Coping

Religion and spirituality

Studies have shown that religious and spiritual values are important to Americans. Most American adults say that they believe in God and that their religious beliefs affect how they live their lives. However, people have different ideas about life after death, belief in miracles, and other religious beliefs. Such beliefs may be based on gender, education, and ethnic background.

Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping. Many caregivers also rely on spiritual coping. Each person may have different spiritual needs, depending on cultural and religious traditions. For some seriously ill patients, spiritual well-being may affect how much anxiety they feel about death. For others, it may affect what they decide about end-of-life treatments. Some patients and their family caregivers may want doctors to talk about spiritual concerns, but may feel unsure about how to bring up the subject.

Some studies show that doctors' support of spiritual well-being in very ill patients helps improve their quality of life. Health care providers who treat patients coping with cancer are looking at new ways to help them with religious and spiritual concerns. Doctors may ask patients which spiritual issues are important to them during treatment as well as near the end of life. When patients with advanced cancer receive spiritual support from the medical team, they may be more likely to choose hospice care and less aggressive treatment at the end of life.

Spirituality and religion may have different meanings

The terms spirituality and religion are often used in place of each other, but for many people they have different meanings. Religion may be defined as a specific set of beliefs and practices, usually within an organized group. Spirituality may be defined as an individual's sense of peace, purpose, and connection to others, and beliefs about the meaning of life. Spirituality may be found and expressed through an organized religion or in other ways. Patients may think of themselves as spiritual or religious or both.

Serious illness, such as cancer, may cause spiritual distress

Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.

Will I experience pain?

Many people with cancer fear pain and, at the same time, believe it to be an unavoidable part of the disease. However, only 30 percent to 40 percent of patients treated for cancer report pain. Not everyone with cancer has pain, and those who do can control it with medication and other state-of-the-art treatments.

Pain left untreated can cause fatigue, depression, anger and stress. It can keep you from sleeping well, enjoying family and friends, and eating properly. If you have cancer and are feeling pain, you need to tell your doctor or nurse. Getting help for your pain early on can make treatment more effective.

Pain from cancer or cancer treatment may be acute or chronic. Acute pain is severe and usually lasts for a limited amount of time. It generally results from tissue damage. Once the cause of pain has been identified, it can be successfully managed. Chronic pain, on the other hand, is persistent and is usually present for greater than three months. Because the cause of chronic pain often cannot be altered, the nervous system will adapt, which may cause depression, anxiety and/or insomnia.

Surgery is sometimes necessary for cancer treatments, to remove a tumor or reduce the size of a tumor to relieve pressure. Pain from surgery can be treated and may go away quickly, after the surgical incision heals. Doctors may prescribe medicines like Advil (ibuprofen), Tylenol (acetaminophen), or patient-controlled analgesia (PCA), a mechanism that allows patients to manage their own intravenous pain medication. Chronic pain can result from surgery if there has been nerve damage or other changes in the body due to surgery. This type of pain may be more difficult to control.

You could also have pain that is completely independent from cancer or cancer treatment (i.e., headaches, backaches, muscle strains, arthritis or other common pains).

The best way to control pain is to prevent it from starting or to address it right away, before it becomes more severe. Pain may get worse if you wait, and it may take longer or require larger doses of medication to get relief. It is important to stay on top of pain by notifying your doctor as soon as you experience it.

Death Anxiety

Human beings have a basic self-preservation drive. Combining this drive with the realization that death is inevitable creates in them a paralyzing terror of death. In other words all human drama is, to a great extent, a story of how human beings cope with the terror of death, and how they overcome death anxiety through a great variety of conscious efforts and unconscious defense mechanisms. Taking into consideration all these factors, it becomes necessary to help people manage death anxiety in such a way that facilitates growth. Following are some of the most commonly used techniques to deal with death anxiety.

Types of Death Fears

 Fear of death is broken down into specific fears:

  • Fear of Pain and Suffering - many people fear that they will meet death with excruciating pain and suffering. This fear is common in many healthy people and is seen often in patients dying of cancer or other painful diseases.
  • Fear of the Unknown - death is the ultimate unknown--no one has survived it to tell us what happens afterward. It's in our human nature to want to understand and make sense of the world around us but death can never be fully understood while we are still alive.
  • Fear of Non-Existence - many people fear that they will cease existing after death. This fear isn't confined only to the non-religious or atheists. Many people of faith worry that their belief in an afterlife isn't real after all.
  • Fear of Eternal Punishment - again this belief isn't only for the most devout of faith. People from every religious sect and even those with no religion at all may fear that they will be punished for what they did - or did not do - here on earth.
  • Fear of Loss of Control - our human nature seeks control over situations. Death is something that is out of our realm of control which is very scary for many of us. Some people will attempt hold some control over death with extremely careful behavior and rigorous health checks.
  • Fear of What Will Become of Loved Ones - probably the most common fear of death among new parents, single parents, and caregivers is the fear of what will happen to those entrusted to our care if we die. 

Are there stages of grief?

In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five stages of grief.” These stages of grief were based on her studies of the feelings of patients facing terminal illness, but many people have generalized them to other types of negative life changes and losses, such as the death of a loved one or a break-up.

The five stages of grief:

  • Denial: “This can’t be happening to me.”
  • Anger:Why is this happening? Who is to blame?”
  • Bargaining: “Make this not happen, and in return I will ____.”
  • Depression: “I’m too sad to do anything.”
  • Acceptance: “I’m at peace with what happened.”