Remember, each one of us is spiritual in our own way. Dealing with advanced cancer can begin a process of looking inward for what is most meaningful and sacred. Out of the turmoil of the crisis, you can actually strengthen and deepen your life at all stages of the illness.

Nurturing the Spirit when Cancer is Advanced

Life changes in many ways when you or a loved one face cancer. You may find yourself turning more frequently to your spiritual beliefs for strength and comfort. On the other hand, you may feel angry and question your faith. Don't be alarmed. Both of these reactions are normal as you try to readjust your life and cope with a serious illness such as advanced cancer.

This brief will respond to some common questions asked by families facing cancer and describe how spirituality can be a support in coping. We hope that this information will encourage you to discuss your spiritual concerns with loved ones, members of your health care team, and clergy.

What is spirituality? What does it have to do with religion?

Each of us has spiritual needs for a sense of meaning and purpose in life. Spirituality refers to each individual's beliefs about, and experience of, the meaning of life. It also refers to our need for a sense of connection to the deepest meaning of life, whether we call that God, truth or some other term. Everyone has a spiritual dimension, whether or not we attend organized services. Spiritual moments can happen at any time: when you feel close to nature, look into the face of a loved one, reach out to a person in need, or enter a house of worship and sense a greater power.

Religions are best thought of as traditions of spirituality developed over thousands of years. For some people, these traditions help to develop their sense of meaning and purpose in life. Still others draw their spiritual beliefs from philosophy, poetry, and life experiences. Some of us have thought about these matters a great deal. Others simply live their beliefs. But all of us are spiritual in our own way.
How can a sense of spirituality help you with cancer?

A sense of meaning and purpose beyond yourself can help improve your quality of life during cancer. Spiritual reflection can provide comfort, inspiration, a sense of self-worth, connection to and support from a spiritual community. For many, spirituality can provide hope and a sense of closeness with God or a higher power, giving focus and direction to life.

Without doubt, your spiritual outlook can change during a crisis such as cancer. Some people are able to find meaning and hope in the face of a cancer diagnosis by re-examining their system of beliefs and values. This helps people to avoid despair and focus on positive factors, no matter how small. It is natural to hope for a complete cure at the time of diagnosis. If cure is not possible, you may hope for a long remission. If treatment fails, you may hope for more time with loved ones, good pain management, and death with dignity, according to your wishes.

Lastly, you may decide to reorganize your priorities, choosing to spend more time with loved ones and less time working, or taking the extra moment to stop and "smell the roses." In these ways, a sense of spirituality can make the stress of cancer more bearable.

What can I do if I've never been aware of my spirituality before?

We can grow spiritually throughout our lives. The crisis of advanced cancer is extremely difficult, but it can also usher in a tremendous period of growth, bring us face to face with central struggles in our lives, and prompt us to search for what really matters to us.

Am I spiritually lost if I am angry, confused, or frightened?

Most people facing cancer feel spiritually troubled at some time, especially if the disease is advanced. It's natural to feel angry and betrayed because you have been given the misfortune of cancer. You may feel cheated if you have lived a good, productive or religious life. You are entitled to have doubts, to question God, or your beliefs and to be angry. No one can answer why some people get cancer and others do not. Such feelings do not imply that you are not a spiritual person. It's important to discuss these uncertainties with loved ones or clergy. That way, you can get support and explore different ways to understand your situation.

Which spiritual practices can help me to cope with cancer and the end of life?

Spiritual practices, such as prayer, meditation, and worship, can help to calm and restore you during times of extreme stress. Familiar religious rituals can be comforting, whether these are practiced in a group setting or on your own. They can give you a sense of attachment to family, ancestors, your spiritual community, and God at a time when you may be feeling lonely and isolated.

People facing advanced cancer need time to reflect on the meaning of their life, call to mind strengths and accomplishments, especially in light of obstacles encountered. It's also helpful to face past regrets, make amends if possible, and forgive oneself and others. This process can be helped by reflecting with loved ones, counselors, and clergy upon such questions as "What did my life mean?", "What is still there for me to accomplish?", and "How will I live on after I die?"

Many people find comfort in contemplating an afterlife, which may include reunion with deceased loved ones. It can be useful to discuss how your tradition views afterlife and decide whether this perspective is helpful to you now. Your clergyperson may be able to suggest reading material in which others have explored these issues. Excellent books include "Beyond the Mirror" by Henri Nouwen, "Who Needs God?" by Harold Kushner, and "The Tibetan Book of Living and Dying" by Sogyal Rinpoche.
Suggestions for nurturing your spirit:

Seek the support of others. Turn to family and friends, support groups, clergy, counselors, health professionals, members of your spiritual community. Discuss painful or distressing feelings with them. Don't try to handle this alone - we are not meant to do that.

Reflect on your own life journey, meaning and purpose. You may want to record your thoughts in a journal, or make a tape about your thoughts and experiences.

Find ways to pray or meditate that are meaningful to you. Your religious tradition may have special prayers or rituals that will calm and comfort you.

Read spiritual writings or have them read to you. The Bible, the Koran, and the Bhagavd Gita can link you with the holy and you can draw strength from the wisdom of these traditions.

Retreat to spiritual spaces or natural settings. Listening to fine music and appreciating beautiful surroundings can help you feel connected to a greater whole.

Pay attention to moments of beauty, peace, love, and hope. Share them with others and capture them for recall during times of distress.