Spirituality in Cancer Care (PDQ®): Supportive care - Health Professional Information [NCI] - Overview
National surveys consistently support the idea that religion and spirituality are important to most individuals in the general population. More than 90% of adults express a belief in God, and slightly more than 70% of individuals surveyed identified religion as one of the most important influences in their lives. Yet even widely held beliefs, such as survival of the soul after death or a belief in miracles, vary substantially by gender, education, and ethnicity.
Research indicates that both patients and family caregivers [3,4] commonly rely on spirituality and religion to help them deal with serious physical illnesses, expressing a desire to have specific spiritual and religious needs and concerns acknowledged or addressed by medical staff; these needs, although widespread, may take different forms between and within cultural and religious traditions.[5,6,7]
Sedation may be considered for comfort.
Patients with advanced cancer or near the end of life may have:
A lot of emotional distress and physical pain.
Difficult and painful breathing.
Confusion (especially when body systems begin to fail).
Sedation can be given to ease these conditions. This is called palliative sedation. Deciding to use palliative sedation may be difficult for the family as well as the patient. The patient and family can get support from the health care team and...
A survey of hospital inpatients found that 77% of patients reported that physicians should take patients' spiritual needs into consideration, and 37% wanted physicians to address religious beliefs more frequently. A large survey of cancer outpatients in New York City found that a slight majority felt it was appropriate for a physician to inquire about their religious beliefs and spiritual needs, although only 1% reported that this had occurred. Those who reported that spiritual needs were not being met gave lower ratings to quality of care (P < .01) and reported lower satisfaction with care (P < .01). A pilot study of 14 African American men with a history of prostate cancer found that most had discussed spirituality and religious beliefs with their physicians; they expressed a desire for their doctors and clergy to be in contact with each other.
Sixty-one percent of 57 inpatients with advanced cancer receiving end-of-life care in a hospital supported by the Catholic archdiocese reported spiritual distress when interviewed by hospital chaplains. Intensity of spiritual distress correlated with self-reports of depression but not with physical pain or with perceived severity of illness. Another study  of advanced cancer patients (N = 230) in New England and Texas assessed their spiritual needs. Almost half (47%) reported that their spiritual needs were not being met by a religious community, and 72% reported that these needs were not supported by the medical system. When such support existed, it was positively related to improved quality of life. Furthermore, having spiritual issues addressed by the medical care team had more impact on increasing the use of hospice and decreasing aggressive end-of-life measures than did pastoral counseling.
This summary will review the following topics:
How religion and spirituality can be usefully conceptualized within the medical setting.
The empirical evidence for the importance of religious and spiritual factors in adjustment to illness in general and to cancer in particular, throughout the course of illness and at the end of life, for both patients and family caregivers.
The range of assessment approaches that may be useful in a clinical environment.