General Information About Spirituality
Spirituality and Quality of Life
Spiritual Assessment
Meeting the Patient's Spiritual and Religious Needs
Get More Information From NCI
Changes to This Summary (03/06/2009)
Questions or Comments About This Summary
About PDQ

General Information About Spirituality

Key Points for This Section

Religious and spiritual values are important to patients coping with cancer. Spirituality and religion may have different meanings. Serious illness, such as cancer, may cause spiritual distress.

Religious and spiritual values are important to patients coping with cancer.

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.

Spirituality and religion may have different meanings.

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. 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.

There is a growing understanding 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, not only for end-of-life issues but also during treatment. (See the PDQ summary on Last Days of Life ¹ for information on end-of-life issues.)

Serious illness, such as cancer, may cause spiritual distress.

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.

Spirituality and Quality of Life

Key Points for This Section

Spiritual and religious well-being may help improve quality of life. Spiritual distress may also affect health.

Spiritual and religious well-being may help improve quality of life.

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 also affect health.

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.

Spiritual Assessment

Key Points for This Section

A spiritual assessment may help the doctor understand how religious or spiritual beliefs will affect the way a patient copes with cancer. A spiritual assessment explores religious beliefs and spiritual practices.

A spiritual assessment may help the doctor understand how religious or spiritual beliefs will affect the way a patient copes with cancer.

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 explores religious beliefs and spiritual practices.

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 Last Days of Life ¹ 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.

Meeting the Patient's Spiritual and Religious Needs

Key Points for This Section

To help patients with spiritual needs during cancer care, medical staff will listen to the wishes of the patient. The health care team will help with a patient's spiritual needs when setting goals and planning treatment.

To help patients with spiritual needs during cancer care, medical staff will listen to the wishes of the patient.

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 will help with a patient's spiritual needs when setting goals and planning treatment.

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.

Get More Information From NCI

Call 1-800-4-CANCER

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 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Chat online

The NCI's LiveHelp® ² online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 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

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6116 Executive Boulevard, MSC8322

Bethesda, MD 20892-8322

Search the NCI Web site

The NCI Web site ³ 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 our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.

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.

Find Publications

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 ⁴. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Changes to This Summary (03/06/2009)

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.

This summary was completely reformatted and some content was added.

Questions or Comments About This Summary

If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form ⁵. We can respond only to email messages written in English.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ³. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

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 are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one method of treating symptoms 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. Some patients have symptoms caused by cancer treatment or by the cancer itself. During supportive care clinical trials, information is collected about how well new ways to treat symptoms of cancer work. The trials also study side effects of treatment and problems that come up during or after treatment. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients who have symptoms related to cancer treatment may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ⁶. Descriptions of the trials are available in health professional and patient versions. 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); TTY at 1-800-332-8615.

Glossary Terms

A chemical substance found in beer, wine, and liquor. Alcohol is also found in some medicines, mouthwashes, essential oils (scented liquid taken from plants), and household products.

Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.

In healthcare, a process used to learn about a patient’s condition. This may include a complete medical history, medical tests, a physical exam, a test of learning skills, tests to find out if the patient is able to carry out the tasks of daily living, a mental health evaluation, and a review of social support and community resources available to the patient.

The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A member of the clergy in charge of a chapel or who works with the military or with an institution, such as a hospital.

To adjust to new situations and overcome problems.

The beliefs, values, and behaviors that are shared within a group, such as a religious group or a nation. Culture includes language, customs, and beliefs about roles and relationships.

In religion, describes a group whose members are organized under a common name and set of rules and have common beliefs and practices.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

The process of identifying a disease, such as cancer, from its signs and symptoms.

Extreme mental or physical pain or suffering.

The use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Drug abuse may lead to social, physical, emotional, and job-related problems.

State of being separated from others. Isolation is sometimes used to prevent disease from spreading.

A type of meditation based on the concept of being “mindful,” or having increased awareness, of the present. It uses breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress.

A patient who visits a health care facility for diagnosis or treatment without spending the night. Sometimes called a day patient.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Having to do with the deeper questions of life and with a person’s basic beliefs, ideas, and attitudes.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Having to do with deep, often religious, feelings and beliefs, including a person’s sense of peace, purpose, connection to others, and beliefs about the meaning of life.

The act of taking one's own life on purpose.

A group of people with similar disease who meet to discuss how better to cope with their disease and treatment.

Treatment.

An ancient system of practices used to balance the mind and body through exercise, meditation (focusing thoughts), and control of breathing and emotions. Yoga is being studied as a way to relieve stress and treat sleep problems in cancer patients.