What spirituality can mean
The National Cancer Institute describes spirituality as the way you look at the world and make sense of your place in it. It can include faith or religion, but also beliefs, values and "reasons for being." The American Cancer Society draws a similar line: religion is a commitment to a system of beliefs or practices, often shared with a community, while spirituality is a broader sense of connection and the deep values you live by. The two often overlap, and they do not have to.
This matters because questions of meaning are not reserved for religious people. Someone with a lifelong faith, someone who left religion years ago, and someone who has never believed in a higher power can all find that cancer brings up the same questions: Why is this happening? What matters most now? What do I want the rest of my life to be about? None of these questions have one right answer, and this article does not suggest any.
How cancer can shake or deepen belief
The National Cancer Institute notes that it is normal to view the cancer experience both negatively and positively at the same time. Some people find that cancer brings more meaning to their faith. Others feel their faith has let them down and struggle to understand why they have cancer, sometimes questioning their faith in God. The American Cancer Society adds that some people become interested in spirituality or a religious community for the first time.
The NCCN patient guide on distress describes other spiritual needs that can surface, including:
- An existential crisis: asking what the meaning and purpose of life are, or what it means to have cancer
- Conflict between your beliefs and a recommended treatment
- A need to talk about death, dying or what comes after
- A change in faith or beliefs, and the need for support during that change
- A desire to stay connected to other people, a deity or nature
- The importance of keeping ritual or dietary practices during care
Anger belongs on this list, too. The National Cancer Institute notes that people who are religious may even feel angry with God, and the American Cancer Society observes that feeling angry, scared or unsure about your beliefs is common. Doubt does not have to mean your faith has failed. For many people it is part of taking their beliefs seriously under pressure.
Meaning without religion
If you are not religious, you may still find yourself thinking about purpose, legacy or what you value. The National Cancer Institute lists many ways people experience spirituality outside of organized faith: meditation or yoga, volunteering, teaching, reading or writing, and time in nature or with animals. It also notes that cancer often changes people's values. Possessions and daily duties may matter less, and time with loved ones, helping others or learning something new may matter more.
It is also fine if these questions do not grip you at all. Some people cope by focusing on practical tasks, on relationships, or simply on getting through treatment, and that is a valid way to live with cancer too.
Ways people find comfort and meaning
Drawing on National Cancer Institute guidance, here are some practices people have found helpful. Choose only what fits your own beliefs:
- Praying or meditating
- Taking time alone to reflect on your life and relationships
- Writing in a journal
- Talking with others who have had similar experiences
- Reading uplifting stories about the human spirit
- Finding a place where you feel beauty or a sense of calm
- Taking part in community or faith gatherings, both to receive support and to give it
Some people also look for peace in relationships. The National Cancer Institute notes that some try to forgive themselves for past actions, forgive others, or use the time to heal strained relationships. For people facing advanced cancer, its guidance on finding purpose and meaning describes "legacy" projects such as recording memories, organizing family photos, or writing letters to loved ones.
Chaplains and spiritual care
Many hospitals and cancer centers have chaplains. The NCCN guide describes a chaplain as a trained professional who provides spiritual support in secular places like hospitals, and says chaplains can help whether you have strong beliefs, different beliefs, conflicted beliefs or no beliefs. Chaplain services can include counseling in line with your beliefs, guidance on spirituality or purpose, guided meditation, prayer and rituals. Chaplains can also connect you with your own spiritual community or refer you to other care.
If your cancer center has no chaplain, the American Cancer Society notes that members of the care team should still be able to make a referral. Questions you might ask include who you can talk with about your purpose in life, who you can talk with about what happens when you die, or whether there is a chaplain who can help if your religious community holds beliefs about illness that you do not share.
When spiritual questions bring emotional distress
Spiritual and emotional struggles often overlap. Questions about meaning can come with grief, fear of death, guilt or hopelessness. Family members and caregivers may have their own spiritual questions, too. A faith leader or chaplain can speak to belief itself. Psychotherapy is not religious guidance, but a psychologist can help you explore the feelings around these questions in a way that respects whatever you believe, including no belief at all.
Dr. Lehmann is a licensed clinical psychologist in Franklin, Michigan, with an insight-oriented, integrative approach. Read about cancer-related emotional support, and contact the practice to ask whether she can help with your situation. If grief is part of what you are carrying, grief counseling may also be relevant. Community programs such as Gilda's Club Metro Detroit in Royal Oak (248-577-0800) offer support for people affected by cancer.