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Posted 2/7/2013

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  Isn't it odd and unfortunate that it is often so difficult to talk about spirituality and religious beliefs? For most of history and, still, in many cultures, this is a central conversation, but somehow it has become marginalized for many of us. No matter what our personal histories have been, however, I am quite certain that questions of faith become central when we are diagnosed with a potentially life-threatening illness. You all know the saying: "There are no atheists in foxholes." I expect there are few atheists, or at least few people who are not pondering the questions, in cancer units.

  When I meet with a woman for the first time, I try to find an opportunity to raise these issues. Sometimes it is easy, and sometimes not. Some women seem a bit embarrassed by the topic, while others relax into a zone of obvious comfort. I have surely heard all kinds of stories and perspectives, but believe that, when facing serious illness, it is surely easier to believe Something. People of strong religious faith may insist that it is most helpful to believe their tradition; some people, as we sadly know, are quite convinced that everyone else (even if that includes most of the world) is wrong. Not infrequently, I am asked what I believe, and it then becomes difficult. Not difficult because I am unwilling to share my thoughts, but difficult because my vocabulary is limited and does not easily describe my feelings.

    I was raised Episcopalian, and one of my older brothers is an Episcopal priest. It would be easy for him to explain his doctrine. I am married to a Jew, and I increasingly have respect for all religious beliefs. I believe in Something/Someone and am reinforced in this belief with every sunrise or budding leaf. Life wins out.

    This is a good summary from the National Cancer Institute (and you know this is a topic of attention when the NCI bothers to write a position paper about it):

Religious and spiritual values are important to patients coping with cancer.

Studies have shown that religious and spiritual values are important to Americans. Most American adults

Studies have shown that religious and spiritual values are important to Americans. Most American adults

say that they believe in God and that their religious beliefs affect how they live their lives. However, people

have different ideas about life after death, belief in miracles, and other religious beliefs. Such beliefs may

be based on gender, education, and ethnic background.

Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their

disease. This is called spiritual coping. Many caregivers also rely on spiritual coping. Each person may have

different spiritual needs, depending on cultural and religious traditions. For some seriously ill patients,

spiritual wellbeing may affect how much anxiety they feel about death. For others, it may affect what they

decide about end of life treatments. Some patients and their family caregivers may want doctors to talk

about spiritual concerns, but may feel unsure about how to bring up the subject.

Some studies show that doctors' support of spiritual wellbeing in very ill patients helps improve their

quality of life. Health care providers who treat patients coping with cancer are looking at new ways to help

them with religious and spiritual concerns. Doctors may ask patients which spiritual issues are important to

them during treatment as well as near the end of life. When patients with advanced cancer receive spiritual

support from the medical team, they may be more likely to choose hospice care and less aggressive

treatment at the end of life. (See the PDQ summary on Last Days of Life for information on endoflife


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