Study Explores Use of Religion and Spirituality to Help Patients Cope With Stress of Radiation Therapy for Gynecologic Cancers

Study Explores Use of Religion and Spirituality to Help Patients Cope With Stress of Radiation Therapy for Gynecologic Cancers

Researchers identify the most meaningful questions to help clinicians open conversations about spirituality with patients

Researchers at the Mount Sinai Health System have identified specific ways in which addressing religion and spirituality during radiation therapy can play an important role in the care of patients with gynecologic cancers. The study, published in the September/October 2025 issue of Practical Radiation Oncology, is the first to identify which aspects of spiritual history patients themselves prioritize and find most meaningful.

A collaborative team from Mount Sinai and NYU Langone Health led the research. Key contributors included Lauren Jacobs, MD, a resident physician in Radiation Oncology at the Icahn School of Medicine at Mount Sinai; Karyn Goodman, MD, MS, Vice Chair for Research and Quality in the Department of Radiation Oncology at Mount Sinai; and senior author Stella Lymberis MD, Director of Quality Initiatives and GYN Disease Management Group Co-Lead in the Department of Radiation Oncology at NYU Langone. This is the first study to assess which spiritual history questions matter most to patients.

Using the validated FICA Spiritual History Tool(developed in 1999 by Christina Puchalski, MD, and a group of primary care physicians); the team interviewed 11 patients with gynecologic malignancies who had received external beam radiation therapy and/or brachytherapy. These patients adhered to a range of faiths, including Christianity, Buddhism, Judaism, Islam, and Hinduism.

"Our study highlights that patients want these conversations and that spirituality plays a vital role in how they cope with stress during cancer treatment," said Dr. Jacobs, first author. "By asking the right questions, clinicians can create meaningful dialogue without adding burden to already time-limited visits."

The study found that 82 percent of patients rated their faith as extremely important, giving it the highest score possible. On average, participants considered nearly all of the FICA Spiritual History Tool questions to be helpful, with six questions consistently identified as especially valuable. The two questions most often highlighted as meaningful ways to begin conversations with providers were: "Do you have spiritual beliefs that help you cope with stress?" and "Have your beliefs influenced you in how you handle stress?"

The findings are especially significant for patients undergoing gynecologic radiation therapy, such as brachytherapy, which can be invasive and emotionally distressing. Previous research has shown that nearly one-third of patients with cervical cancer develop acute stress symptoms after treatment, with more than 40 percent reporting post-traumatic stress months later.

"Patients are telling us clearly that their spiritual health matters just as much as their physical health," said Dr. Goodman. "By engaging with them on these issues, we can better support emotional well-being, reduce distress, and provide truly whole-patient cancer care."

The research team plans to expand the study to larger patient cohorts, apply the approach earlier in the cancer journey (diagnosis and pre-treatment), and extend it to other cancer types. They also aim to develop protocols and training for clinicians and trainees to normalize and integrate these discussions into routine practice.

About the Icahn School of Medicine at Mount Sinai

The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City's large and diverse patient population.

The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master's degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,600 clinical residents and fellows training throughout the Health System. Its Graduate School of Biomedical Sciences offers 13 degree-granting programs, conducts innovative basic and translational research, and trains more than 560 postdoctoral research fellows.

Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. More than 4,500 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.

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* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.

About the Mount Sinai Health System

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across seven hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time-discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 10 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek's^® "The World's Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals" and by U.S. News & World Report's^® "Best Hospitals" and "Best Children's Hospitals." The Mount Sinai Hospital is on the U.S. News & World Report^® "Best Hospitals" Honor Roll for 2025-2026.

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