“I lost a critical year of my life, and now I can’t move forward. I feel stuck. My life is passing me by, and I don’t know what I’m supposed to do anymore.”

This quote is from a composite case example that focuses on the spiritual distress experienced by some cancer survivors. Treatment may be over with, and the prognosis may be excellent. All signs may point to the probability of a cancer-free future. But after confronting a potentially life-threatening diagnosis, many survivors struggle with a sense of meaninglessness or disconnectedness.

In “Assessing and Managing Spiritual Distress in Cancer Survivorship” in the January issue of AJN, Timiya Nolan and colleagues explore the concept of spiritual distress and its impact on a person’s quality of life.

A topic that often goes unaddressed.

The authors emphasize the need for clinicians to actively screen for this problem and learn how to initiate conversations with patients. Clinicians are often reluctant to raise the issue of spiritual well-being, and thus wait for survivors to voice any spiritual concerns. While this approach is effective in some cases, if the conversation never occurs, the survivor’s spiritual needs may be unmet.

Guidelines and recommendations do exist.

The authors summarize guidelines and recommendations to address spiritual distress that come from the National Comprehensive Cancer Network, the National Cancer Institute, and the National Consensus Project for Quality Palliative Care. They also point readers to specific spiritual assessment tools, along with their strengths and weaknesses, emphasizing that both primary care and oncology clinicians should be alert for spiritual distress in patients who have survived cancer.