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Respecting the Spiritual Side of Advanced Cancer Care: a Systematic Review

  • Palliative Medicine (A Jatoi, Section Editor)
  • Published:
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Abstract

Spirituality is among the resources that many turn to as they deal with a diagnosis of advanced cancer. Researchers have made much progress in exploring and understanding spirituality’s complex and multifaceted role in the midst of metastatic disease. As a result, spirituality is seen as an important aspect of a holistic and respectful approach to clinical care for patients and their loved ones. In this article, we provide a systematic review of the literature related to the interface between spirituality and metastatic cancer. We included articles published from January 2013 to June 2014. Twenty-two articles were reviewed, consisting of clinical intervention trials, association studies, surveys, qualitative studies, and review articles. The articles discussed efforts to improve patients’ spiritual well-being, with relevant measurement scales; the associations of spirituality and end of life treatment practices; and efforts to better understand and meet the spiritual needs of patients and caregivers.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Richardson P. Assessment and implementation of spirituality and religiosity in cancer care: effects on patient outcomes. Clin J Oncol Nurs. 2012;16:E150–5. doi:10.1188/12.cjon. e150-155.

    Article  PubMed  Google Scholar 

  2. Rousseau P. Spirituality and the dying patient. J Clin Oncol. 2000;18:2000–2.

    CAS  PubMed  Google Scholar 

  3. Swinton J, Bain V, Ingram S, Heys SD. Moving inwards, moving outwards, moving upwards: the role of spirituality during the early stages of breast cancer. Eur J Cancer Care. 2011;20(5):640–52.

    Article  CAS  Google Scholar 

  4. Dy SM. Evidence-based approaches to pain in advanced cancer. Cancer J. 2010;16(5):500–6. doi:10.1097/PPO.0b013e3181f45853.

    Article  PubMed  Google Scholar 

  5. Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, et al. The landscape of distress in the terminally ill. J Pain Symptom Manag. 2009;38(5):641–9. doi:10.1016/j.jpainsymman.2009.04.021.

    Article  Google Scholar 

  6. Reeve BB, Potosky AL, Smith AW, Han PK, Hays RD, Davis WW, et al. Impact of cancer on health-related quality of life of older Americans. J Natl Cancer Inst. 2009;101(12):860–8. doi:10.1093/jnci/djp123.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Ferrell B, Otis-Green S, Economou D. Spirituality in cancer care at the end of life. Cancer J. 2013;19(5):431–7. doi:10.1097/PPO.0b013e3182a5baa5. This article provides a superb synthesis of the major issues related to spirituality and the care of patients with cancer at the end of their lives. The tables, which provide guidelines and resources, are thorough and expansive.

    Article  PubMed  Google Scholar 

  8. Buck HG, Meghani SH. Spiritual expressions of African Americans and Whites in cancer pain. J Holist Nurs. 2012;30(2):107–16. doi:10.1177/0898010111423420.

    Article  PubMed  Google Scholar 

  9. King M, Llewellyn H, Leurent B, Owen F, Leavey G, Tookman A, et al. Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care. Psychooncology. 2013;22(11):2505–12.

    Article  PubMed  Google Scholar 

  10. Puchalski CM. Spirituality in the cancer trajectory. Ann Oncol. 2012;23(Suppl (3)):49–55.

    Article  PubMed  Google Scholar 

  11. Delgado-Guay MO, Hui D, Parsons HA, Govan K, De la Cruz M, Thorney S, et al. Spirituality, religiosity, and spiritual pain in advanced cancer patients. J Pain Symptom Manag. 2011;41(6):986–94. doi:10.1016/j.jpainsymman.2010.09.017.

    Article  Google Scholar 

  12. Barlow F, Walker J, Lewith G. Effects of spiritual healing for women undergoing long-term hormone therapy for breast cancer: a qualitative investigation. J Altern Complement Med. 2013;19(3):211–6. doi:10.1089/acm.2012.0091.

    Article  PubMed  Google Scholar 

  13. Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA. The relationships among coping strategies, religious coping, and spirituality in African American women with breast cancer receiving chemotherapy. Oncol Nurs Forum. 2013;40(2):120–31. doi:10.1188/13.onf. 120-131.

    Article  PubMed  Google Scholar 

  14. Iwatani T, Matsuda A, Kawabata H, Miura D, Matsushima E. Predictive factors for psychological distress related to diagnosis of breast cancer. Psychooncology. 2013;22(3):523–9.

    Article  PubMed  Google Scholar 

  15. Sealy PA. Integrating job, Jesus’ passion, and Buddhist Metta to bring meaning to the suffering and recovery from breast cancer. J Relig Health. 2013;52(4):1162–7.

    Article  PubMed  Google Scholar 

  16. Hanson LC, Armstrong TD, Green MA, Hayes M, Peacock S, Elliot-Bynum S, et al. Circles of care: development and initial evaluation of a peer support model for African Americans with advanced cancer. Health Educ Behav. 2013;40(5):536–43.

    Article  PubMed  Google Scholar 

  17. Darby K, Nash P, Nash S. Understanding and responding to spiritual and religious needs of young people with cancer. Cancer Nurs Pract. 2014;13(2):32–7.

    Article  Google Scholar 

  18. Kassam A, Skiadaresis J, Habib S, Alexander S, Wolfe J. Moving toward quality palliative cancer care: parent and clinician perspectives on gaps between what matters and what is accessible. J Clin Oncol. 2013;31(7):910–5.

    Article  PubMed  Google Scholar 

  19. Lyon ME, Jacobs S, Briggs L, Cheng YI, Wang J. A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: anxiety, depression, quality of life, advance directives, spirituality. J Adolesc Health. 2014;54(6):710–7. doi:10.1016/j.jadohealth.2013.10.206.

    Article  PubMed  Google Scholar 

  20. Applebaum AJ, Stein EM, Lord-Bessen J, Pessin H, Rosenfeld B, Breitbart W. Optimism, social support, and mental health outcomes in patients with advanced cancer. Psychooncology. 2014;23(3):299–306. doi:10.1002/pon.3418.

    Article  PubMed  Google Scholar 

  21. Daly BJ, Douglas SL, Gunzler D, Lipson AR. Clinical trial of a supportive care team for patients with advanced cancer. J Pain Symptom Manag. 2013;46(6):775–84.

    Article  Google Scholar 

  22. Clark MM, Rummans TA, Atherton PJ, Cheville AL, Johnson ME, Frost MH, et al. Randomized controlled trial of maintaining quality of life during radiotherapy for advanced cancer. Cancer. 2013;119(4):880–7.

    Article  PubMed  Google Scholar 

  23. Glare PA. Early implementation of palliative care can improve patient outcomes. J Natl Compr Cancer Netw. 2013;11 Suppl 1:S3–9.

    Google Scholar 

  24. Ellison CG, Benjamins MR. Advancing research on spiritual influences at the end of life: comment on “Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life”. JAMA Int Med. 2013;173(12):1117–8.

    Article  Google Scholar 

  25. Fischbeck S, Maier B-O, Reinholz U, Nehring C, Schwab R, Beutel ME, et al. Assessing somatic, psychosocial, and spiritual distress of patients with advanced cancer: development of the Advanced Cancer Patients’ Distress Scale. Am J Hosp Palliat Med. 2013;30(4):339–46.

    Article  Google Scholar 

  26. Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383(9930):1721–30. doi:10.1016/S0140-6736(13)62416-2.

    Article  PubMed  Google Scholar 

  27. Piderman KM, Johnson ME, Frost MH, Atherton PJ, Satele DV, Clark MM, et al. Spiritual quality of life in advanced cancer patients receiving radiation therapy. Psychooncology. 2014a;23(2):216–21. doi:10.1002/pon.3390.

    Article  PubMed  Google Scholar 

  28. Lloyd-Williams M, Cobb M, O’Connor C, Dunn L, Shiels C. A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer. J Affect Disord. 2013;148(1):141–5.

    Article  PubMed  Google Scholar 

  29. Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, et al. Managing Cancer And Living Meaningfully (CALM): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliat Med. 2014;28(3):234–42. doi:10.1177/0269216313507757.

    Article  PubMed  Google Scholar 

  30. Balboni TA, Balboni M, Enzinger AC, Gallivan K, Paulk ME, Wright A, et al. Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Int Med. 2013;173(12):1109–17. This study provides insight into some of the complexity of spiritual care, especially when provided by those who are not part of the medical team. Ellison and Benjamin (2014) raise some methodological concerns, and their commentary may be helpful to those who want to continue in this line of research.

    Article  Google Scholar 

  31. Kypriotakis G, Francis LE, O’Toole E, Towe TP, Rose JH. Preferences for aggressive care in underserved populations with advanced-stage lung cancer: looking beyond race and resuscitation. Support Care Cancer. 2014;22(5):1251–9.

    Article  PubMed  Google Scholar 

  32. Douglas SL, Daly BJ. The impact of patient quality of life and spirituality upon caregiver depression for those with advanced cancer. Palliat Support Care. 2013;11(5):389–96.

    Article  PubMed  Google Scholar 

  33. Delgado-Guay MO, Parsons HA, Hui D, De la Cruz MG, Thorney S, Bruera E. Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. Am J Hosp Palliat Med. 2013;30(5):455–61.

    Article  Google Scholar 

  34. Vilalta A, Valls J, Porta J, Vinas J. Evaluation of spiritual needs of patients with advanced cancer in a palliative care unit. J Palliat Med. 2014;17(5):592–600. doi:10.1089/jpm.2013.0569. It is very important for medical providers to understand the nature of the spiritual needs of their patients. This article provides ratings of several possible spiritual needs by a group of 50 patients with advanced cancer in Spain. Future research with advanced cancer patients in other countries would be interesting.

    Article  PubMed  Google Scholar 

  35. Balboni MJ, Sullivan A, Amobi A, Phelps AC, Gorman DP, Zollfrank A, et al. Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. J Clin Oncol. 2013;31(4):461–7. Results of this investigation highlight the importance of the training of medical providers in spiritual care so that patients’ expectations are met. The article provides motivation for the development of innovative training programs.

    Article  PubMed  Google Scholar 

  36. Lepherd L. Spirituality in men with advanced prostate cancer: “it’s a holistic thing … it’s a package”. J Holist Nurs. 2014;32(2):89–101. doi:10.1177/0898010113504492. quiz 2–3.

    Article  PubMed  Google Scholar 

  37. Sterba KR, Zapka J, Gore EI, Ford ME, Ford DW, Thomas M, et al. Exploring dimensions of coping in advanced colorectal cancer: implications for patient-centered care. J Psychosoc Oncol. 2013;31(5):517–39.

    Article  PubMed  Google Scholar 

  38. Best M, Butow P, Olver I. Spiritual support of cancer patients and the role of the doctor. Support Care Cancer. 2014;22(5):1333–9.

    Article  PubMed  Google Scholar 

  39. Burke SM, Brunet J, Sabiston CM, Jack S, Grocott MPW, West MA. Patients’ perceptions of quality of life during active treatment for locally advanced rectal cancer: the importance of preoperative exercise. Support Care Cancer. 2013;21(12):3345–53.

    Article  PubMed  Google Scholar 

  40. Freire MEM, Sawada NO, de Franca ISX, da Costa SFG, Oliveira CDB. Health-related quality of life among patients with advanced cancer: an integrative review. Revista Da Escola de Enfermagem Da Usp. 2014;48(2):357–67.

    Article  Google Scholar 

  41. Moreno PI, Stanton AL. Personal growth during the experience of advanced cancer: a systematic review. Cancer J. 2013;19(5):421–30. This review article speaks to the vitality of those with advanced cancer and their ability to use the challenges they face for growth. This is an inspiring perspective for all to remember, medical providers, patients, and caregivers, alike.

    Article  PubMed  Google Scholar 

  42. Jaiswal R, Alici Y, Breitbart W. A comprehensive review of palliative care in patients with cancer. Int Rev Psychiatry. 2014;26(1):87–101. doi:10.3109/09540261.2013.868788. The authors address the issue of spiritual distress in patients with advanced cancer and provide several detailed interventions of various kinds that may be helpful in ameliorating it.

    Article  PubMed  Google Scholar 

  43. Daher M. Ethical issues in the geriatric patient with advanced cancer ‘living to the end’. Ann Oncol. 2013;24 Suppl 7:vii55–8.

    Article  PubMed  Google Scholar 

  44. Johnson ME, Dose AM, Pipe TB, Petersen WO, Huschka M, Gallenberg MM, et al. Centering prayer for women receiving chemotherapy for recurrent ovarian cancer: a pilot study. Oncol Nurs Forum. 2009;36(4):421–8. doi:10.1188/09.ONF. 421-428.

    Article  PubMed  Google Scholar 

  45. Zainal NZ, Booth S, Huppert FA. The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psychooncology. 2013;22(7):1457–65. doi:10.1002/pon.3171.

    Article  PubMed  Google Scholar 

  46. Koenig HG, King DE, Carson VB. Handbook of religion and health. New York: Oxford University Press; 2012.

    Google Scholar 

  47. Johnson ME, Piderman KM, Sloan JA, Huschka M, Atherton PJ, Hanson JM, et al. Measuring spiritual quality of life in patients with cancer. J Support Oncol. 2007;5(9):437–42.

    PubMed  Google Scholar 

  48. Piderman KM, Radecki Breitkopf C, Jenkins SM, Lovejoy LA, Dulohery YM, Jatoi A, et al. The feasibility and educational value of Hear My Voice, a chaplain-led spiritual life review process for patients with brain cancers and progressive neurologic conditions. J Cancer Educ. 2014b. doi:10.1007/s13187-014-0686-y.

    PubMed  Google Scholar 

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Acknowledgments

We gratefully acknowledge the work of Heidi L. Durland in the preparation of this manuscript.

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Conflict of Interest

Katherine M. Piderman, Simon Kung, Sarah M. Jenkins, Terin T. Euerle, Timothy J. Yoder, and Gracia M. Kwete declare that they have no conflict of interest.

Maria I. Lapid has received a grant through the Mayo Clinic Cancer Center.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Katherine M. Piderman.

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This article is part of the Topical Collection on Palliative Medicine

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Piderman, K.M., Kung, S., Jenkins, S.M. et al. Respecting the Spiritual Side of Advanced Cancer Care: a Systematic Review. Curr Oncol Rep 17, 6 (2015). https://doi.org/10.1007/s11912-014-0429-6

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  • DOI: https://doi.org/10.1007/s11912-014-0429-6

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