Spirituality and cancer: quality of life, anxiety/depression and symptom severity

As a leading cause of morbidity and mortality worldwide, cancer imposes psychological, physical and functional burdens. Recent paradigms focus on integrative treatment approaches in patients with cancer, which include psychological and spiritual care. While spirituality has been shown to have a potential role in alleviating disease burdens, both psychological and physical, this effect has not yet been fully elucidated in the Middle East. Our study examines the impact of spirituality on the quality of life (QoL), depression, anxiety and cancer symptom severity in patients with cancer within the Lebanese population.

Our cross-sectional study followed 200 adults with solid tumours in a tertiary care centre in Beirut, Lebanon. Data were mainly collected through questionnaires: Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale, MD Anderson Symptom Inventory and 36-item Short Form Survey Instrument. Multivariable logistic regression analyses were conducted to predict anxiety and depression. Interaction terms between spirituality and each of symptom severity levels, physical QoL and mental QoL were assessed.

Higher spirituality significantly reduced the odds of anxiety (adjusted OR (aOR)=0.89, 95% CI (0.84 to 0.94), p<0.001) and depression (aOR=0.9, 95% CI (0.85 to 0.95), p<0.001) in patients with cancer, independent of symptom severity or QoL measures.

Our findings shed the light on the role that spiritual care plays in alleviating cancer burden despite physical symptoms severity-and pave the way to potentially modify cancer treatment protocols in the Middle East.