Abstract
Purpose: Spirituality is an important component of the cancer experience. This study aims to assess characteristics of spiritual health following a cancer diagnosis, and evaluate the relationship between spiritual change and the use of complementary and alternative medicine (CAM) among a population-based cohort of cancer survivors. Method: A mailed, cross-sectional survey was completed by 614 cancer survivors identified through the Pennsylvania Cancer Registry. All subjects were 3 to 4.5 years postdiagnosis. Relationships between various characteristics of spiritual health and CAM use were examined, along with clinical and sociodemographic factors. Results: Although large proportions of individuals reported that having cancer had positively affected their spiritual well-being (eg, 40.3% experienced highly positive spiritual changes, 68% felt a high sense of purpose, 75.9% reported being very hopeful), some individuals experienced negative spiritual change (36.1%) and continued to experience high levels of uncertainty (27.2%). In multivariate analyses, those survivors who felt spiritual life became more important (adjusted odds ratio [AOR] = 1.92, 95% confidence interval (CI) = 1.21-3.04, P = .006), or experienced positive changes resulting from the cancer experience (AOR = 1.99, 95% CI = 1.26-3.15, P = .003), were more likely to use CAM than those who stated otherwise. Conclusions: Having cancer affects many different aspects of spiritual well-being, both positively and negatively. Positive changes and increased spiritual importance appear to be associated with the use of CAM. Prospective research is needed to test whether integrating CAM into conventional cancer care systems will facilitate positive, spiritually transformative processes among diverse groups of cancer survivors.