients, spiritual well-being may affect how much anxiety they feel about death. For others, it may affect what they decide about end-of-life treatments. Some patients and their family caregivers may want doctors to talk about spiritual concerns, but may feel unsure about how to bring up the subject.
Some studies show that doctors' support of spiritual well-being in very ill patients helps improve their quality of life. Health care providers who treat patients coping with cancer are looking at new ways to help them with religious and spiritual concerns. Doctors may ask patients which spiritual issues are important to them during treatment as well as near the end of life. When patients with advanced cancer receive spiritual support from the medical team, they may be more likely to choose hospice care and less aggressive treatment at the end of life. (See the PDQ summary on Planning the Transition to End-of-Life Care in Advanced Cancer for information on end-of-life issues.)
The terms spirituality and religion are often used in place of each other, but for many people they have different meanings. Religion may be defined as a specific set of beliefs and practices, usually within an organized group. Spirituality may be defined as an individual's sense of peace, purpose, and connection to others, and beliefs about the meaning of life. Spirituality may be found and expressed through an organized religion or in other ways. Patients may think of themselves as spiritual or religious or both.
Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.
This summary is about spirituality and religion in adults with cancer.
It is not known for sure how spirituality and religion are related to health. Some studies show that spiritual or religious beliefs and practices create a positive mental attitude that may help a patient feel better and improve the well-being of family caregivers. Spiritual and religious well-being may help improve health and quality of life in the following ways:
- Decrease anxiety, depression, anger, and discomfort.
- Decrease the sense of isolation (feeling alone) and the risk of suicide.
- Decrease alcohol and drug abuse.
- Lower blood pressure and the risk of heart disease.
- Help the patient adjust to the effects of cancer and its treatment.
- Increase the ability to enjoy life during cancer treatment.
- Give a feeling of personal growth as a result of living with cancer.
- Increase positive feelings, including:
- Hope and optimism.
- Freedom from regret.
- Satisfaction with life.
- A sense of inner peace.
Spiritual and religious well-being may also help a patient live longer.
Spiritual distress may make it harder for patients to cope with cancer and cancer treatment. Health care providers may encourage patients to meet with experienced spiritual or religious leaders to help deal with their spiritual issues. This may improve their health, quality of life, and ability to cope.
A spiritual assessment is a method or tool used by doctors to understand the role that religious and spiritual beliefs have in the patient's life. This may help the doctor understand how these beliefs affect the way the patient responds to the cancer diagnosis and decisions about cancer treatment. Some doctors or caregivers may wait for the patient to bring up spiritual concerns. Others may use an interview or a questionnaire.
A spiritual assessment may include questions about the following:
- Religious denomination, if any.
- Beliefs or philosophy of life.
- Important spiritual practices or rituals.
- Using spirituality or religion as a source of strength.
- Being part of a community of support.
- Using prayer or meditation.
- Loss of faith.
- Conflicts between spiritual or religious beliefs and cancer treatments.
- Ways that health care providers and caregivers may help with the patient's spiritual needs.
- Concerns about death and afterlife.
- Planning for the end of life. (See the PDQ summary on Planning the Transition to End-of-Life Care in Advanced Cancer for information on end-of-life planning).
The health care team may not ask about every issue the patient feels is important. Patients should bring up other spiritual or religious issues that they think may affect their cancer care.
Spirituality and religion are very personal issues. Patients should expect doctors and caregivers to respect their religious and spiritual beliefs and concerns. Patients with cancer who rely on spirituality to cope with the disease should be able to count on the health care team to give them support. This may include giving patients information about people or groups that can help with spiritual or religious needs. Most hospitals have chaplains, but not all outpatient settings do. Patients who do not want to discuss spirituality during cancer care should also be able to count on the health care team to respect their wishes.
Doctors and caregivers will try to respond to their patients' concerns, but may not take part in patients' religious practices or discuss specific religious beliefs.
The health care team may help with a patient's spiritual needs in the following ways:
- Suggest goals and options for care that honor the patient's spiritual and/or religious views.
- Support the patient's use of spiritual coping during the illness.
- Encourage the patient to speak with his/her religious or spiritual leader.
- Refer the patient to a hospital chaplain or support group that can help with spiritual issues during illness.
- Refer the patient to other therapies that have been shown to increase spiritual well-being. These include mindfulness relaxation, such as yoga or meditation, or creative arts programs, such as writing, drawing, or music therapy.
Check NCI’s list of cancer clinical trials for U.S. supportive and palliative care trials about spiritual concerns and spiritual therapy that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
This PDQ cancer information summary has current information about religious and spiritual coping in cancer care. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
The best way to cite this PDQ summary is:
National Cancer Institute: PDQ® Spirituality in Cancer Care. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/coping/day-to-day/faith-and-spirituality/spirituality-pdq. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site’s E-mail Us.
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s E-mail Us. We can respond only to email messages written in English.
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
- NCI Public Inquiries Office
- 9609 Medical Center Dr.
- Room 2E532 MSC 9760
- Bethesda, MD 20892-9760
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).