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How spiritual beliefs relate to cancer patients' physical, mental, and social well-being


Research reveals that most individuals with cancer have religious and spiritual beliefs, or derive comfort from religious and spiritual experiences. But what impact does this have on patients' health? Recent analyses of all published studies on the topic--which included more than 44,000 patients--shed new light on the associations of religion and spirituality with cancer patients' mental, social, and physical well-being. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the analyses indicate that religion and spirituality have significant associations with patients' health, but there was wide variability among studies regarding how different dimensions of religion and spirituality relate to different aspects of health.

In the first analysis, investigators focused on physical health. Patients reporting greater overall religiousness and spirituality also reported better physical health, greater ability to perform their usual daily tasks, and fewer physical symptoms of cancer and treatment. "These relationships were particularly strong in patients who experienced greater emotional aspects of religion and spirituality, including a sense of meaning and purpose in life as well as a connection to a source larger than oneself," said lead author Heather Jim, PhD, of the Moffitt Cancer Center in Tampa. Dr. Jim noted that patients who reported greater cognitive aspects of religion and spirituality, such as the ability to integrate the cancer into their religious or spiritual beliefs, also reported better physical health; however, physical health was not related to behavioral aspects of religion and spirituality, such as church attendance, prayer, or meditation.

In the second analysis, the researchers examined patients' mental health. The team discovered that the emotional aspects of religion and spirituality were more strongly associated with positive mental health than behavioral or cognitive aspects of religion and spirituality. "Spiritual well- being was, unsurprisingly, associated with less anxiety, depression, or distress," said lead author John Salsman, PhD, who conducted the research while at Northwestern University's Feinberg School of Medicine in Chicago, but is now at Wake Forest School of Medicine in Winston-Salem. "Also, greater levels of spiritual distress and a sense of disconnectedness with God or a religious community was associated with greater psychological distress or poorer emotional well-being."

The third analysis pertained to social health, or patients' capacity to retain social roles and relationships in the face of illness. Religion and spirituality, as well as each of its dimensions, had modest but reliable links with social health. "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," said lead author Allen Sherman, PhD, of the University of Arkansas for Medical Sciences in Little Rock. "In contrast, those who struggled with their faith fared more poorly."

Many researchers have conducted literature reviews on the impact of religion and spirituality on cancer patients' health, but none have taken such thorough and painstaking efforts to analyze the data in such detail. "To date, this series of meta-analyses represents the most comprehensive summary and synthesis of a rapidly growing area of psychosocial oncology: the role of religion and spirituality for patients and survivors managing the experience of cancer," said Dr. Salsman.

Future research should focus on how relationships between religious or spiritual involvement and health change over time, and whether support services designed to enhance particular aspects of religion and spirituality in interested patients might help improve their well-being. "In addition, some patients struggle with the religious or spiritual significance of their cancer, which is normal. How they resolve their struggle may impact their health, but more research is needed to better understand and support these patients," Dr. Jim noted.


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