Two years ago, Kevin Brumett was diagnosed with lung cancer. He was 29, and had never smoked in his life. After an initial round of successful treatment, the cancer has since spread to his brain.
Still, Brumett is determined to fight the disease, and says God is on his side every step of the way. He hopes his fight can help others who share his condition.
"It's not right that people get cancer," says Brumett, from Newton, Mass. "God is giving me the strength to fight this as hard and as long as I possibly can."
Cancer fighters such as Brumett, who employ faith in their battle against the deadly disease, are often able to adjust psychologically to a serious illness, according to several studies. But new research suggests they may also be more likely to exacerbate their own suffering in the final days of life and to leave behind caregivers who have a hard time adjusting to bereavement.
A recent study in the Journal of the American Medical Association finds that cancer patients who use "positive religious coping," or collaborating with God to overcome illness, are more likely to seek heroic measures in an attempt to prolong life. These religious patients were three times more likely to opt for mechanical ventilation and other intensive procedures in their last week of life.
Researchers at Dana-Farber Cancer Institute in Boston had thought that religious patients would opt for more aggressive care at the end of life, but were nonetheless a bit surprised by the results.
Because religious patients often trust in God's sovereignty and an afterlife, "one might expect them to be more accepting of death and let nature take its course at the end of life, rather than pursuing very aggressive treatments," said Dr. Andrea Phelps, lead author on the study and senior medical resident at Beth Israel Deaconess Hospital in Boston. Such a view, she said, reflects a commonly held assumption about how religious patients approach the prospect of imminent death.
But, Phelps added, a few reasons might help explain why religious cancer patients commonly opt for aggressive care in their final days. Among the possibilities:
—faith leads to optimism, even when a prognosis is bleak;
—faith gives purpose to suffering, and in turn helps patients muster stamina for invasive treatments;
—beliefs about sanctity of life may give rise to a quest to prolong life at almost any cost.
"We were concerned" by the study's findings, Phelps said. "We are worried because aggressive care, at least among cancer patients, is a difficult and burdensome treatment that medically doesn't usually provide a whole lot of benefit."
To be sure, not everyone who looks to God for help in battling cancer is determined to prolong life even at great cost. Tad Woodhull, a 75-year-old boat dealer in Owls Head, Maine, believes "God has protected me for some reason" in two bouts with cancer over the past 25 years. But he also watched his brother endure a "miserable" final six months in aggressively battling lung cancer, and has resolved not to experience the same.
"I would go with faith rather than put myself and my family through a version of hell," says Woodhull, an Episcopalian. In a late stage and bleak situation, he said he'd decline invasive medical options and instead trust God with his soul.
For many, leaning on God involves enduring optional treatments that take a weighty toll.
Bill Wilson of Flattop Mountain, Tenn., has felt "God had something more for me to do" since he was diagnosed with stomach cancer in 2005, according to an open letter from his wife, Nancye Wilson. Since chemotherapy treatments began, they've experienced "a life that we in our wildest nightmares couldn't have imagined."
At the same time, chemotherapy has led to kidney damage, hearing loss, debilitating weakness and nausea, and the loss of all body hair. Cancer now afflicts Wilson's liver, and doctors are trying to prevent a recurrence in his stomach.
But the Wilsons have also taken the Psalms to heart by rejoicing, even around total strangers. Bill Wilson, now 62, even traveled this year to watch the Daytona 500 in Florida. He's signed a do-not-resuscitate order to prevent intervention under certain circumstances, but neither he nor his wife can remember what those circumstances would be.
"All of the discoveries, the medicines, the physicians who care for us — these are all gifts from God, gifts that he intends for us to use," Nancye Wilson said in an interview. "He will not give us burdens that are too much for us to bear."
Meanwhile, researchers are considering what lessons to draw from the Dana-Farber research. The study concluded that pastoral counselors and religious communities should discuss how positive religious coping may sometimes be associated with certain negative outcomes, such as a "poor quality of death."
Others add that the study may offer insights to guide the practice of medicine. Kenneth Pergament, a psychologist at Bowling Green State University who studies religious coping, said health care workers too often embrace a "bias against religiousness."
As a result, they often fail to appreciate how motivated religious patients routinely are to overcome illness.
"It's been terribly problematic in psychology and medicine, where the assumption has been that religion is a force of passivity, a defense, a way of avoiding life situations," Pergament said. This new study "challenges the notion that religious people are passive, never experience any anxiety and enter into a kind of gradual and happy decline to death."
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