Physicians’ role in the spiritual journey of patients with terminal cancer
Key Takeaways
Many patients with terminal cancer find that spirituality helps them come to terms with their diagnosis.
Healthcare professionals (HCPs) can help their patients through a terminal cancer diagnosis by explaining all aspects of their cancer and its care, as well as providing emotional support and understanding.
In discussing terminal cancer, clinicians should be open to learning about their patient’s spiritual beliefs and how these may affect their perceptions of their illness and preferred treatments. This may help patients better accept their situation.
For patients with a diagnosis of terminal cancer, spirituality may be helpful as they live through their final days.
Clinicians can play a role in their patients’ end-of-life journey.
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.[] 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.[]
Because such high percentages of people view themselves as spiritual or religious—or both—it is important for HCPs to be able to navigate conversations on these topics with patients, especially those with a terminal prognosis.
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.[]
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.[]
Another Cancer study showed better mental health in patients with higher religiosity.[]
Allen Sherman, PhD, was lead author of a Cancer study on social health.[] 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.”
It is in a spiritual patient’s best interest for an HCP to help facilitate their religious needs, whether that means introducing them to a hospital chaplain or lending them an ear.
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.”[]
"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. "
— Thomas R. McCormick, DMin., University of Washington Medicine
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.
What this means for you
Talking to a patient with terminal cancer about their spirituality could make them more comfortable discussing health concerns and treatment options, while also offering emotional support. Further, such conversations contribute to an additional level of understanding within the clinician-patient relationship. Spiritual and religious issues can be important to patients as they approach the end of life and can affect their social, mental, and physical well-being during this time.