Why Connection, Agency, and Small Acts of Kindness Matter in Cancer Care

Hope isn’t just a feeling or belief; it’s a purposeful orientation toward the future, grounded in connection and a sense of agency. And both have measurable effects on health, especially in cancer care.

In oncology settings, research shows that higher levels of dispositional hope are associated with more prolonged survival among advanced cancer patients, even when adjusting for clinical variables (1). Moreover, greater hope correlates with lower emotional distress, improved coping, and post-traumatic growth, key indicators of a better quality of life in the cancer journey (2).

But hope doesn’t always come easily, especially in cancer. It’s often described as a battle, but for many, it feels more like a slow erosion: a repetitive, passive trauma. So much feels out of your control. Your world narrows. The future blurs, just out of reach.

The body responds by shutting down, not out of weakness, but as a survival response. When the threat feels constant and escape seems impossible, the nervous system does what it was designed to do: it freezes, conserving energy and waiting for a sign that it’s safe to re-engage.

And that loop, of fear, helplessness, and reactivation, can become chronic if we don’t receive signals that it’s safe to come back. In the animal world, a threat passes and the body instinctively returns to balance. But humans are more complex. We need more than the absence of danger, we need the presence of connection. We need to feel safe. We need to feel seen.

That’s where hope becomes biological.

When someone receives a gesture of care, a card, a kind word, a moment of presence, it can interrupt that trauma loop. It sends a new signal to the body: You’re not alone. The danger isn’t here right now. You’re still human, and still worth reaching for.

This isn’t just symbolic. A 2020 article in The Economist highlighted research showing that small acts of kindness, especially when exchanged during periods of solitude, can disrupt the downward spiral into loneliness and even reduce biological markers of inflammation. In one large-scale trial, involving over 4,200 participants across the U.S., U.K., and Australia, people who were asked to perform one intentional act of kindness per week for four weeks reported reduced loneliness, social anxiety, and stress, especially in the U.S. and U.K. groups (3). Other studies show that repeated acts of kindness can downregulate gene expression patterns linked to chronic stress and inflammation (4), and that giving support to others is associated with lower levels of IL-6, a key inflammatory marker (5).

Agency gives people a role in their story, even amid uncertainty. It reminds them they’re not just being acted upon, they’re still capable of meaning-making.

Connection restores the emotional and physiological signal of safety. It reminds the nervous system that not every internal storm is a lion at the door.

So when someone takes a moment to create a card, they’re not just offering paper and ink. They’re offering an opening. A moment. A lifeline that whispers: You matter. This moment is survivable. There’s still movement left in you.

References

1. Corn, B. W., Feldman, D. B., Hull, J. G., et al. (2021). Dispositional Hope as a Potential Outcome Parameter Among Patients With Advanced Malignancy: An Analysis of the ENABLE Database. Cancer. 
2. Feldman, D. B. (2023). Hope and Cancer: Evidence That Hope Is Associated with Coping, Symptom Burden, Distress, and Possibly Survival. Current Opinion in Psychology, 49, 101506 
3. The Economist. (2020). Acts of kindness prevent a downward spiral from solitude to loneliness
4. Nelson-Coffey, S. et al. (2017). Prosocial behavior and gene expression. Psychoneuroendocrinology.
5. Tristen K Inagaki, Gabriella M Alvarez, Edward Orehek, Rebecca A Ferrer, Stephen B Manuck, Nicole M Abaya, Keely A Muscatell, Support-Giving Is Associated With Lower Systemic Inflammation, Annals of Behavioral Medicine, Volume 57, Issue 6, June 2023, Pages 499–507,