Impact of Spiritual Wellbeing in Advanced Cancer Patients Receiving Genomic Test Results

Little is known about the impact of treatment availability on the spiritual wellbeing of advanced cancer patients. The aim of this study was to examine the relationships between spiritual wellbeing and patient anxiety, depression, hope, and fear of cancer progression, depending on whether advanced cancer patients were able to access novel therapies.

Australian adult advanced cancer patients who had exhausted all therapeutic options were recruited to undergo comprehensive genomic profiling (CGP) to determine whether a novel treatment was available. Questionnaires were administered prior to testing and within 2 weeks of receiving CGP results. Spiritual wellbeing was measured using the FACIT-Sp-12. Structural equation modeling was used to examine the predictive and mediating relationships among spiritual wellbeing at both time points, mediated by anxiety, depression and hope subscales at time 1 on the fear of cancer progression.

Both questionnaires were completed by 397 patients. A total of 238 (60%) patients had actionable CGP results. At baseline, the spiritual wellbeing constructs of meaning, peace and faith were identified as explanatory variables. At time 1, measures of spiritual wellbeing (meaning, peace and faith), and of hope, anxiety and depression, were identified as mediating variables for the outcome of fear of cancer progression. The test results were non-significant in the model.

The level of spiritual wellbeing in advanced cancer patients undergoing CGP was not impacted by test results but influenced a number of patient outcomes. Efforts to support patient spiritual wellbeing in such cohorts is recommended.