Religious and spiritual leaders help their congregants get through life’s most difficult moments — death, divorce, lost jobs, crises of faith. But what should they tell a person devastated by a cancer diagnosis?
More than 35 Los Angeles area religious and spiritual leaders came together recently to learn from UCLA professionals — psychologists, a hospital chaplain, an oncologist and an oncology social worker — about how the clergy can help patients and their families get through treatment and beyond.
It was the first conference of its kind held at UCLA to focus on integrating the science of medicine with spiritual care. The conference was co- sponsored by the Simms/Mann-UCLA Center for Integrative Oncology at the Jonsson Comprehensive Cancer Center and the Simms/Mann Institute for Education and Community Development.
"Physicians focus on disease and medicine, vitally important incancer treatment, but cancer affects more than just the body. It is a disease that changes most parts of a person’s life — the mind, body and soul of an individual," UCLA psychologist Anne Coscarelli, founding director of the Simms/Mann center, told participants.
Medicine alone is not enough, she said. "We need to integrate medical science with what we have learned about optimizing psychological well-being, including spirituality to heal patients with cancer and their families."
As a UCLA oncologist and a survivor of acute lymphocytic leukemia himself, Dr. Herbert Eradat said cancer specialists recognize the value of spiritual care. An article in the Journal of Clinical Oncology reported that as many as 88 percent of patients concurred that spirituality is at least somewhat important or frequently extremely important in coping with cancer.
Describing himself as a religious person, Eradat said that tending to his spiritual needs helped him endure and survive his own cancer diagnosis. "Cancer is one of the most anxiety-inducing words a patient can hear," he said, "so anything that can be done to reduce that anxiety would be very helpful."
One way members of the clergy can help is by urging patients and their families, often left reeling after hearing a diagnosis of cancer, to inform themselves about what they are facing. There are some important questions they should counsel their congregants to ask their doctors, Eradat advised:
What type of cancer is this?
What is the stage of the cancer?
What are the best treatments and how soon do we need to treat this cancer?
What are the side effects of treatment?
What are the goals of treatment — curative or long-term stabilization of the cancer?
What can you give for symptom management?
Eradat said patients often ask their oncologists to speak to their religious and spiritual leaders to let them know what issues may arise and need addressing so that doctors and clergy can work together.
Michael Eselun, an interfaith chaplain at the Simms/Mann center, shared his experiences in addressing the spiritual challenges faced by cancer patients and their families.
"Many patients identify themselves as spiritual but not religious, so it’s important to ask them what breathes life into their life — God, a higher power, a dog, their family, surfing or whatever it is, a place where they feel a connection to a larger sense of meaning," Eselun said. "Cancer can really mess with that. I see the role of a chaplain as one who walks beside the patient through their journey, just to be ‘with’ them and to extend compassion. The patient is the teacher in this situation, and I am the student." Allowing patients to be teachers empowers them, and knowing that they are not alone becomes a soothing balm to a sore spirit, he said.
A cancer diagnosis can also allow doubt to creep into the picture. Religious individuals may question why their God has done this to them, the chaplain said. Secular patients may come to believe that there has to be more to this life than they believed. "Doubt is a disquieting visitor," Eselun said. "Grace in the cancer journey is vital."
Eselun shared stories about the spiritual crises that some of the patients he has counseled have experienced. Myra, a woman in her 30s with leukemia, had been raised a Catholic, but didn’t go to church. After she got cancer, Myra felt that maybe she should begin praying. But she also felt there was only so much grace to go around and that she had not earned it.
Phyllis, also a leukemia patient, wondered if she had offended God in some way and that leukemia was the result of that offense. But her cancer was curable, so really what she got was just a slap on the wrist from God, she felt. Did God have favorites, and if so, did this mean she was one?
Coscarelli also had some advice for the clergy. It’s important to take each individual separately and consider his or her own needs. Young cancer patients, for example, often have more stress and anxiety. And when the treatment ends, the cancer experience continues. In fact, in many cases, that’s when patients really start to begin dealing with the psychological impact of their disease, she said.
"Many patients can go from coping very well during treatment to experiencing episodes of acute anxiety and fear," Coscarelli said. Having multiple strategies to deal with the stresses and the flexibility to move between the strategies when necessary can help patients and their families to cope effectively, "leading to greater healing and reduced suffering."
With psychological and spiritual care, cancer patients can come out on the other side feeling that they are stronger, more self-assured, better able to face challenges, and often, with a greater purpose and meaning, experts said.
Participants at the conference said they now had a better understanding of how doctors and spiritual leaders can work together.
"As pastors, we are regularly called upon to walk the dark night of the soul with our congregants through the journey of cancer, but often perceive the medical community to be disinterested in the intersection of body and soul," said the Rev. Lynn Cheyney of the Westwood Presbyterian Church. "The bridge that the Simms/Mann center is building between the medical world and the faith community will allow for far better care for the whole person."
The conference "opened a conversation on how clergy might work with physicians, chaplains and therapists to heal the spirit and restore life and strength to souls threatened by despair and darkness," said Rabbi Ed Feinstein of Valley Beth Shalom in Encino.