Existential crisis and the awareness of dying: the role of meaning and spirituality.

An existential crisis may occur in cancer patients when they realize that their death may be imminent. We explore the ways in which patients deal with this crisis, in which the meaning of life itself is at stake. In dealing with an existential crisis, it is important to have the courage to confront the loss of meaning and security. Then, a new sense of meaning may emerge which is essentially a receptive experience of connectedness with an ego-transcending reality, such as mankind, nature, or God. This reduces existential fear and despair and leads to acceptance of "life-as-it-is", including its finitude. The article concludes with implications for healthcare workers.