Cancer and faith

Cancer ranks among the most dreaded of all diseases. In the United States alone, 1.3 million new cases are diagnosed each year, with 8,000 of them being children.

Andrew J. Weaver, Ph.D., is a United Methodist pastor and clinical psychologist working in New York City, New York, United States.
Harold G. Koenig, M.D., is professor of psychiatry at Duke University Medical Center in Durham, North Carolina, United States.

Cancer ranks among the most dreaded of all diseases. In the United States alone, 1.3 million new cases are diagnosed each year, with 8,000 of them being children. Currently 8.9 million people are living with the killer disease, with 62 percent being in the bracket of the five-year survival rate. The second leading cause of mortality, cancer is responsible for one in every four deaths in America—totaling some 550,000 deaths.1

While such statistics are alarming, researchers have found a strong relationship between patients’ faith experience and the effectiveness of their coping with cancer.2 Faith can give a suffering person a framework for finding meaning and perspective through a source greater than self, and it can provide a sense of control over feelings of helplessness. Religious practice supplies the natural social support of community.

Religious faith also appears to make an objective, measurable difference in the mental health of cancer patients. In a study of 100 older adults diagnosed with cancer, a consistent positive relationship was discovered between the practice of faith, spiritual well-being, and hope and low anxiety and depression.3

Hope is particularly important for those suffering with cancer, and researchers have found a strong link between religious belief and hope.4 In a study of cancer patients at the University of Michigan Medical Center, 93 percent said that their faith had increased their capacity to be hopeful.5 Hope enables persons to actively cope with difficult and uncontrollable life situations. Patients with a strong sense of hope report a high quality of life,6 with hopefulness specifically linked to better adjustment by those receiving radiation therapy.7 Robust hope can provide strength and courage to face the stress of illness and treatment, while hopelessness brings passivity and resignation.

Quality of life has become increasingly important for patients as treatment advances extend the length of survival. One study, involving a random sample of 296 breast cancer survivors in southern California, found that spiritual care was more important to the patients’ quality of life than support groups, counseling sessions, or even peer or spouse support.8 Spiritual well-being among these patients often involved feelings of hopefulness, sense of purpose, participation in prayer or meditation, and attendance at religious services.

A second study of 1,337 cancer patients in the United States and Puerto Rico found that spiritual well-being influenced their quality of life as much as their emotional and physical well-being did.9 Spiritual well-being was associated with the ability to enjoy life, even when experiencing negative symptoms—and the relationship remained strong even after accounting for many other factors associated with quality of life.

 

Coping strategies

The most common coping strategy for cancer patients is praying alone or with others, as well as having others pray for them.10 Fathers of children being treated for cancer in a hospital clinic were asked about various methods of coping. Among 29 separate strategies used, prayer was both the most common and most helpful for men.11 Patients also place a high value on interactions with clergy, noting that pastoral visits and prayers help them maintain hope and optimism.12

 

Caregivers and faith

Family caregivers of those with chronic illness often rely heavily on their religious faith to cope with the burden of providing care. Researchers at Johns Hopkins University surveyed caregivers of persons with end-stage cancer and Alzheimer’s disease. They discovered that successful coping was associated with only two variables: the number of social contacts and support received from religious faith.13

When these persons were followed for two years to determine what characteristics predicted faster adjustment to the caregiver role, again only the number of social contacts and support received from personal religious faith predicted better adaptation over time.14 Thus, having support from one’s faith appears to be one of the most important factors responsible for successful coping with the stress of caregiving.

Religious teachings can foster an ethos of care and responsibility. This is an important resource for those providing long-term care. Furthermore, caregivers who have an active faith tend to have a better relationship with their care recipients than do nonreligious caregivers.15

As their illness advances, cancer patients tend to focus on religious issues increasingly. When 231 patients with end-stage cancer were asked what maintained their quality of life, their “relationship with God” was the most common response among 28 choices that included “how well I eat,” “physical contact with those I care about,” and “pain relief.”16

According to these findings, terminal patients maintained their relationship with God in spite of severe functional difficulties and serious physical symptoms. In a study of 108 women in Michigan at various stages of cancer, about half felt they had become more religious since they were diagnosed, and none said they were less religious.17

 

How churches can help

Churches and other faith-based communities can play a vital role through measures such as promoting early detection and screening. Research indicates that the participation of clergy and key lay members in church-based cancer control programs can improve access to and participation in screening for cancer, particularly by African and Hispanic Americans.18

For example, a study published in the American Journal of Public Health found that church-based telephone counseling in ethnic minority communities in Los Angeles significantly increased the regular use of mammography screening.19 Such faith-based programs can have great impact in promoting regular cancer screening. Their support and implementation by religious communities will help ensure congregations that are healthy in both body and soul.

 

Resources on cancer

While these organizations do not serve all countries, they may be able to put you in contact with an organization in your area.

1. American Cancer Society, 1599 Clifton Road, NE, Atlanta, GA 30329- 4251 (800-ACS-2345, www.cancer.org), is a nationwide, community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing and diminishing suffering from cancer through research, education, advocacy, and service.

2. Candlelighters Childhood Cancer Foundation, 7910 Woodmont Avenue, Suite 460, Bethesda, MD 20814 (800-366-2223; www.candlelighters.org), offers support for parents of children and adolescents with cancer, their family members, and adult survivors of childhood cancer.

3. Leukemia Society of America, Family Support Group Program, 600 Third Avenue, 4th fl oor, New York, NY 10016 (212-450-8834; www.leukemia.org), a national program of 125 professionally run groups, offers mutual support for patients, family members, and friends coping with leukemia, lymphoma, multiple myeloma, and Hodgkin’s disease.

4. Make Today Count, c/o Mid- America Cancer Center, 1235 East Cherokee Street, Springfield, MO 65804-2263 (800-432-2273), provides self-help support groups in nearly 200 communities for persons facing a lifethreatening illness.

5. National Coalition for Cancer Survivorship, 1010 Wayne Avenue, Suite 770, Silver Spring, MD 20910 (301-650- 9127, www.canceradvocacy.org), works on behalf of persons with all types of cancer. Its mission is to strengthen and empower cancer survivors and advocate for policy issues. It provides information on employment and insurance issues, referrals, and publications.

6. Y-ME National Breast Cancer Organization, 212 West Van Buren Street, Suite 1000 Chicago, IL 60607- 3903, (800-221-2141, 24 hrs., or Spanish, 800-986-9505, 24 hrs.; www.y-me.org), provides information and peer support for breast cancer patients and their families during all stages of the disease. It also offers community outreach to educate people on early detection.

1 Cancer Facts and Figures 2003 (Atlanta, GA: American Cancer Society, 2003).

2 J. C. Holland, S. Passik, K. M. Kash, S. M. Russak, M. K. Gronert, A. Sison, M. Lederberg, B. Fox, and L. Baider, “The Role of Religious and Spiritual Beliefs in Coping With Malignant Melanoma,” Psycho-Oncology 8 (1999): 14–26.

3 R. J. Ferhring, J. F. Miller, and C. Shaw, “Spiritual Well-Being, Religiosity, Hope, Depression, and Other Mood States in Elderly People Coping With Cancer,” Oncology Nursing Forum 24, no. 4 (1997): 663–71.

4 L. Koopmeiners, J. Post-White, S. Gutknecht, C. Ceronsky, K. Nickelson, D. Drew, W. Mackey, and J. J. Kreitzer, “How Healthcare Professionals Contribute to Hope in Patients with Cancer,” Oncology Nursing Forum 24, no. 9 (1997): 1507–13.

5 J. A. Roberts, D. Brown, T. Elkins, and D. B. Larson, “Factors Infl uencing Views of Patients with Gynecological Cancer About End-of-Life Decisions,” American Journal of Obstetrics and Gynecology, 176, no. 1 (1997): 166–72.

6 B. R. Ferrell, M. M. Grant, B. M. Funk, S. A. Otis-Green, and N. J. Garcia, “Quality of Life in Breast Cancer Survivors: Implications for Developing Supportive Services,” Oncology Nursing Forum 25, no. 5 (1998): 887–95.

7 N. Christman, “Uncertainty and Adjustment During Radiotherapy,” Nursing Research 39 (1990): 17–20.

8 B. R. Ferrel, et. al.

9 M. J. Brady, A. H. Peterman, G. Fichett, and D. Cella, “A Case for Including Spirituality in Quality of Life Measurements in Oncology,” Psycho-Oncology 8 (1999): 417–28.

10 K. E. Soderstrom and I. M. Martison, “Patients’ Spiritual Coping Strategies: A Study of Nurse and Patient Perspective,” Oncology Nursing Forum 14 (1987): 41–6.

11 L. N. Cayse, “Fathers of Children With Cancer: A Descriptive Study of the Stressors and Coping Strategies,” Journal of Pediatric Oncology Nursing 11, no. 3 (1994): 102–8.

12 S. C. Johnson and B. Spilka, “Coping with Breast Cancer: The Role of Clergy and Faith,” Journal of Religion and Health 30 (1991): 21–33.

13 P. V. Rabins, M. D. Fitting, J. Eastham, and J. Zabora, “Emotional Adaptation Over Time in Caregivers for Chronically Ill Elderly People,” Age and Aging 19 (1990): 185–90.

14 Ibid.

15 B. Chang, A. E. Noonan, and S. L. Tennstedt, “The Role of Religion/Spirituality in Coping With Caregiving for Disabled Elders,” The Gerontologist 38, no. 4 (1998): 463–70.

16 S. C. McMillian and M. Weitzner, “How Problematic Are Various Aspects of Quality of Life in Patients with Cancer at the End of Life?” Oncology Nursing Forum 27, no. 5 (2000): 817–23.

17 J. A. Roberts, et. al. (see no. 5).

18 D. T. Davis, A. Bustances, C. P. Brown, G. Wolde-Tsadik, E. W. Savage, X. Cheng, and L. Howland, “The Urban Church and Cancer Control: A Source of Social Infl uence in Minority Communities,” Public Health Reports 109, no. 4 (1994): 500–8.

19 N. Duan, S. A. Fox, K. P. Derose, and S. Carson, “Maintaining Mammography Adherence Through Telephone Counseling in a Church- Based Trial,” American Journal of Public Health 90, no. 9 (2000): 1468–71.


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Andrew J. Weaver, Ph.D., is a United Methodist pastor and clinical psychologist working in New York City, New York, United States.
Harold G. Koenig, M.D., is professor of psychiatry at Duke University Medical Center in Durham, North Carolina, United States.

January 2007

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