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Home  /  Integrative Cancer Care  /  Spirit  /  Existential Crisis and Cancer

Existential Crisis and Cancer

By Jeannine Walston and Lora Matz, MS, LICSW

Existential Crisis and Cancer 3What is an existential crisis?

An existential crisis challenges beliefs about life, death, meaning, purpose, our sense of mastery and potency in the world, and all the foundations upon which we build our lives. The crisis is an exacerbation of thoughts about one’s existence and potential for nonexistence1.

What is the relationship between an existential crisis, cancer, and spirituality?

Cancer creates an existential crisis and through its very nature is a spiritual crisis. The cancer diagnosis often initiates a process of deep spiritual questioning about life and death. Cancer challenges people to look at purpose, suffering, and the inevitability of death.

The existential crisis of cancer is commonly referred to as the search for meaning. The crisis is psychological and spiritual, and therefore psychospiritual.

“If there is any gift in cancer, it is a deeper listening to ourselves and an examination into the life we’ve been living. The tragedy of cancer often holds the seeds of grace that wake us up. The powerful trauma of cancer can open people to really profound spiritual issues—What does it mean to be a human being? What are my gifts? What is my purpose? Why am I here? The spiritual crisis of cancer can often be a bridge to the inner guide and higher self where wisdom resides. Cancer creates the necessity that we confront our lack of security and certainty in the world. We suddenly need to look at life from a much broader and wider perspective. The existential crisis is a turning point.”
-Lora Matz, MS, LICSW

Do all cancer patients experience existential plight?

A Harvard study suggests that almost all cancer patients are subject to what they call existential plight1.

  • One feels as though one’s very existence is threatened
  • Signifies an exacerbation of thoughts about life and death
  • Encompasses many fears, including abandonment, loss of control, loneliness, pain, panic, and the unknown
  • Begins with the actual diagnosis and continues at least until the initial distress subsides or resolution occurs
  • Patients can be distressed without showing overt signs
  • Severe and persistent symptoms with prolonged treatment induce more vulnerability

Other findings from the study include the following.

  • First 100 days are the most important time for support, and that impacts subsequent cancer stages
  • First 100 days are relevant for overall quality of life in respect to the impact of cancer and predictive value
  • More existential concerns were reported than any other worry
  • Plight includes measurable changes in emotional responses and in the interpretations of how one relates to the network of people and things that compromise the immediate world
  • Plight contains cues and clues which are useful in predicting future distress and coping

Does existential plight continue in cancer patients beyond 100 days?

The Harvard study only evaluated the first 100 days of existential plight in people with cancer. Future studies are needed to assess existential plight throughout the entire trajectory of cancer.

Health care professionals and patients alike may be inclined to approach cancer as one big stage. Each stage—before the diagnosis, the time of diagnosis, treatments, end of treatment, recurrence, cancer as a chronic disease, and end of life—has specific characteristics, existential issues, needs, and interventions. The ways in which people move through each stage prepare them for each subsequent stage. Learn more in Stages of the Cancer Journey.

What is the difference between coping and defense strategies?

People with cancer may use either coping or defense strategies1, 2. The same types of behaviors may be used with coping and defense, but the goals are different.

  • Coping seeks resolution of a declared problem

    Coping is what one does about a perceived problem in order to bring about relief, reward, quiescence, or equilibrium. All of these aims are included under the concept of mastery, control, or resolution. Resolution means the degree to which coping strategies succeed or fail to succeed. Successful coping requires a balance between what one can accept or confront, and what can be harmlessly ignored or postponed.
  • Defense seeks relief through avoidance and disavowal instead of resolution

    Defense is rooted in the desire to avoid and self protect for some level of comfort. The avoidance is often associated with disavowal that involves the denial of any connection or knowledge about the situation.

Identifying and strengthening pre-existing coping skills, and developing new ones, can be a helpful focus for people affected by cancer.

What are some strategies to help cancer patients, and their loved ones, navigate the existential plight of cancer?

Many strategies exist to navigate existential plight. The most helpful approaches may vary depending on the person and their circumstances.

Identifying and exploring universal themes and core areas may offer support in coping, reducing stress, finding meaning, and potentially transforming components of the crisis into opportunities.

A qualified trained professional can also provide assistance to help people affected by cancer develop understanding and identify strategies that work best for them.

Explore these strategies to support navigation through the existential plight of cancer.

Spirituality Assessments
Spirituality assessments are questions for people to ask of themselves to reflect, identify, and define important components of their spirituality. The question and answer process supports exploration of some deeper parts of self and existence, and may encourage people to better care for their own spiritual needs.

Creating Healthier Beliefs
Habits of mind are powerful constructs. Our beliefs are the blueprint of who we are. Beliefs unconsciously drive our decisions, attitudes, feelings, coping patterns, life choices, and more. Evaluating your belief system is a tool toward healthier living, better clarity, and reduced stress. Clear beliefs also help people make decisions about cancer treatments based on wisdom instead of fear.

The existential crisis of the mind with traumatic psychological constructs about existence can be shattered through movement.

Breathing Techniques
Balanced, deep, rhythmic inhales and exhales help regulate all of the functions in your body. Focusing on breathing moves people into a more relaxed state. When people get into the habit of it, the breath becomes an anchor. Deep breathing is especially helpful during stress. Remember to breathe.

Meditation Techniques
Meditation can provide a combination of relaxation and self-awareness bringing people calm and relief during times of stress. Devote time to sit quietly and be with yourself. Breathe deeply and relax your body. Feel roots from the ground helping to support you.

Stages of the Cancer Journey
Learn about stages of the cancer journey to explore from some informative perspectives where you have been, where you are, and where you are going. The ways in which people move through each stage prepare them for each subsequent stage.


People dealing with cancer may benefit from telling their story reflecting on their journey. Storytelling helps people define themselves, their experiences, world, and relationship to life in general. Stories can provide the opportunity for people to make meaning.

Reducing Stress
Understanding stress and learning to cope with it supports movement through an existential crisis.

Other Strategies
Explore the Mind and Spirit sections for information about other strategies that support people navigating existential plight.

Jeannine Walston would like to thank Lora Matz, MS, LICSW for her input related to Existential Crisis.

1. Weisman AD, Worden JW. The existential plight in cancer: significance of the first 100 days. Int J Psychiatry Med. 1976-1977;7(1):1-15. PubMed PMID: 1052080.
2. Weisman AD, Sobel HJ. Coping with cancer through self-instruction: a hypothesis. J Human Stress. 1979 Mar;5(1):3-8. PubMed PMID: 217927