Catholic Teaching on Suffering and Cancer

This page is for Catholic patients and families who have been told to "offer it up." It explains what Church teaching says about suffering, and what it never says about your treatment.

"Offer it up" is one of the most-used phrases in Catholic life. It is also one of the most misused. Used well, it offers meaning to a person carrying something meaningless. Used badly, it is a way of telling somebody to stop complaining. People with cancer hear it that way often enough that some of them stop mentioning their symptoms at all.

It helps to know what the tradition actually says. It is a good deal more sympathetic than the folk version.

Before it says anything about meaning, the Catechism describes what illness does to a person:

Illness and suffering have always been among the gravest problems confronted in human life. In illness, man experiences his powerlessness, his limitations, and his finitude. Every illness can make us glimpse death.

And then, without softening it:

Illness can lead to anguish, self-absorption, sometimes even despair and revolt against God.

Revolt against God is in the official text. It is listed as something illness does. It is not listed as something the sick person has done wrong. Some people have been told that anger at God is a sign of weak faith. They are entitled to know that the Catechism got there first, and treated it as ordinary.

John Paul II's 1984 letter Salvifici Doloris is the main text. Its most useful passage for someone with cancer is not about theology. It is about the feeling of being a burden:

A source of joy is found in the overcoming of the sense of the uselessness of suffering, a feeling that is sometimes very strongly rooted in human suffering. This feeling not only consumes the person interiorly, but seems to make him a burden to others. The person feels condemned to receive help and assistance from others, and at the same time seems useless to himself.

That is an accurate description of what advanced illness does to people. It was written forty years ago. The answer it proposes may or may not work for you. The diagnosis is recognizable either way.

The letter is just as clear that this is not a call to endure quietly. Its most quotable line runs the other way: "Christ's revelation of the salvific meaning of suffering is in no way identified with an attitude of passivity. Completely the reverse is true. The Gospel is the negation of passivity in the face of suffering."

Redemptive suffering is not an instruction to refuse treatment. It is not an instruction to refuse pain relief. The Vatican's 1980 declaration on euthanasia says plainly that "it would be imprudent to impose a heroic way of acting as a general rule." It adds that prudence suggests "for the majority of sick people the use of medicines capable of alleviating or suppressing pain." Do not stop or change any treatment or pain medicine because of this page. Talk with your care team.

There is no Catholic teaching that a particular illness is sent for a particular sin. The Catechism notes something that cuts directly against that idea. Christ "did not heal all the sick. His healings were signs of the coming of the Kingdom of God."

If healing were a reward for faith, the Gospels would look very different.

This is where people are most often hurt, usually by other believers. The Catechism answers it in one sentence: "The Holy Spirit gives to some a special charism of healing so as to make manifest the power of the grace of the risen Lord. But even the most intense prayers do not always obtain the healing of all illnesses."

That is not a hedge added by a cautious editor. It sits in the article on the sacrament of the sick. It is in the section explaining what the Church actually expects.

NCI says that some patients with cancer may feel they are being punished by God, or may lose faith after a diagnosis. NCI also notes that most hospitals have chaplains, though not all outpatient settings do. A chaplain or your care team can help with this kind of distress.

If you are carrying this kind of distress, two plain sentences are worth saying. Say them to a chaplain, a priest, or your care team. I am angry. And I do not know what to do with this. Both are ordinary sentences on a cancer ward. The Church's own texts record both as ordinary. And both tend to be the beginning of feeling less alone, rather than the end of anything.

As for whoever tells you to offer it up, one answer is entirely reasonable. You are offering it up. You also want the anti-nausea medication.

• National Cancer Institute — Spirituality in Cancer Care (PDQ) Patient Version
• National Cancer Institute — Faith and Spirituality with Cancer
• The Holy See — Declaration on Euthanasia (1980)
• The Holy See — Salvifici Doloris (1984)
• The Holy See — Catechism of the Catholic Church, 1500-1508