Yesterday, Francis Cardinal George, the archbishop of Chicago, asked the Catholic Church to begin the process of choosing his successor. The 77-year old Cardinal was diagnosed with bladder cancer in 2006. In 2012, the cancer returned and spread to his kidney and liver. Cardinal George started aggressive chemotherapy treatment last month after doctors discovered new cancer cells in his kidney.
The Cardinal's announcement caused your Cancer Examiner to reflect on what we can learn from Cardinal George, what we have learned previously from Cardinal Bernardin, and what the proper role is for religion, spirituality, and prayer in battling and beating cancer.
Lessons in strength, practicality, and love from Frances Cardinal George
“As you have chemo, there are good days and bad days,” Cardinal George aptly noted. His trip to Rome had been postponed as he was hospitalized for a week due to an infection and his doctors have advised him against making the journey to Rome at this time to avoid complications. The Cardinal’s announcement should not be read as a signal of impending demise. Rather, it simply is responsible leadership to provide for succession. It reflects the Cardinal’s love for the people who depend upon him.
Ironically, cancer was front and center on my mind the first time I met Cardinal George many years ago. It was the night before my cancer surgery. My wife, Charlene, and I stayed at a hotel in downtown Chicago to be closer to the hospital. After checking in to the hotel, we went out for what I thought might be my last super. While walking to the restaurant, we saw a group of priests stirring and starting to vacate a gathering. Charlene looked over and declared, “there’s Francis Cardinal George.” She called the Cardinal over, introduced us, and told him about my impending surgery. Cardinal George could not have been nicer. He wished me the best and promised to pray for me. I felt I needed the prayer, so I did not bother to mention that I was not Catholic. Our respect for the Cardinal has grown over the years.
Of course, we wish Cardinal George all the best and hope he will continue to serve as the archbishop of Chicago for years to come. He has lived a remarkable life particularly considering that he has faced health challenges since he was young. Obviously, Cardinal George reminds us that religion does not shield us from a diagnosis of cancer or the rigors and side-effects of treatment. But Cardinal George is teaching us much more. He is teaching us the importance of planning for the future and making provisions for those we care about at the same time we are enduring our treatment and battling mightily to beat the disease. The concepts of preparing for the worst and planning for the best are consistent. The Cardinal also reminds of us of the importance of following the cogent orders of our doctors. Though a meeting withe the Pope is important, it is more important that the Cardinal take the steps necessary to get his needed treatment and minimize the likelihood of infection. In many of our writings, we point out the importance of double checking and challenging our health care providers where appropriate. But as cancer advocates we must remind people that one of the most important parts of beating cancer is following the sound advice of good doctors!
Lessons in loving, praying, humility, living, and dying from Joseph Cardinal Bernardin
Years earlier, we learned that living a holy life does not prevent cancer from taking life. We turn to Cardinal George’s predecessor - our friend and Chicago’s beloved Joseph Cardinal Bernardin. The Cardinal had pancreatic cancer and was being treated at Loyola University of Chicago Medical Center at the cancer center that later would bear his name. Charlene and I always respected Cardinal Bernardin because he was a religious leader in the best sense of the word. He was someone who brought people of all religions together.
One of our friends was battling cancer at the time. Charlene was frustrated because our friend was not getting better. We saw Cardinal Bernardin on the news. They reported on him spending a lot of time in the cancer center. Not so much for his own treatment, but because he was taking the time to talk to, comfort, and get to know all of the many patients undergoing treatment who sought him out. The Cardinal’s cancer was put in remission and Charlene thought that it would give our friend (who was a devout Catholic) a boost to get a note of encouragement or a prayer from the Cardinal. So Charlene called the archdiocese and left a message.
A night or two later, we were sitting on our living room couch watching a Sinatra movie when the phone rang. This was before the days of caller identification and “do not call” lists. Charlene answered it abruptly because we received a couple of unsolicited marketing calls a few minutes before. Suddenly, her tone changed. “Hello Cardinal Bernardin,” said Charlene while motioning me to silence the television. The Cardinal called to ask how our friend was doing and to get her address. She lived about 50 minutes outside of the city and the Cardinal said he was not up to going on that long of a drive yet. The Cardinal said that he would like to write her a letter and Charlene handed me the phone while she dashed off to get the address.
My conversation with the Cardinal went something like this: “Hello Cardinal. I am Charlene’s husband. I am so glad that you are in remission. You are the best Cardinal in the country and we need to keep you healthy. I am a lawyer and if you ever need anything, do not hesitate to contact me.” The Cardinal said he was giving his first post-cancer mass Sunday at his residence on State Parkway and asked whether I thought our friend was up to attending. I was not sure but responded “if there is any way possible to come, she will be there.” The Cardinal added that we should come and bring Charlene’s mother Mary as well. I mentioned to the Cardinal that I was not Catholic and asked whether I was still invited. Cardinal Bernardin deadpanned, “of course, nobody’s perfect.” When I hung up the phone I told Charlene the deal I just negotiated. We were both excited because we knew that this would mean a lot to our friend and were hoping that this might start her down the road to recovery.
On that Sunday morning, we arrived at the Cardinal’s residence along with Mary. The Cardinal gave us a tour of the residence, it was beautiful. I asked about his health – the Cardinal was optimistic and feeling well that day. I immediately understood that it does not matter what religion you were, when you were in Cardinal Bernardin’s presence, you were in the presence of a holy man. He was not only a holy man, but a loving, humble, and generous man. Naturally, I asked him some questions about being a cardinal and about prayer. He told us of his daily routine and how he prayed. I asked him how he was able to keep his concentration during prayer, which drew a stern and irritated look from Charlene. But the Cardinal readily admitted that his mind sometimes would wander and he would have to re-focus. The Cardinal went upstairs and emerged with a few items that he would share later. He said over the years he had collected numerous items, but he gave them all away. He did not like the fact that he seemed to value material things.
Soon our friend arrived along with some members of her family. She was in a wheel chair that extended out like a bed so that she was lying almost flat. We carried her up the stairs and we all went into the cathedral in the Cardinal’s residence. The Cardinal’s niece and nephew were there along with a couple of nuns and another well-known priest. They were all so gracious and it truly was an enriching experience. The Cardinal said a touching prayer for our friend and Charlene’s mother. When the Cardinal had finished, I got up and approached the altar. Charlene’s mouth opened and she reached out to try to stop me. According to Charlene, “you are not supposed to go on the altar.” Charlene did not know it, but I had cleared this with the other priest ahead of time. I said a 3 or 4 minute heart-felt prayer for the Cardinal. The Cardinal and I embraced afterwards. Charlene offered to make a donation to the church, but the Cardinal flatly refused to accept any donation. The Cardinal said he wanted to do this for our friend because he was touched by Charlene having reached out to him on behalf of her friend.
Before we left, the Cardinal passed out rosary beads that were blessed personally by Pope John Paul II when the Cardinal was last in the Vatican. He gave our friend a special relic from Saint Peregrine, the patron saint of cancer patients. The Cardinal spoke with our friend and, while he was looking at her, Charlene and I got the feeling that the Cardinal was wondering whether he would be in a similar condition down the road. Whether we picked up on something the Cardinal was thinking or not, we don’t know. Little did we know (and we never imagined) that a couple of years later I would be battling cancer and would be treated at the Cardinal Bernardin Cancer Center!
Cardinal Bernardin was a holy man and a wonderful man. We would speak with him periodically and Charlene would send him fruit baskets because she knew that he loved fruit. We were very moved by the experience and grateful that we had the Cardinal’s friendship for the remainder of his life. We called him the evening after he announced that his cancer had returned. He talked about his deep faith and said he knew he would be going to a better place. But he also said that he was scared.
Cardinal Bernardin personified all that is right with religion. He displayed knowledge, faith, passion, and commitment. In the midst of his own battle, the Cardinal talked to, comforted, cared about, and helped others people. Equally telling was what the Cardinal did not do. He did not encourage or even accept a contribution – he flatly rejected it. He did not try to convert me, he welcomed me. He did not admonish me for having the audacity of cobbling together a prayer, he understood that it was genuine and he genuinely welcomed it.
Many people say Pope John Paul II taught people how to die, but actually Cardinal Bernardin taught those of us in the Chicago area that lesson several years earlier. In fact, we learned a lot from Cardinal Bernardin about how to live, how to pray, and how to treat others.
Do religion, spirituality, and prayer actually help people battling cancer?
When people are battling cancer or other hardships, it is common to turn to prayer. Charlene really believed that prayer would help our friend and was somewhat depressed and disillusioned when the prayers did not accomplish what we wanted. But we realized that we are not in charge of the world. This is the part where we are supposed to write that the Lord works in mysterious ways and sometimes we do not have a full appreciation for his plans. Nonetheless, the seeds were planted for an approach that we would use down the road. We would do whatever we could to help people with cancer and to cure cancer during our lifetime. Although many things are beyond our control, it should not prevent us from trying.
Our experience suggests that religion and spirituality may not prevent or cure cancer. After all, if Cardinal George can be diagnosed with cancer and suffer side-effect, it is safe to assume that other religious people may face similar consequences? As comforting as it was, prayer did not save our friend. Certainly, one would be hard-pressed to find anyone more spiritual than Cardinal Bernardin. Nonetheless, he died from the disease. Yet, we can point to several individuals that seemed to have lived longer and suffered less than doctors expected and who attribute this to their faith. Indeed, it seems undeniable that faith enable many people to better cope with their diagnoses and treatments.
What does the scientific evidence say about the role of religion in battling cancer successfully?
Many studies have been conducted on the impact of prayer and spirituality on health and survival, some on which are studies of cancer and heart patients. The results in many instances have been mixed. Rather than engaging in a detailed discussion of various studies, the American Cancer Society website provides a useful summary on the subject:
Although some research has found that religious groups with orthodox beliefs and behavior have lower cancer death rates, this may be due to healthier habits. For example, some religious groups ban smoking, limit food intake, and drink little or no alcohol. These factors often help promote good health outcomes and lower cancer risk.
The U.S. Office of Technology Assessment reported that a survey of articles published in the Journal of Family Practice over ten years found that 83% of studies on religiosity found a benefit in physical health. Another study of 2 major psychiatric journals over 12 years found that for the studies that measured religiosity, 92% showed a benefit for mental health, 4% were neutral, and 4% showed harm. Religiosity was measured by participation in religious ceremony, social support, prayer, and belief in a higher being. . . . In the late 1980s, a study in San Francisco reported that heart patients who were prayed for by others appeared to have fewer complications, although length of hospital stay and death rates did not differ between those who were prayed for and those who were not. A larger study at a Kansas City hospital coronary care unit reported similar findings. Although overall length of hospital stay and time in the critical care unit did not differ between groups, the group that had been prayed for had 11% fewer complications. These results suggested that prayer might be helpful when used with conventional medical care, although more research was needed to be sure. . . . In a further study, a group of Harvard researchers studied more than 1,800 patients who were undergoing heart surgery in 2006. The patients were randomly assigned to 3 groups. The first group was told that prayers would be said for them, while the second and third groups were told that they might or might not have prayers said for them. The first and second groups received prayer, and the third group did not. Complications occurred within 30 days for 59% of the first group, 52% of the second group, and 51% of the third group. Prayer did not reduce complications for those who had heart surgery in this large, well-controlled scientific study. Available scientific evidence does not support claims of reduced complications or improved medical outcomes in those who receive prayer.
Spiritual well-being and coping. An analysis of 43 studies on people with advanced cancer noted that those who reported spiritual well-being were able to cope more effectively with terminal illnesses and find meaning in their experience. Major themes of spiritual well-being included self-awareness, coping with stress, connectedness with others, faith, empowerment, confidence, and the ability to live with meaning and hope.
A more recent study found that spiritual well-being was linked with lower distress levels in people who had been treated for colorectal cancer. The researchers reported that the factors with the strongest link to lower emotional distress were finding peace and meaning in their lives. This result would suggest that spiritual well-being might mean less emotional distress at several stages of cancer.
At a minimum, a strong case can be made that religion and spirituality help patients cope with the disease and treatment.
What can we learn from the Hippocratic Oath?
The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine honestly. It is widely believed to have been written directly by Hippocrates who is regarded as the father of western medicine or by one of his students. The oath is written in Greek late in the 5th century BC. The oath is considered a rite of passage for physicians in many countries. Here it is:
I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
Initially, your Cancer Examiner intended to cite it for the proposition that the physician’s first obligation is to do no harm. Because of the references to religion, we thought readers would find it to be interesting in the context of our present discussion.
What harm can a little prayer do?
Regardless of whether readers believe religion and prayer are helpful, we suspect most would agree that they usually do not hurt. There is one common situation, however, where religion may be invoked in a deleterious manner. That is where people forego undergoing traditional medical treatment with a proven record of success in the name of religion or rely upon prayer in lieu of – as opposed to in addition to – such treatment. Fortunately, we do not have to cite to studies on the appropriate approach to take. Once again, Cardinal George and Cardinal Bernardin have showed us the way on this subject. Both have undergone traditional medical treatment at reputable treatment centers in addition to prayer!
Please share your thoughts and experiences regarding the role and impact of religion and prayer on battling and beating cancer.