SPIRITUALITY AND CANCER CARE

Cancer has been found to be the second leading cause of death worldwide; about 1 in 6 deaths is due to cancer. Diagnosis and medical treatment for cancer is a cause of great physical and emotional pain and add stress to cancer patients’ lives. Spirituality and religious beliefs have been found, especially important for patients who suffer from severe illness and/or are facing life-threatening health problems.

Most adults agree in the existence of God and believe in Him and also agree that one’s religious beliefs affect the way one lives their lives. However, people have different ideas about life after death, belief in miracles, and other religious beliefs. Such beliefs may be based on one’s education, gender and ethnicity.

Spirituality is a person’s sense of purpose, peace and connection to others as well as their beliefs about the meaning of life. Finding meaning in life is a deeply personal process – and having cancer can affect the process of understanding the spiritual meaning of life .. what you think has sense in life and how you go about finding it. This is the reason as to why cancer may affect your thoughts on spirituality or how you go about practising and showing your spirituality.

SPIRITUALITY AND RELIGION

The terms spirituality and religion are often used interchangeably, but for many people they have different meanings. Religion may be defined as a specific set of principles, 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 consider themselves as spiritual or religious or both.

Spirituality is expressed by some through the means of an organized religion, which acts as a source of comfort and strength. Organized religion, which is usually on specific beliefs and practices, often provides a community of people who meet regularly, share similar experiences and provide support. The framework of beliefs that organized religion provides may help one address the questions that cancer brings to one’s life.

For others, spirituality is something separate from organized religion. They may find such spirituality either in nature, the goodness of other people around them or in the connections between everyone around them, be it living or non-living, animate or inanimate. They may meditate or practise rituals from different cultures or may find spiritual value in activities such as art, yoga, journaling, music or spending time in nature or with their loved ones.

One may find that cancer brings a new or deeper meaning to one’s spiritual beliefs and activities The sense of comfort may come from different sources. Praying, meditating, reading spiritual books or connecting with others in one’s spiritual support community brings within oneself, the feeling of positivity and also meets the spiritual requirement.

Cancer can also make one challenge beliefs that one has had for a long time. Sometimes, people living with cancer feel that their faith has let them down. One may struggle to understand why one has cancer or question one’s relationship with one’s God. If one’s faith has been very strong in the past, he or she may find this very upsetting.

Research has shown that people with a particular faith or spiritual belief often have hope, a sense of peace and a better quality of life.

THE EFFECT OF CANCER ON SPIRITUALITY

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 reprimanded by God for the acts that they may have done in the past or may experience a loss in faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.

A cancer diagnosis confronts one with the fact that he/she is vulnerable to disease and suffering, that one is mortal, and that one’s time is limited. When one is in good health, these realities often reside at the back of one’s mind; but when a serious illness strikes, they surge forward and challenge everyone related to the patient (including him/her). Such realities challenge us especially with the question of whether we are using our time wisely. This question is linked to what our time is for—to what our life is all about. Many see cancer as a wake-up call because such questions take on central and compelling importance.

Patients who are fighting for their lives can be strengthened and sustained by a clear vision of what they want to survive. Many people talk about surviving for the sake of their families, to meet certain life goals, and to fulfill certain inner potentials or strivings. Whatever a person’s answer, it reflects deeply held religious, spiritual, or philosophical beliefs about what is important and why.

As cancer patients reflect on their ultimate priorities, they often identify changes that they wish to make in themselves or their lives or in someone else’s life. This is often referred to as the “enlightenment” or the “gift” of cancer. Many patients have commented that they regret that it took a cancer diagnosis to “wake up” and have their attention captured, but they feel that many positive and overdue changes in themselves and their lives have resulted from it. In making these changes, these patients have found some positive meaning in their illness.

THE POSITIVE EFFECTS OF SPIRITUALITY

According to Florence Nightingale’s philosophy of care, spirituality is inherent in humans and is the deepest and strongest source of healing. Thus, back in her time, one of the nurses’ responsibilities was to attend to spiritual dimensions of care and to provide a healing ambience for the patients.

Spiritual well-being is found to be positively associated with spirituality and health outcomes in patients diagnosed with cancer. Cancer patients who had high levels of spiritual well-being reported the following:-

• Better quality of life
• A lower level of depression
• Less anxiety about death
• A lower level of distress.

Cancer patients have reported that spirituality has been a source of strength that has helped them cope with their cancer experiences, define wellness during treatment and survivor-ship, find meaning in their lives, a sense of health, and make sense of their cancer experiences during illness.

Consistent associations between spirituality, spiritual well-being, and health outcomes found in published studies highlight the importance of providing spiritual care to enhance cancer patients’ spiritual well-being and address their spiritual needs.

SPIRITUAL CARE AND HOW TO PROVIDE IT?

A majority of patients who have been asked the question say that they consider attention to spiritual concerns to be an important part of cancer care by physicians and nurses.

Patients who received less spiritual care than desired reported more depressive symptoms and less meaning and peace.

Attending to the spiritual needs of patients has begun to be formally recognized by professional spiritual care providers, health care councils, and regulatory agencies, palliative care clinicians, and health care delivery systems over the past 30 years. Existing research into the core elements of oncology-related spiritual care programs has shown that organizational and institutional issues are significant and are often under-recognized factors in the success of such programs.

Sinclair, et al, found that spiritual care programs that were centrally located within the cancer center, reported and provided guidance to senior leaders, reflected a multi faith approach, and had an academic role, were better resourced, used more frequently, and viewed as integral members of an interdisciplinary care team.

An inclusive list of ways to provide spiritual care to self include, but are not restricted, are:-

Breathing exercises
Chanting
Connecting with nature
Dancing
Feng shui
Gratitude
Guided imagery
Intentional living
Listening to music
Listening to spiritual podcasts
Loving/Kindness, leading a virtuous life
Mantras
Mindfulness
Meditation
Pilates
Prayer beads
Prayer
Reading spiritual writings
Reiki
Relationship with God
Retreats/Travel/Visiting sacred places
Tai Chi/Qi Gong
Writing
Yoga

If you have a health care team, chances are, one will have a spiritual advisor, also known as a chaplain. It is his role to provide spiritual support. Chaplains are trained to talk about the major questions of life, death, and existence. They can also help with making a legacy and finding purpose. Chaplains work with people from every faith and background, including atheists. A chaplain might work closely with a social worker at the hospital or clinic. Social workers help with practical, social, and sometimes emotional issues. This type of practical and social help can also comfort spiritual pain, such as feeling discouraged or alone.

Spiritual support could also be offered if one belongs to a religious community. In such cases, the leader/priest could be consulted on how to provide such support to the cancer patient/survivor. Accordingly, such help and spiritual support could be provided either to the patient/survivor or his/her family by either the leader/priest or the members of the same religious community. Additionally, support groups could be made within the same community to help/empower the patient/survivor and also raise awareness among the community.

CONCLUSION

Cancer is a disease that can have a huge impact on the lives of the patients affected by it, irrespective of their spiritual or their religious background, especially in their thought processes. It often brings within them negativity and a sense of hopelessness, as many tend to see death as a means to meet his Creator. Some may also see it as a way that God is punishing him or her for their sins which may bring about a sense of spiritual distress. Whatever might be the reason, it is at this juncture that spiritual care can help bring about a positive change in the patient.

Cancer also happens to act as a wake-up call for certain individuals, who, after implementing a more spiritual outlook, realize that their lives have changed for good. Spirituality bring about a sense of peace and tranquillity and helps one realize that there is more to life than what meets the eye or what is usually done. Engaging in spiritual practices such as praying, meditating, or even engaging in activities that may seem mundane, such as writing, listening to music, travel etc. may seem spiritual to some. It is best that the survivor or patient decides on how to spiritually connect with Nature as that is the way how he would discover the inner peace and healing that he needs the most.

Even though it is technically different from spirituality, religion or religiosity has a very big influence on spirituality. It is, therefore, unsurprising that chaplains are an integral part of the health care network of the patients and/or survivors to guide them spiritually. They are often referred to their religious leaders as well to help them provide a more clear vision on their religion, religious outlook and how leading a religious life would bring about a positive outcome and attainment of spirituality.