PROSTATE CANCER AND SPIRITUALITY – A SYSTEMATIC REVIEW

Introduction: Prostate cancer is the second most diagnosed cancer and the sixth leading cause of cancer death among men worldwide. The diagnosis, treatment and sequels of cancer are relevant sources of stress, conflicts, and suffering. In this context spirituality may be a positive coping element. However, studies involving the correlation between prostate cancer patients and spirituality are few and heterogeneous. Objective: This systematic review performed a broad research on indexed literature to find strengths and weaknesses of this field of study. Methods: The bibliographic research was made using the MEDLINE database with the keywords “spirituality”, “religion” and “prostate cancer”. The objective was to find studies including exclusively prostate cancer patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was chosen to perform the review. Only full disponible articles in English were included. Reviews, casereports, and conferences reports were excluded. Results: 122 articles were found and 24 were eligible fulfilling all inclusion criteria with a remarkable heterogeneity in objectives, methodologies, and conclusions between them. Four articles (17%) included health people in screening for prostate cancer, fourteen articles (58%) patients in treatment and six articles (25%) cancer survivors. Most studies were unicentric from United States (83%) and non interventional (75%). Only half of the studies aimed region issues and all accessed spirituality with different scales. Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp) was the most common tool utilized. A positive statistical relevant association between higher spirituality scores and health outcomes was found in 20 studies (83%). Few randomized trials were found (17%). Conclusion: Among prostate cancer patients, higher spirituality scores are associated with positive coping and better health outcomes, including treatment stress reduction and improvements in adhesion to health care strategies. But studies in this field are heterogeneous and most of them unicentric, small and non-randomized. Therefore, more interventional, randomized and multicentric trials are needed to clarify this relationship.