How does spiritual care help in cancer treatment?

Cancer and its management can open new opportunities for spiritual support, addressing needs you may have never been aware of before. Raymond Wadlow, MD, is a medical oncologist at the Inova Schar Cancer Care Center in Fairfax, Virginia. In Dr. Wadlow’s experience, common questions include:

• Why me?
• Is cancer my fault?
• Is God or the universe punishing or testing me?
• Did this happen because I smoked, drank alcohol, ate certain foods or did something bad in the past?
• Will I die soon?
• What will happen to my spirit after I die?
• Has my life mattered?

Worrying about these questions can have a negative effect on your physical, social and emotional quality of life. On the other hand, spiritual care has been found to positively impact quality of life ⁴ and be especially helpful at the end of life. ⁵ Honoring and accommodating each person’s belief system and spiritual practices is important. ⁶

It is also important to know that not all spiritual experiences during cancer are positive. Some people feel angry at God, abandoned by their faith community or spiritually lost. Feeling “punished” by a higher power or struggling with a loss of faith can add to distress. This is sometimes called “negative religious coping,” and it is real and common. If you are experiencing these feelings, tell your health-care team. A chaplain, therapist or spiritual counselor can help. ⁷

A spiritual care plan is designed to help people do the following things and more:

• Understand how they are struggling and talk about their needs.
• Cope with anxiety, worry, grief, and anger.
• Talk about change, loss, and death and dying when appropriate.
• Gain acceptance of their situation and develop a sense of peace and hope.

Talking with your care team about spiritual care

In whole person care, we often refer to three dimensions: body, mind, and spirit. But if you rely on your oncologist as the main source of treatment resources, finding spiritual care may take some extra effort.

“Physicians are not taught to discuss spirituality,” explains Dr. Wadlow. He says that talking about spiritual life and religion is still “somewhat taboo, and often delegated to other team members.”

Your cancer care team may be hesitant to bring up spiritual life because they don’t want to intrude on your personal beliefs. They may even believe it is not ethical to talk about these issues with you. However, most are willing to talk with you if you ask.

Your doctor or another person on your cancer team may also be willing to talk with your pastor, faith healer or spiritual leader, especially if they understand the importance of spirituality and religion in cancer care. They can also help you find spiritual care by connecting you with a chaplain, a therapist, a support group or a meditation class at the hospital or cancer center.

Requesting a spiritual assessment

A spiritual assessment is another way to include spirituality and religion in your cancer care plan. An assessment is a tool, like an outline or list, which allows you or your clinician to consider spiritual beliefs, concerns, and desires. While the tools listed below were designed for use by chaplains and other health care team members, you can use them for yourself or a loved one, changing “the patient” to “you.”

Spiritual assessment tools include:

• The Joint Commission Spiritual Beliefs and Preferences questions — You may use this whether you are receiving treatment, acting as someone’s caregiver or treating patients with cancer. Scroll down the page for questions.
• The FICA Spiritual History Tool — A free download from the George Washington Institute for Spirituality and Health at Icahn Mt. Sinai.
• NCCN Distress Thermometer and Problem List (PDF) — The most widely used cancer-specific screening tool in U.S. cancer centers. This free tool includes a category for spiritual or religious concerns (such as sense of meaning or purpose, changes in faith and relationship with the sacred). ⁸

Drawing on many types of care

Ask any three people with cancer what “spiritual care” means, and you’re likely to receive different answers. These may include:

• “Praying with the hospital chaplain and having people at my church pray for me.”
• “Using traditional herbs and having a sweat lodge ceremony.”
• “Meditating more often and going to therapy.”

Not all spiritual interventions look the same. For example, research now shows that spending time in nature—through gardening, “forest-bathing,” yoga, and meditation—can be a meaningful spiritual practice. Multiple studies confirm these activities can increase immune cell activity and reduce anxiety, depression, and stress in people with cancer. ⁹

Talking with a therapist is another way to address spiritual needs. Having cancer may lead you to explore working with a counselor. Spiritual care for cancer may also include meditation or mindfulness-based stress-reduction techniques. The Society for Integrative Oncology and the American Society of Clinical Oncology now recommend mindfulness-based practices as evidence-based care for anxiety and depression in people with cancer. ¹⁰ Art and music therapy are other helpful therapeutic tools. ¹¹

Two other structured programs are worth asking about at your cancer center. Meaning-centered psychotherapy is a short series of sessions—usually seven to eight—that helps people with advanced cancer find or hold on to a sense of meaning and purpose. Dignity therapy invites you to talk about what has mattered most in your life, creating a written document you can share with loved ones. Both programs have been evaluated in clinical trials and are offered at many major cancer centers. ¹²

The Inova Life with Cancer Center, where Dr. Wadlow practices, has courses in mindfulness and related practices and is even beginning to require that physicians and other clinicians taking advanced specialty training participate in the courses. Many cancer centers have similar programs.

How chaplains can help

A chaplain is a trained spiritual leader who works at a hospital or for another organization such as the military. Most service members are familiar with chaplains, who may be of any faith and are trained to help people of all faiths or none.

Your hospital or cancer center may have a chaplain who can support you. They can:

• Read spiritual material to you.
• Talk with you about your concerns and about making health care decisions.
• Help family members with spiritual needs.
• Support members of the health care team at the hospital or clinic.
• Help you, your family and your health care team communicate with each other. ¹³

Chaplains are increasingly available by telephone or video call, especially for people receiving outpatient treatment or living far from a cancer center. This is called telechaplaincy, and it works much like an in-person visit. If you are interested, ask your care team whether remote chaplain services are available at your cancer center or through the HealthCare Chaplaincy Network. ¹⁴

Spiritual care should feel right for you, whatever your background or beliefs. If you come from a faith tradition that does not typically
use hospital chaplains, such as Hindu, Buddhist, Sikh or Jain traditions, it is still okay to ask for spiritual support. Let your care team know what kind of support would mean the most. They can help connect you with the right resource. ¹⁵

Spiritual care beyond the hospital

Chaplains are available in the hospital. For support when you or your loved ones are at home, you may want to contact your spiritual community, even if you have not been active recently (or ever). You may feel awkward at first, but nearly every organization will welcome a request to talk about essential life questions or provide help. A hospital chaplain can also help you connect with a local organization for spiritual care, including organizations for those with no specific faith such as the American Humanist Association (americanhumanist.org).

Here are some ways to ask for spiritual support:

• I have cancer, and I’d like to talk to someone.
• My family is looking for a supportive community during cancer care.
• We used to attend [church, temple, mosque, dojo]. We’d like to get involved again, especially since [I, a family member, my partner] am/is having cancer treatment.
• I would like to be added to a prayer group.

Other health care team members who can connect you with a spiritual or religious organization include social workers, nurses and therapists.

Spiritual care after treatment ends

Spiritual needs don’t end when active treatment is finished. Many cancer survivors say that the time after treatment—returning to everyday life, living with uncertainty or thinking about the future—raises its own spiritual questions. Research shows that spirituality is strongly connected to quality of life during survivorship: people who feel a sense of meaning and purpose tend to do better emotionally and physically. ¹⁶

If you are a cancer survivor and spiritual questions arise, reach out to your care team, a chaplain, your faith community or a support group. The same types of support that helped during treatment—mindfulness, therapy, nature, art community—can continue to help afterward.

Tips for finding spiritual care

Based on his experience of caring for people with cancer, Dr. Wadlow suggests:

• Being open to exploring your questions about faith and spirituality.
• Recognizing that taking care of your spiritual side can help you heal as a whole person, whether the cancer is cured or not.
• Introducing your clinician and other team members to your spiritual leaders or mentors if they visit or participate in your care.
• Knowing that you can still discuss fears, worries and questions of meaning and purpose if you do not have a spiritual bent or aren’t religious. You may find hope or peace in nature, movement, meditation, art or a support group.

“Most health care providers are extremely dedicated and looking for ways to help you,” says Dr. Wadlow. “But they may also feel sensitive because spirituality can be so private, so don’t hesitate to ask if you are looking for guidance in this area.”

When you are seeking help to support and mend your spirit, it’s important to ask—and be open to receiving the help and support you need.

To learn more about the connection between medicine and spirituality, read Healing Words: The Power of Prayer and the Practice of Medicine by Larry Dossey, MD. You can find other resources below.

Resources

Online Resources

• Spirituality in Cancer Care (PDQ) — National Cancer Institute (patient version)
• Spiritual Support and Cancer — American Cancer Society (updated 2025)
• Cancer: Religion and Spirituality — Stanford University
• GW Institute for Spirituality and Health (Includes FICA tool and clinician resources)
• HealthCare Chaplaincy Network, including telechaplaincy services
• NCCN Distress Thermometer and Problem List (free, for patients and clinicians)
• CancerCare — Spirituality resources and oncology social work support, including a series of Connect booklets
• Cancer Survivors Network — Spirituality, Prayer, and Meditation community forum
• “My Wife Susan’s Response to Cancer” — Wayne Jonas, MD

Books

• When Things Fall Apart by Pema Chodron — A classic Buddhist guide to facing difficulty and uncertainty. It is still widely recommended for people navigating serious illness.
• Kitchen Table Wisdom by Rachel Naomi Remen, MD — Stories of healing, meaning, and the sacred in everyday life. A perennial favorite for cancer patients and caregivers.
• Spirituality in Healthcare by edited by Mark Cobb, Christina Puchalski and Bruce Rumbold — A comprehensive academic and clinical reference. More for clinicians and chaplains than general readers.
• Healing Words: The Power of Prayer and the Practice of Medicine by Larry Dossey, MD — Explores the link between prayer, spirituality, and healing.
• When Breath Becomes Air by Paul Kalanithi — A Stanford neurosurgeon’s memoir written after his Stage IV lung cancer diagnosis. A moving exploration of meaning, faith and what makes life worth living. New York Times bestseller.
• Everything Happens for a Reason: And Other Lies I’ve Loved by Kate Bowler — A Duke Divinity School professor diagnosed with Stage IV colon cancer at 35 reflects on faith, suffering and what it means to live fully. New York Times bestseller.
• The Cancer Journals by Audre Lorde — A groundbreaking memoir by poet and activist Audre Lorde about breast cancer, identity and the power of speaking one’s truth.
• Being Mortal: Medicine and What Matters in the End by Atul Gawande — A surgeon’s exploration of how medicine can better honor what matters most to people facing serious illness—meaning, relationships and dignity. Widely used in medical education.

References

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