“…advanced cancer is contrary to the results of studies which suggest that existential concerns and religious/spiritual activities play a prominent role for many patients in coping with incurable malignancy. 5,7,14,15 Our results are similar to a study of patients newly diagnosed with advanced gastrointestinal cancer where almost half expressed a belief in God, a higher power or a divine power 27 , and in contrast with studies in patients with more advanced disease from other settings in the USA and UK. [14][15][16][17] Despite the conflicting research results as to whether appraised meaning, and the results of meaning-making, change over time, it is possible that the role of spirituality and/or religion will become a more relevant influence in our patients as they become more symptomatic and progress towards a terminal state.…”