Spirituality includes the search for ultimate meaning and purpose in life. Each person has his or her own beliefs and experiences. Expressions of spirituality include music, art, nature and other religious, philosophical, or supernatural beliefs. There are also spiritual aspects to many relationships people have. At life’s crossroads, birth, deaths, marriages, or serious illness, we are reminded of just how spiritual life is and how important it is to attend to our own sense of meaning. Many individuals may turn to their spirituality to help them deal with the feelings, questions, or worries that come up when they have cancer. Although there are no easy answers, spirituality is one way to come to peace, and help find hope and meaning in the midst of suffering. Spiritual concerns are those feelings of discomfort arising from the cognitive dissonance between one’s own beliefs about life and situation in which one finds oneself.

How do people describe their spiritual concerns/distress?

Spiritual distress can take the form of fears that one is being punished; of anger at oneself or at God for having cancer; closing oneself off from loved ones out of a fear of hurting them or not wishing to burden them.

What causes spiritual concerns?

Having spiritual concerns is normal when you have a serious illness, like cancer, and they can happen for a variety of reasons. When people have a serious illness, they may feel uncertain, confused, helpless, or angry about their future. They may ask, “Why me?” “Why now?” “Why cancer?” “What’s going to happen to me?” “Why is God doing this to me?” Answers to these questions of spirituality may not come easily or quickly.

How do individuals cope with spiritual concerns?

Everyone has the capacity for reaching a deeper sense of spiritual well being when dealing with the vulnerability of an illness like cancer.

Spiritual concerns are different for each individual. Here are some things to consider when dealing with spiritual concerns.

• Do I have spiritual beliefs that help me cope with stress or illness?
  • What gives me hope, peace or my life meaning?
• Are spiritual beliefs important to me?
  • Do they influence how I think about my health and illness?
  • Do they influence my healthcare decisions?
• Do I belong to a spiritual community (church, temple, mosque or other group)?
  • Am I happy there?
  • Do I need to do more with the community?
    • Attend services more regularly?
    • Go on a retreat?
• Do I need to search for another community?
• If I don’t have a community, would it help me if I found one?
  • Explore different religious groups if you do not have a regular group to meet with.
• What should be my action plan?
  • What changes do I need to make?
  • Are there spiritual practices I want to develop?
    • Try meditation or prayer.
    • Try yoga or guided imagery.
    • Spend time in nature.
    • Write in a journal every day.
  • Would it help for me to talk with a spiritual advisor, counselor, minister, pastor, priest, hospital chaplain, or rabbi?
  • Explore different readings at your library or a local bookstore in books on spirituality.
  • Talk to a counselor or therapist who deals with spirituality.
  • Talk to the hospital chaplain. They are trained to help people who have a serious illness and are sensitive to spiritual concerns.
  • Ask your family members and/or friends to pray with you and for you.
  • Join a support group for cancer patients.
  • Write letters to friends and/or family members.
• Take your questions seriously and keep in mind that many others also have them.

• Talking to family members and friends allows you the opportunity to:
  • make peace,
  • seek forgiveness,
  • share hopes and dreams,
  • share fears and anxiety.
• Ask family members or friends about their own experiences with serious illness, any spiritual concerns, and what they did to help deal with them.
• Talk to your family members and/or friends about your spiritual concerns.
• Ask family members and/or friends to go to spiritual community services with you.
• Ask family members and/or friends to help you find books to help you through your spiritual concerns.
• Ask family members and/or friends to recommend reading material that they find helpful.
• Ask your family members and/or friends to pray with you or for you.

• Be open and honest about your feelings with your family members.
• Try to describe what your concerns are.
• Tell family and/or friends how your spiritual concerns are affecting you.
• Ask your family members or friends what they think may be causing your spiritual concerns.
• Ask your family members or friends how your cancer and spiritual concerns are affecting him/her.
• Keep in mind this is a very difficult subject to bring up and to listen when a person is facing a serious illness. Many people misinterpret this type of discussion.

Many health care professionals will talk to you about your spiritual concerns. Many say that they wait for the person with cancer to bring the topic up in order to not say or do anything to hurt or offend. Many health care professionals want to provide holistic care by supporting human relationships, spirituality, and the meaning of life.

Here are some ideas for bringing up your spiritual concerns to your health care professionals:

• Ask them to help you find someone to talk to, such as a chaplain or therapist.
• Ask them to help you find a support group or other support resources.

• Call the chaplain or social worker at the hospital where you receive your care.
• Visit your local library or bookstore for books and readings.
• Call your priest, minister, rabbi, or other religious elders or leaders from your place of worship.

American Association of Pastoral Counselors
9504A Lee Highway
Fairfax, VA 22031-2303
Phone: 703-385-6967
http://www.aapc.org

National Cancer Institute
Cancer Information
http://www.nci.nih.gov/cancerinfo/support

Hospice Association of America
228 Seventh Street, SE
Washington, DC 20003
Phone: (202) 546-4759
Fax: (202) 547-9559
http://www.hospice-america.org

References

Halstead, M.T., & Hull, M. (2001). Struggling with paradoxes: the process of spiritual development in women with cancer. Oncology Nursing Forum, 28(10), 1534-44.

Puchalski, C.M. (2002). Spirituality and end-of-life care: a time for listening and caring. Journal of Palliative Medicine, 5(2), 289-94.

Tate, D.G., & Forchheimer, M. (2002). Quality of life, life satisfaction, and spirituality: comparing outcomes between rehabilitation and cancer patients. American Journal of Physical Medicine & Rehabilitation, 84(6), 400-10.

Meraviglia, M.G. (2002). Prayer in people with cancer. Cancer Nursing, 25(4), 326-31.