When Debbie Adudell learned she had breast cancer a couple of years ago, she remembers, "I couldn't breathe or talk. I was raised Catholic, so I immediately prayed to God for help."
"Prayer kept me going throughout the whole process," that included a number of tests, surgery, radiation and chemotherapy.
"The whole cancer process has definitely changed my life spiritually," Debbie shared with dailyRx.
What is spirituality?
The Association of American Medical Colleges Medical School Objectives Report in 1999 defined spirituality as a "factor that contributes to health in many persons."
This definition goes on to say, "It is expressed in an individual’s search for ultimate meaning through participation in religion and/or belief in God, family, naturalism, rationalism, humanism and the arts."
In an interview with dailyRx, Christina M. Puchalski, M.D., M.S., F.A.C.P., founder and director of the George Washington Institute for Spirituality and Health (GWish) defined spirituality in simpler terms.
"Spirituality is how people find meaning and purpose in their lives," she says.
Dealing and suffering with serious illness, a person can sometimes lose sight of the meaning of their lives, and Dr. Puchalski believes healthcare professionals can intervene to ease pain that's not physical.
Because, in terms of care, she says, "spirituality is just as important as physical, emotional and mental issues."
After her diagnosis, Debbie went through so many tests and they all made her nervous. "Being able to just say a prayer to myself before, during, and after the test was a huge help to me," she says.
The spirituality of healing
GWish was established in 2001 to change the face of medicine by focusing on education and clinical issues related to spirituality and health.
According to its website, the organization is "working toward a more compassionate system of healthcare by restoring the heart and humanity of medicine through research, education and policy work focused on bringing increased attention to the spiritual needs of patients, families and healthcare professionals."
This will come to bear when physicians and other health professionals become "aware of the importance of the spiritual needs of those who are ill and suffer. Such awareness will lead to compassionate care," the GWish website says.
For cancer patients, their families and caregivers, spiritual beliefs and practices can help them cope with the disease and its impact.
Along with prayer, Debbie said, "I would also carry with me in my pocket a rosary that a friend of mine got for me at the Vatican that had been blessed by the Pope. And I would wear a gold necklace that had belonged to my mother that was a St. Christopher medal. Those two things made me feel so much better just to have them with me.
"It made me feel that God was with me and so was my mother," Debbie told dailyRx.
Spiritual well-being
Research has shown that a person's spirituality, freely expressed and practiced, can improve mental outlook and overall quality of life. Spiritual well-being can also affect physical health in a number of ways, including:
- Reduce anxiety, anger, depression, and discomfort
- Decrease feelings of isolation and the risk of suicide
- Lower alcohol and drug abuse
- Improve blood pressure and decrease heart disease risks
- Assist patients in accepting the cancer diagnosis
- Enhance the ability to enjoy life during and after cancer treatment
- Increase feelings of hope, optimism and satisfaction
- Promote a sense of inner peace
Spiritual distress
Living with a serious illness such as cancer can also leave a person feeling lost. Dr. Puchalski says doctors need to be able to identify "spiritual distress," a frightening state that includes hopelessness, despair, conflict about one's beliefs and lack of meaning.
Addressing the spiritual needs of a patient can assist with and ease suffering.
"Every patient is a statistic of one," Dr. Puchalski says. "I tell my patients to listen, but don't lose hope.
"There's meaning and purposes to your life regardless of what stage of cancer you have.
"Live life as fully as possible with cancer. And reach within to find strength," Dr. Puchalski encourages her patients.
Starting the conversation
Dr. Puchalski says that while spirituality is a part of the curriculum at the majority of medical schools these days, discussing one's beliefs is not a routine doctor-patient conversation.
As a result, patients often hesitate to start the conversation, and doctors often don't broach the topic, although there are guidelines for doing so.
Many doctors feel ill-equipped to enter into such discussions or fear they have nothing to offer patients who are suffering deeply.
"Patients need to feel free to say 'my spiritual beliefs are really important to me, and I'd like to talk about them. Could I see a chaplain?'"
"The key piece is having board-certified chaplains who can talk to patients and their families," says the advocate for compassionate care.
These professionals should be available wherever cancer care is provided, Dr. Puchalski said. But for now, there simply aren't enough chaplains available, she says.
Spiritual support
According to the National Cancer Institute, cancer patients should expect their health team to respect their religious and spiritual beliefs.
For those who use spirituality to cope with cancer, they should be able to call on their health providers to offer support.
Such support could include providing information and referrals to groups, individuals or organizations that help with spiritual needs.
Likewise, people who don't want to discusses their spiritual or religious beliefs should also be comfortable knowing their providers will respect their wishes.
As Dr. Puchalski puts it, "Every person has their own unique journey."
The transformative power of cancer
Cancer can also be a blessing, Dr. Puchalski says "Many of my patients tell me they look at life differently as a result of having had cancer."
Debbie says that cancer has transformed her spiritual life, "I feel closer to God and I feel that it has helped me to cope. I felt all alone and I don't think I would have had the strength to get through it without prayer," she said.
