Use of religion and spirituality can help patients cope with stress of radiation therapy

Researchers at the Mount Sinai Health System have identified specific ways in which addressing religion and spirituality during radiation therapy can play an important role in the care of patients with gynecologic cancers. The study, published in the September/October 2025 issue of Practical Radiation Oncology, is the first to identify which aspects of spiritual history patients themselves prioritize and find most meaningful.

A collaborative team from Mount Sinai and NYU Langone Health led the research. Key contributors included Lauren Jacobs, MD, a resident physician in Radiation Oncology at the Icahn School of Medicine at Mount Sinai; Karyn Goodman, MD, MS, Vice Chair for Research and Quality in the Department of Radiation Oncology at Mount Sinai; and senior author Stella Lymberis, MD, a radiation oncologist at NYU Langone’s Perlmutter Cancer Center. This is the first study to assess which spiritual history questions matter most to patients.

Using the validated FICA Spiritual History Tool (which was developed in 1999 by Christina Puchalski, MD, in collaboration with a group of primary care physicians), the team interviewed 11 patients with gynecologic malignancies who had received external beam radiation therapy and/or brachytherapy. These patients adhered to a range of faiths, including Christianity, Buddhism, Judaism, Islam, and Hinduism.

“Our study highlights that patients want these conversations and that spirituality plays a vital role in how they cope with stress during cancer treatment,” said Dr. Jacobs, first author. “By asking the right questions, clinicians can create meaningful dialog without adding burden to already time-limited visits.”

The study found that 82% of patients rated their faith as extremely important, giving it the highest score possible. On average, participants considered nearly all of the FICA Spiritual History Tool questions to be helpful, with six questions consistently identified as especially valuable. The two questions most often highlighted as meaningful ways to begin conversations with providers were: “Do you have spiritual beliefs that help you cope with stress?” and “Have your beliefs influenced you in how you handle stress?”

The findings are especially significant for patients undergoing gynecologic radiation therapy, such as brachytherapy, which can be invasive and emotionally distressing. Previous research has shown that nearly one-third of patients with cervical cancer develop acute stress symptoms after treatment, with more than 40% reporting post-traumatic stress months later.

“Patients are telling us clearly that their spiritual health matters just as much as their physical health,” said Dr. Goodman. “By engaging with them on these issues, we can better support emotional well-being, reduce distress, and provide truly whole-patient cancer care.”

The research team plans to expand the study to larger patient cohorts, apply the approach earlier in the cancer journey (diagnosis and pre-treatment), and extend it to other cancer types. They also aim to develop protocols and training for clinicians and trainees to normalize and integrate these discussions into routine practice.