A program aimed at improving spiritual well-being, quality of life, and general well-being in women who have metastatic cancer appeared to show benefits when used in a randomized, controlled trial. Results were reported in the journal The Oncologist.

The Growing Resilience and Courage (GRACE; ClinicalTrials.gov Identifier: NCT02707510) trial enrolled women with metastatic cancer who reported spiritual or existential distress. Women were randomly assigned to the intervention group, which involved participation in the GRACE program, or to a wait-list control group. All participants were given surveys at baseline (T0), immediately after GRACE or 6 weeks after baseline for the control group (T1), and at 1 month later (T2).

The GRACE program is a psycho-educational and experiential program involving a variety of approaches using media and materials, meditation, and weekly group classes. It was provided to patients in the intervention group for 6 weeks, and participants of the wait-list control group could join the program after completing the wait-list period.

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The primary objective of the study was to measure the effects on spiritual well-being with the intervention, and this was evaluated using the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale–Expanded tool. Secondary objectives related to quality of life and general well-being, using a variety of measures.

The study included 71 participants (37 in the GRACE group and 34 in the wait-list group), with a median age of 61 years. More than half (54.24%) of the participants did not have a history of depression, and 50.85% had no history of anxiety. At baseline, participants were at a median of 49.08 months since their initial diagnosis and a median of 16.02 months from their diagnosis of metastatic disease.

At T0, both groups reported similar scores for spiritual well-being, but at both T1 and T2, scores demonstrated greater improvement in spiritual well-being for the group participating in GRACE than for the control group. In adjusted analyses, differences between the groups at these time points were significant (P <.001 for both T1 and T2).

Scores for general quality of life also were similar between the groups at T0 but were higher at both T1 and T2 for those participating in GRACE than for the control group. These differences were also significant in adjusted analyses (P <.001 at T1 and P =.007 at T2). Scores for depression and hopelessness also were significantly better for the GRACE group at both T1 and T2, compared with the control group (P <.001 for each comparison).

“The findings of the current randomized clinical trial suggest that the GRACE intervention is successful at improving spiritual well-being, quality of life, and dimensions of general well-being among women with metastatic cancer experiencing existential and spiritual concerns,” the study investigators concluded in their report.

Disclosures: This research was supported by Pfizer. Please see the original reference for a full list of disclosures.


Asher A, Shirazipour CH, Capaldi JM, et al. A 6-week program to strengthen resiliency among women with metastatic cancer: a randomized clinical trial. Oncologist. Published online April 27, 2023. doi:10.1093/oncolo/oyad091