Spirituality and quality of life in low-income men with metastatic prostate cancer

Little in human experience is more difficult than a disease for which there is no cure. It undoubtedly raises existential concerns of mortality and purpose. This leads many patients to seek comfort in their spirituality, which may improve their ability to cope with their disease.

While a positive relationship between spirituality and the quality of life (QOL) of chronically-ill patients has been established in the literature, a study of this relationship in men with metastatic prostate cancer was noticeably absent. This presentation describes the association between spirituality and health-related quality of life (HRQOL) in an ethnically-diverse cohort of low-income men with metastatic prostate cancer. Following a diagnosis of metastatic disease, 86 uninsured, low-income men enrolled in a state-funded program providing free prostate cancer treatment completed a survey containing validated measures of spirituality and general and disease-specific HRQOL. Multivariate analyses were used to assess the effect of spirituality and its two subscales, faith and meaning/peace. Greater spirituality was associated with better HRQOL and psychosocial function. When assessing spirituality subscales, meaning/peace closely tracked with HRQOL. In the absence of high meaning/peace scores, higher faith scores were negatively associated with HRQOL.

This study confirms the positive association between spirituality and HRQOL and provides insight as to how religious faith and life meaning/peace may relate differently to HRQOL. Based on our findings, we encourage clinicians to be mindful of the relationship between spirituality and HRQOL, utilize techniques that may improve patients' spirituality, and recognize potential barriers to working with spirituality in clinical settings.