THE MEAN I N G OF RELI GI OUS BELI EFS FOR A GROUP OF
CANCER PATI ENTS DURI NG REHABI LI TATI ON
1Ver ôn ica Vr ban Aqu in o2 Már cia Mar ia Font ão Zago3
Aquino VV, Zago MMF. The m eaning of r eligious beliefs for a gr oup of cancer pat ient s dur ing r ehabilit at ion. Rev Lat in o- am En f er m agem 2 0 0 7 j an eir o- f ev er eir o; 1 5 ( 1 ) : 4 2 - 7 .
The obj ect ive of t his explor at or y st udy w as t o ident ify how r eligion influences t he sur vival of a gr oup of
cancer pat ient s. The st udy consist ed of an et hnogr aphic case w it h t he par t icipat ion of six lar yngect om ized m ale
and fem ale pat ient s bet w een 51 and 72 y ear s old, w ho had been oper at ed on t w o t o fiv e y ear s ear lier . Dat a
w er e collect ed by sem ist r uct ur ed int er v iew s and analy zed on t he basis of t he concept s of cult ur e and r eligion.
Th e r esu lt s w er e sy n t h esized in t o t h r ee descr ipt iv e cat egor ies: t h e m or al r epr esen t at ion of can cer , r eligiou s beliefs about t he cancer t r aj ect or y, and negot iat ion w it h r eligion for sur vival. These cat egor ies give r ise t o t he
m eaning “ t he hope for a second chance” , w hich em phasizes t he im por t ance of r eligion as par t of t he suppor t
net w or ks t hat ar t iculat e w it h t he pat ient ’s coping w it h t he st igm a of cancer , w it h t he hope for cur e, and w it h t he
w ay s of or ganizing ev er y day life, dur ing sur v iv al.
DESCRI PTORS: n eoplasm s; m edical on cology ; r eligion ; cu lt u r e; su r v iv al; r eh abilit at ion
EL SI GNI FI CADO DE LAS CREENCI AS RELI GI OSAS PARA UN GRUPO
DE PACI ENTES ONCOLÓGI COS EN REHABI LI TACI ÓN
La finalidad de est e est udio ex plor at or io fue ident ificar cóm o la r eligión influencia la super v iv encia de
u n gr u po de pacien t es on cológicos. Con sist ió en u n est u dio de caso et n ogr áfico con la par t icipación de seis
lar ingect om izados, de am bos sexos, con edad de 51 a 72 años, que habían sido oper ados de dos a cinco años
an t es. Los d at os f u er on r ecogid os p or en t r ev ist as sem i- est r u ct u r ad as y an alizad os segú n los con cep t os d e
cu lt u r a y r elig ión . Sin t et izam os los r esu lt ad os en t r es cat eg or ias d escr ip t iv as: la r ep r esen t ación m or al d el
cáncer , las cr eencias r eligiosas en el t r ay ect o del cáncer y la negociación con la r eligión por la super v iv encia.
El significado que r esult a - “ la expect at iva por una segunda opor t unidad” - enfat iza la im por t ancia de la r eligión
com o par t e de las r edes de apoy o qu e se en caden an con la con ciliación con el est igm a del cán cer , con la
ex pect at iv a de cur a y con las for m as de ar r eglar la v ida cot idiana, en la super v iv env ia.
DESCRI PTORES: n eoplasm as; on cologia m édica; r eligion ; cu lt u r a; su per v iv en cia; r eh abilit ación
O SI GNI FI CADO DAS CRENÇAS RELI GI OSAS PARA UM GRUPO
DE PACI EN TES ON COLÓGI COS EM REABI LI TAÇÃO
Est e est udo explor at ór io t eve o obj et ivo de ident ificar com o a r eligião influencia a sobr evivência de um
g r u p o d e p a ci e n t e s o n co l ó g i co s. Co n si st i u e m e st u d o d e ca so e t n o g r á f i co , co m a p a r t i ci p a çã o d e se i s
lar ingect om izados, de am bos os sex os, na faix a et ár ia de 5 1 a 7 2 anos, oper ados de dois a cinco anos. Os
d ad os f or am colet ad os p or en t r ev ist as sem i- est r u t u r ad as e an alisad os seg u n d o os con ceit os d e cu lt u r a e
r elig ião. Sin t et izou - se os r esu lt ad os em t r ês cat eg or ias d escr it iv as: a r ep r esen t ação m or al d o cân cer , as cr en ças r eligiosas n a t r aj et ór ia do cân cer e a n egociação com a r eligião par a a sobr ev iv ên cia. O sign ificado
que em er ge - “ a ex pect at iv a por um a segunda chance” - enfat iza a im por t ância da r eligião com o par t e das
r edes de apoio que se ar t iculam com o enfr ent am ent o do est igm a do câncer , com a expect at iva da cur a e com
as for m as de or ganizar a v ida cot idiana, na sobr ev iv ência.
DESCRI TORES: n eoplasias; on cologia; r eligião; cu lt u r a; sobr ev iv ên cia; r eabilit ação
1
St udy pr esent ed at t he 20t h Sym posium of Scient ific I nit iat ion at t he Univer sit y of São Paulo, Funded by t he Brazilian Council of Scient ific and Technological Developm ent - CNPq, pr ocess num ber 520604/ 96- 2; 2 Under gr aduat e St udent , Scient ific I nit iat ion grant holder ; 3 Advisor, Associat e Pr ofessor, em ail:
m m fzago@eer p.usp.br. Univer sit y of São Paulo at Ribeir ão Pr et o College of Nur sing, WHO Collabor at ing Cent r e for Nur sing Resear ch Developm ent
I NTRODUCTI ON
I
n We s t e r n s o c i e t i e s , t h e s y m b o l i s m associat ed w it h can cer is t h at of an in cu r ab le an dm y st er iou s d isease t h at in v ad es t h e b od y, cau sin g losses an d su f f er in g . Th is sy m b olism p er sist s ev en t h ou gh t h e pr ogr esses of diagn osis an d t r eat m en t s
hav e incr eased t he pat ient sur v iv al.
T h e c a r e o f c a n c e r p a t i e n t s c o m p r i s e s r e h a b i l i t a t i o n , a c o n t i n u o u s a n d i n d i v i d u a l i z e d
pr ocess t hat aim s at dev eloping and m ax im izing t he indiv iduals’ capacit ies w it hin t he lim it at ions im posed by t he disease and t he t r eat m ent( 1). The pur pose of
r ehabilit at ion is t o pr om ot e t he pat ient ’s sur v iv al w it h t h e b e st p o ssi b l e q u a l i t y o f l i f e . I n t h i s co n t e x t , sur v iv al r efer s t o t he per iod t hat begins at t he t im e
of d iag n osis an d last s in d ef in it ely d u r in g an d af t er t r eat m en t( 2 ).
We f o l l o w e d u p c a n c e r p a t i e n t s w h o
par t icipat ed of a suppor t gr oup called GARPO ( Gr upo
d e Assist ên cia à Reab ilit ação d o Lar in g ect om izad o,
Gr o u p f o r S u p p o r t t o t h e Re h a b i l i t a t i o n o f t h e
Lar y n gect om ized) . Th e f r equ en t r ef er en ces t h at t h e p a t i en t s m a d e t o t h ei r r el i g i o u s b el i ef s l ed u s t o r e s u m e o u r p r e v i o u s w o r k t h a t f o c u s e d o n t h e
m eaning of being lar yngect om ized. For t hese pat ient s, t h e r eligiou s pr act ice w as a st r at egy f or r ecov er in g t h e s t r e n g t h l o s t w i t h t h e d i s e a s e a n d t h e
t r eat m ent s( 3). Thus w e st ar t ed t he pr esent st udy w it h t he obj ect iv e t o ev aluat e how r eligion influences t he su r v iv al of can cer pat ien t s, u sin g an in t er pr et at iv
e-cu lt u r al appr oach .
TH EORETI CAL AN D M ETH OD OLOGI CAL
BACKGROUN D : CULTURE, RELI GI ON AN D
ETHNOGRAPHI C CASESTUDY
Cu lt u r e is a b od y of m ean in g s t r an sm it t ed hist orically w it hin t he social group, by m eans of w hich
t h e i n d i v i d u a l s d e v e l o p t h e i r k n o w l e d g e a n d t h e act ivit ies relat ed t o life. As a social const ruct , cult ure pr ov ides a w ay of seeing and int er pr et ing t he w or ld,
fr am ing t he cognit iv e and t he affect iv e life, and as a con seq u en ce in f lu en ces t h e in d iv id u al’s at t it u d e t o healt h and disease. The ex per ience of hav ing cancer
is par t icu lar ly ch allen gin g t o t h e pat ien t , w h o look s for m eans t o confr ont it , and in t he West er n cult ur e r eligion is view ed as a valuable st rat egy t o cope w it h
disease and it s t r eat m ent s( 4).
The et hnogr aphic case- st udy( 5- 6), a t radit ional
t o o l o f t h e a n t h r o p o l o g i c a l r e s e a r c h , w a s t h e m et h o d o l o g i cal st r at eg y sel ect ed t o ap p r o ach t h e pr oblem , sin ce it allow s t o con solidat e t h e r eligiou s
ex per ience of t he cancer sur v iv or s and at t he sam e t im e recognizes t he singularit y of each individual and his ( or her ) point - of- v iew .
The st udy included six pat ient s ( t hr ee m ales and t hr ee fem ales) w ho had been subm it t ed t o t ot al lar y n gect om y bet w een t w o t o f iv e y ear s bef or e t h e
st udy, w ho did not pr esent physiological com plicat ions, a n d co m m u n i ca t e d b y e so p h a g e a l sp e e ch , v o ca l pr ot hesis or elect r onic lar y nx . They w er e fr om 51 t o
7 2 - y ear of ag e, t h r ee w er e m ar r ied , t w o w id ow ed an d on e sin gle; t w o h ad r et ir ed befor e t h e su r ger y, t w o aft er t he oper at ion and t w o w er e st ill w or king.
Dat a w er e collect ed on t he m ont hly m eet ings of t h e su ppor t gr ou p an d in t h e pat ien t ’s h om e, by m eans of sem i- st r uct ur ed obser vat ions and int er view s
orient ed by t he quest ion: “ how t he religious fait h helps you t o cope w it h your condit ion?” The int er view s w er e r e c o r d e d a n d t r a n s c r i b e d , w i t h t h e s u b j e c t ’ s
perm ission. A m ean of t hree int erview s per part icipant w er e car r ied ou t , last in g an av er age of 2 0 m in u t es each, dur ing a per iod of eight m ont hs.
Th e r e s e a r c h w a s a p p r o v e d b y t h e inst it ut ional review com m it t ee. All t he pat ient s agreed t o p ar t icip at e, sig n ed a t er m of f r ee an d in f or m ed
con sen t an d t h eir n am es w er e cod ed b y let t er s t o pr eser v e t h eir iden t it ies.
Dat a an aly sis w as p er f or m ed in t w o st ep s.
Fi r s t l y, b y r e a d i n g r e p e a t e d l y t h e i n t e r v i e w t r anscr ipt ions, w e const r uct ed descr ipt iv e cat egor ies t h at descibe t h e con t en t s or m ean in gs giv en t o t h e
t h e m e . Th e n , o n t h e b a s i s o f t h e t h e o r e t i c a l r efer ences, w e const r uct ed analy t ical cat egor ies t hat revealed religion as a coping st rat egy for t he oncologic
pat ient( 5- 6).
RESULTS AND DI SCUSSI ON
Th e descr ipt iv e cat egor ies r ecogn ized w er e:
t he m oral represent at ion of cancer, t he religious beliefs i n t h e c a n c e r t r a j e c t o r y, a n d t h e c o v e n a n t [ co m p r o m i se, d eal i n g ] w i t h r el i g i o n f o r su r v i v i n g .
Th ese cat egor ies su m m ar ize t h e m ean in gs t h at t h e part icipant s of t he st udy at t ach t o t he religious beliefs as a st rat egy for sur viving t o cancer. On t he basis of
an d cu lt u r al ch ar act er ist ics of t h e p ar t icip an t s, t h e
abov e cat egor ies w er e in t egr at ed in t o t h e m ean in g “ t he hope for a second oppor t unit y”.
Th e m or al r epr esen t at ion of can cer
The m or al and r eligious punit iv e connot at ion
of can cer as a f at al d isease, p r ev ailin g am on g t h e l o w e r s o c i a l s t r a t a , w a s e m p h a s i z e d b y t h e par t icipant s of bot h sex es and all ages.
“ God chooses st rong persons for t he t rial of t his disease.
I t is not a punishm ent . God t ries people because som e need t o be
m olded, t ransform ed. God draws a good from t he evil! ” ( B., fem ale,
51 year s) . “ Now , aft er all t his suffer ing, I under st and t hat m y
life w as not so good! I t hink t hat I didn’t do t he r ight t hings. I
t hink t hat I am paying for w hat I ’ve done. This disease m akes us
t hink about t he life, what was right and what was wrong... Sm oking
and dr inking w er e not t he cause of t he disease; it ’s som et hing
else, t he im pr oper lifest yle....” ( D, m ale, 62 year s) .
Th i s c o n n o t a t i o n i s c h a r a c t e r i s t i c o f t h e West er n ch r i st i an i t y t h at r el ay s t h e i d ea t h at t h e i n d i v i d u a l s a r e su b j e ct f o r ce s o f a f a t e d i v i n e l y
det erm ined, w hich highlight t he relat ion of punishm ent a n d r e d e m p t i o n( 7 ). Fr o m t h i s p o i n t - o f - v i e w , t h e r eligious int er pr et at ion of healt h- disease conv ey s t he
u n d er st an d i n g t h at t h e w o r l d h as an o r d er i n t h e s a c r e d - p r o f a n e f i e l d . By s u b m i t t i n g t o Go d a n d accept ing t he chaot ic sit uat ions of life, it is possible
t hat t he sacr ed subm it t he pr ofane. I n t his way, t he divine ent it y dom inat es t he hum an life, t he unexpect ed ( i. e., t he disease) m ay be for eseen, t he haphazar d
m ay be ex plain ed, f at e is su bst it u t ed by t h e div in e p r ov id en ce( 8 ).
The ex per ience of a chr onic disease and it s
t her apies env isages [ conceiv es, assum es] a sy m bolic b r id g e t h at lin k s t h e b od y, t h e self- im ag e an d t h e societ y. Th is ch ain in t er - r elat es t h e p r ocesses, t h e
m eanings and t he relat ionships, in such a way t hat t he social w or ld is connect ed t o t he per sonal ex per ience. This world is defined by [ lim it ed t o?] what is of int erest
for t he individuals and t he social groups( 9- 10).
The r eligious beliefs in t he cancer t r aj ect or y
The subj ect s em phasize t heir religious beliefs and behav ior befor e t he beginning of t he disease.
“ I ’ve alw ays been a cat holic, but befor e m y disease I
used t o pr ay alone” ( C. Fem ale, 56 year s) . “ I ’ve alw ays been a
cat holic, like ever yone else! But I didn’t go t o t he chur ch, I didn’t
t alk t o God” ( D., m ale, 62 year s) . “ Befor e t he sur ger y I follow ed
t he cat holic r eligion, w ent t o chur ch ever y Sunday, but I didn’t
pray t he rosary” ( A, fem ale, 51 years) . “ I am a cat holic. I don’t go
t o church, don’t pract ice, but I ’m a cat holic” ( E., m ale, 72 years) .
Wo m e n st r e sse d m o r e e m p h a t i ca l l y t h e i r
religious links t hen m en, but all point ed out t hat t hey w er e chr ist ian, in or der not t o st r ay fr om t he social pat t er ns of t he gr oup.
They st ar t ed t o look for t he r eligious st r at egy at t he t im e of diagnosis, searching for an explanat ion for t he inev it able.
“ I w ent t o t he r eligious feast , ent er ed int o t he chur ch
and st art ed praying t he rosary. Then I asked God t o show m e t he
w ay. The doct or had not yet t old m e t hat it w as cancer . I found
t he rosary and st art ed t o pay. When t he doct or t old m e t hat I had
a m alignant t um or, it was incredible. I t seem ed t hat I was wait ing
for t hat ...” ( A, fem ale, 51 year s) .
I n t h e sear ch for r eligiou s su ppor t for t h eir afflicit on, a par t icipant liv ed an unex pect ed sit uat ion.
“ One w eek befor e being oper at ed I w ent t o t he chur ch
and t alked t o t he m inist er . I w ent t her e because it is near m y
house and I already knew t hat part icular religion by t he t elevision.
He t old m e t hat if I had a t r ue fait h in Jesus, I should not subm it
t o t he operat ion, because Jesus would operat e m e wit hout need t o
do any sur ger y. But m y niece said t o m e: Don’t believe t hat ! You
w ill loose your t ur n in t he oper at ion list and t hen you’ll need t o
w ait your t ur n again. I w as feeling ver y badly and t hought : I w ill
go t hrough wit h t he surgery. For m e, Jesus is t he doct ors’ doct or.”
( D, m ale, 62 years) .
Th i s a cco u n t sh o w s h o w t h e p r o p o sa l f o r t r eat m ent by r eligious int er v ent ion caused a conflict t o t h e p at i en t , w h i ch w as h o w ev er so l v ed b y t h e
fam ily’s int er vent ion t hat helped her t o decide for t he m edical t r eat m en t .
Th is im age of su f f er in g giv es t h e on cologic
pat ient a dist inct iv e ident it y w it hin t he social gr oup, an ident it y t hat sim ult aneously ev ok es st r engt h and w e a k n e s s , v u l n e r a b i l i t y a n d d e t e r m i n a t i o n ,
r esign at ion an d cou r age. Th is w ay of in t er pr et in g a sev er e d isease d er iv es f r om com m on sen se am on g d i f f e r e n t so ci a l g r o u p s( 1 1 ). I n t h i s si t u a t i o n , t h e
individuals t urn t o God for t he first t im e in t heir lives, or m or e oft en and fer vent ly t hen befor e, because God
alw ay s h elp .
Ex p r ession s su ch as “ God w illin g , God w ill
h el p m e, I ask Go d ” , an d “ I t h an k Go d ” t h at t h e
par t icpant s used fr equent ly ar e lear ned v er y ear ly in
life in t he fam ily surroundings, and help t o underst and t he influence of r eligion. How ev er, t hese ex pr essions ar e not r elat ed t o t he or ganic dim ension, but r at her
elicit ed b y t h e st ig m a associat ed w it h t h e p r of an e
im age of t he disease.
Th u s, t h e se a r ch o f r e l i g i o u s su p p o r t b y m eans of r it ualist ic par ct ices or by inv ok ing God, in
t he chaot ic sit uat ion represent ed by t he disease, is a p r act ical st r at eg y, esp ecially b ecau se in t h e u r b an env ir onm ent a lar ge v ar iet y of r eligious ser v ices ar e
av ailable, an d t h e m em ber s of t h e su ppor t n et w or k incent ivat e t he pat ient s t o use t hem( 11).
The cov enant w it h r eligion t o sur v iv e cancer
Fr om t he t im e of diagnosis and t he sur ger y,
sur v iv al is const ant ly t hr eat ened by t he possibilit y of relapse. Alt hough t he part icipant s were going t hrough a part icularly good period when t hey were int erviewed,
o w i n g t o t h e g o o d p h y si ca l co n d i t i o n s a n d t h e psychosocial rehabilit at ion, t here was a perm anent dread of r elapse, r ev ealed by t he com m ent s t hat cir culat ed
during t he group m eet ings, about t he pat ient s who were not in r em ission any m or e. I n t his cont ex t , r eligious beliefs fulfill t he need for hope in t he fut ure.
“ I believe t hat God dr aw s good fr om t he evil. I t is
im por t ant t hat people do not give in t o deat h, Jesus give us a lot
of st r engt h” ( B, fem ale, 54 year s) . “ I t r uly believe in God. I f you
believe in Him , you m ay go t hr ough difficult ies but He helps you”
( C, fem ale, 56 year s) . “ Of cour se I changed! Aft er all t his, w e get
m or e at t ached t o God. When w e ar e w ell, w e for get Got . I t hink
God is one and t he sam e, w hat ever t he r eligion. Consider ing t he
t ype of oper at ion t hat w as subm it t ed t o... I f you have st r engt h
and fait h in God, He will help you! ” ( F, m ale, 53 years) . “ I don’t go
t o t he chur ch, don’t pr act ice, but I am a cat holic. I have alw ays
pr ayed and cont inue t o pr ay... This helped m e, because I asked
God t o get bet t er , for ever yt hing t o go w ell, and ever yt hing w ent
w ell, God be blessed! ” ( E, m ale, 72 year s) .
The sear ch for r eligious suppor t inv olv es t he w hole social net w or k of t he pat ient and t he com m unit y,
as r ev ealed by t he account s.
“ I ’ve gone t o var ious chur ches, t he fr iends invit e m e
and we go t here t o pray... t hey are always helping us...” ( F, m ale,
53 years) . “ When I was operat ed, m y brot her asked a brot herhood
t o help m e, t o pr ay for m e. The w hole chur ch helped m e, t he
bret hren prayed for m e... When I was discharged from t he hospit al
I w ent t o t he chur ch; I w ent t o t he Univer sal Chur ch, t hen t o t he
I nt er nat ional Chur ch of t he God’s Gr ace, t o w hich m y sist er
b el o n g s, an d n o w I ’m f r eq u en t i n g t h e Br azi l i an Ch r i st i an
Congregat ion. God is only one, always t he sam e, only t he churches
ar e differ ent . I t is w or t h t o be on God’s w ays; if you have fait h,
you’ll succeed” ( D, m ale, 62 years) . “ My wife helped m e by praying
for m e in t he chur ch” ( E, m ale, 72 year s) .
Th e m a j o r i t y o f t h e p a r t i c i p a n t s r e p o r t
accept an ce an d at t en t ion by t h e ch u r ch com m u n it y dur ing t he per iods of gr eat est sever it y of t he disease, in t his w ay approxim at ing t he religion w it h t he disease
set t ing. Fam ily and t he r eligious pract ices ar e par t of t he social net w or ks t hat pr ovide suppor t t o t he pat ient , in par t icular in t he cognit ive, nor m at ive and affect ive
dom ain( 7 ).
Ther e ar e sever al st udies t hat em phasize t he role of religious influence in t he care of pat ient s w it h
sev er e diseases such as cancer. Som e aut hor s hav e point ed out t hat t he r ehabilit at ion of t he pat ient s w ho h av e r eligiou s belief s is associat ed w it h a sen se of
h ope an d sat isf act ion w it h lif e an d less depr ession . For t h is r eason , r elig iou s b elief is r ecog n ized as a cop in g st r at eg y f or su r v iv al in can cer, esp ecially in
low er social classes, independent ly of age and sex(
11-14)
. The pow er at t r ibut ed t o t he div ine ent it y per m it t h e sa t i sf a ct i o n o f n e e d s t h a t e sca p e t h e h u m a n
cont r ol, avoiding t he sent im ent s of fear of t he fut ur e.
Meaning: The hope for a second oppor t unit y
When t he pat ient s connect t he disease w it h a r eligious design, t he indiv idual act ions ar e r econciled
w it h t he sacred, acquiring a qualit y of m oral or spirit ual super ior it y t hat do not allow t he separ at ion of t heir healt h condit ion befor e and aft er t he t r eat m ent . Fr om
t he account s of all t he par t icipant s em er ged t he m agic-r eligious belief t hat t he divinit y can cont agic-r ol t he w oagic-r st sit u at ion s.
“ God helped m e t o accept w ell… When God closes a
door , He opens a w indow . I t is by God’s m er cy t hat I ’m w ell. Now
I can go out , t ake car e of m y affair s, do t he cleaning up at hom e.
I t w as a God’s m ir acle. I t hought t hat m y life had com e t o t he
end. I t ’s been four year s since m y oper at ion… This m ust be a
sign of God’s help” ( A, fem ale, 51 year s) . “ Aft er all t hat , God
t eaches us ever yt hing… We loose t he fear of t he dying. I t old
Mar y, t he Mot her of God: now I w on’t hold Your hand any m or e,
I ’ll j ust lay m y head on your bosom and let you do Your w ill” ( B,
fem ale, 54 year s) . “ God doesn’t punish anyone. He helped m e,
because w hen I w as going t o t he sur ger y I said: I ’m going t o die.
How ever , w hen I w oke up fr om t he sur ger y I said: m y God, I ’m
st ill her e, t hank you! You need t o t hank… I oft en ask for God’s
for giveness for m y er r or s, and He for gives m e” ( C, fem ale, 56
year s) . “ I t hought : I ’m not hing, I ’ll follow t he pat h of t he chur ch.
I w ant t hat Jesus pr ot ect m e in all senses. Ther e ar e som e days
t hat I w ake up br eat hless because of t he em physem a, w hich is
sever e and has no cur e. Then I t hink: God suffer ed m or e t han
wouldn’t have learned to speak again. I ’m sure that I owe everything
t o God. I can be cur e any m om ent . I do m y par t …” ( D, m ale, 62
years) . “ I t ’s because I have a will, I don’t give in. Religion t eaches
you t o be pat ient , t o have hope… t he w or st t hing is t o give in t o
t he disease. Then, you m ust m ake an effor t , it ’s not easy” ( F,
m ale, 53 year s) .
Ca n ce r e l i ci t s t w o e st a b l i sh e d i m a g e s o f
cancer in t he popular cult ur e: diagnosis of cancer is equiv alent t o a deat h sent ence, leading t o fear ; t he under st anding t hat diagnosis and t r eat m ent lead t o a
change - t he opport unit y of a second life. Wit hin t his cont ext , t he search for religion should not be seen as a m e a n s t o e sca p e f o r m r e a l i t y, b u t r a t h e r a s a
p er sp ect iv e f or t h e f u t u r e b ecau se of t h e su f f er in g u su ally associat ed w it h can cer. Th is v iew h elp s t o u n d e r s t a n d w h y t h e r e l i g i o n s o f f e r r e s u l t s o f a
sy m bolic efficacy, in r elat ion t o w ell- bein g an d self-cont rol. Cult urally, religions play various role: t o creat e an ident it y of cohesion bet w een t he people, t o gain
new st rengt h in t he fight for survival, and t o reinforce a cult ural resist ance t hat by it self reinforces t he search of r elig ion as a solu t ion , as r elat ed b y on e of t h e
par t icipant s of t his st udy( 15).
Alt hough som e of t he pat ient s have at t ended ser v ices at sev er al r eligious denom inat ions, t he for m
by which t hey refer t o t he religious fait h is charact erist ic o f Ca t h o l i ci sm . I n d e e d , a l l t h e d i f f e r e n t r e l i g i o u s pr act ices t hat t hese pat ient s at t ended shar e com m on
aspect s wit h popular Cat holicism in relat ion t o cure for a severe disease: t he belief in a m agic power, a kind o f g r av i t at i o n al ci r cl e o f en er g y t h at l i n k s al l t h e
believ er s w ho shar e t he sam e ex pect at ions, and t he f e e l i n g o f a s o c i a l o r d e r t h a t d e r i v e s f r o m t h e m i r a cu l o u s i n t e r v e n t i o n( 1 2 ). We n e e d t o co n si d e r,
how ev er, t hat fait h, a cent ral v alue for t he r eligious sy st em , is a per sonal ex per ience or adhesion t o t he sacr ed . We ob ser v ed t h at t h e p ar t icip an t s f ollow a
p op u lar ch u r ch d en om in at ion , su ch as t h e Cat h olic Chur ch, for conv enience or t r adit ion, r at her t han by con v ict ion d er iv ed f r om d oct r in al k n ow led g e. As a
con seq u en ce, t h e f or m of p r act icin g t h e r elig ion is individual, alt hough all t he part icipant s refer t o at t end som e for m s of cult s or r it uals, such as collect iv e or
individual pray. Thus, despit e t he personal involvem ent w it h t he r eligion being only par t ial, it is sufficient t o give t he feeling of part icipat ing of a religious com m unit y,
cont ribut ing t o lessen t he discrim inat ions of t he profane life in relat ion t o cancer( 11).
Th e a p p a r e n t f a c i l i t y w i t h w h i c h t h e
p a r t i c i p a n t s m o v e b e t w e e n d i f f e r e n t c h u r c h
denom inat ions suggest s t hat t he social pr act ices ar e
d i s c o n n e c t e d f r o m t h e p r o j e c t s o f t h e d i f f e r e n t r eligious denom inat ions. This m eans t hat t he m odels t hat w e use t o under st and t he r eligious w or ld of t he
in d iv id u als m u st ev alu at e t h e r elat ion sh ip b et w een t h e sy m b o l s o f a r el i g i o n an d t h e p r act i ces o f i t s follow er s. The analy sis of r eligion is t hen appr oached
f r om t h e per spect iv e of t h e r eligiou s ex per ien ce, i. e . , h o w t h e r e l i g i o u s s y m b o l s a r e u t i l i z e d a n d cont inuously gain nov el m eanings, as a consequence
of t he int er act ion bet w een indiv iduals and gr oups( 11).
CLOSI NG COMMENTS
This st udy allow ed us t o under st and t hat t he
cancer sur v iv or s live w it h a t r ansit ion ident it y, ow ing t o t h e lon g t im e sin ce t h e op er at ion an d t h e g ood em ot ional and phy siological condit ions: t hey ar e not
“ n o r m a l ” so ci a l l y - b e ca u se o f t h e se q u e l s - a n d sy m bolically t hey ar e hum an beings w it h differ ences. Th i s cr e a t e s a m b i g u i t y a n d u n ce r t a i n t y f o r t h e i r
ident it y, and increases t he need t o respect t he cult ural t r adit ion of r eligious beliefs and pr act ices. Thus, t he p a r t i ci p a n t s, w h o b el o n g t o t h e p o p u l a r st r a t a o f
societ y and t o t he age gr oup above 50 year s, behave as t hey feel appropriat e t o t he sit uat ion of illness and sur v ival t o cancer, independent ly of t heir sex .
Spir it u alit y is a con st r u ct of t h e per son alit y of each in div idu al - an ex pr ession of h is/ h er iden t it y a n d p u r p o se a t t h e l i g h t o f t h e p er so n a l h i st o r y,
ex per ien ce an d aspir at ion s. For t h is r eason , r eligion l e sse n s su f f e r i n g , si n ce i t p e r m i t s t o ch a n g e t h e su bj ect iv e per spect iv e u n der w h ich t h e pat ien t an d
t h e c o m m u n i t y e x p e r i e n c e t h e s e v e r e d i s e a s e . O w i n g t o t h e m e a n i n g s o f c a n c e r, t h e p a t i e n t r ed ir ect s h is at t en t ion t o n ew asp ect s or p er ceiv es
t h e ex per ien ce fr om a n ew poin t of v iew . Th e r eliev e of su f f er in g, t h e su r v iv al or t h e cu r e w ou ld n ot m ean t h e r e t u r n t o t h e st a t e b e f o r e t h e d i se a se ; t h i s
ch a n g e d si t u a t i o n i s f e l t a s n e w e x p e r i e n ce - a secon d oppor t u n it y of lif e br ou gh t abou t by su r v iv al. To a c h i e v e t h i s , t h e a d h e s i o n t o a r e l i g i o n , i n
accor dan ce w it h t h e cu lt u r al con st r u ct of t h e social g r o u p , i s m o r e v er b a l t h a n f o r m a l o r sy st em a t i c, an d t h e p at ien t at t en d s t o sev er al of t h e r elig iou s
p r act ices an d or g an izat ion s av ailab le w it h su p p or t of t h e social n et w or k .
One of t he difficult ies of t he professionals w ho
of oncologic pat ient s is t o under st and how t he pat ient p er cei v es h i s/ h er o w n l i f e af t er t h e d i sease. I t i s possible t hat t he relat ionship t hat t he healt h personnel est ablish w it h t he pat ient s is ruled by t he expect at ion of searching for a rat ional and efficient survival, w hich m ay be incom pat ible w it h a com pr ehensiv e appr oach t o t h e d i sease as a so ci al an d cu l t u r al co n st r u ct . Recen t ly, t h e r ole of sp ir it u alit y an d r elig ion in t h e e x p e r i e n c e o f c a n c e r h a s b e e n i n c r e a s i n g l y
r e c o g n i z e d , b e c a u s e i n s t e a d o f t h e r e d u c t i o n i s t ex plan at ion of m edicin e, t h e r eligiou s sy st em s offer an ex planat ion for t he disease t hat is int egr at ed int o t he pat ient ’s social and cult ur al cont ex t .
For t his r eason, t he healt h pr ofessionals ar e increasingly aw are of t he im port ance t o t ake religiosit y int o consider at ion w hen planning and deliv er ing car e t o can cer su r v iv or s, in or d er t o m ain t ain t r u st an d r espect in r elat ion t o t he pat ient s’ beliefs.
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