Hope in the Context of Pain and Palliative Care

  • Richard T. Penson
  • Lynette Su-Mien Ngo
  • Gillianne Lai


Hope is a good, even essential component of the resilience that translates into better coping and quality of life in the setting of a life-threatening illness, especially as death approaches and the hope for positive outcomes turns to hope for being comfortable, well informed, accompanied by those who love us, and making meaning in devastating situations. There is little empirical data on the components and impact of hope in cancer care but a wealth of information about the psychology of hope and factors associated with hope and hopelessness. Hope can positively impact an individual’s behavior and choices, and interventions decrease levels of depression and hopelessness. However, the biology and mechanism of benefit is complex, and the relative contribution of the nonspecific physical, neuroendocrine, and inflammatory pathways unknown. Hope can enhance quality of life in cancer patients, but any benefit in the length of survival is much more controversial, and new avenues of investigation show how social networks foster hope through support, information, and access to care. A common fear is that when the patient gives up, the disease takes over, and patients need structured informational and psychological support (An agreed (1) plan, (2) information and (3) support), with committed, optimistic, and personal attention. The ethics of hype and hope, and the need for honesty and realism apply as much to alternative as to conventional medicine. When “all hope is gone” working toward a “good death” requires addressing the transcendent hopes of the moment, and those embodied in spiritual beliefs and legacy. Hope can exist, even when the challenge is impossible, the odds long, and the time short. It is a huge privilege to nurture realistic hopefulness and to not abandon patients to fear and despair in their last days. The best care demands the science of medicine and the art of compassion. Then we can all speak the language of hope, of trust, and respect.


Palliative Care Good Death Psychoeducational Intervention Spiritual Distress Cancer Pain Relief 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  • Richard T. Penson
    • 1
  • Lynette Su-Mien Ngo
    • 2
  • Gillianne Lai
    • 3
  1. 1.Massachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.National Cancer Centre SingaporeSingaporeSingapore
  3. 3.National University of SingaporeSingaporeSingapore

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