Understanding the Stigma of Lung Cancer

Disappointed young girl posing with folded arms
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Being diagnosed with lung cancer carries a certain stigma.

”How long did you smoke?” “I didn’t know you were a closet smoker.” “Too bad he didn’t quit smoking sooner.” Unlike the unconditional support ​given to those with other forms of cancer, people with lung cancer often feel singled out, like somehow they “deserve” to have cancer. Where does this stigma come from?

Public Perception of a Diagnosis

There is a feeling among the general public, that lung cancer is a self-inflicted disease. Smoking is responsible for 80 to 90 percent of lung cancers, but let’s put this in perspective: Twice as many women die from lung cancer in the United States each year as die from breast cancer, and 20 percent of these women have never touched a cigarette. Even for those who smoke and develop lung cancer, why do we attach such a stigma to them? Many cancers and other chronic diseases are related to lifestyle choices. We don’t seem to judge as harshly those who overeat, are sedentary or sunbathe extensively.

Physicians’ Attitude

Physicians are people too, and the bias we see among the public is present in the doctor's office as well. Joan Schiller, MD, the President and Founder of the National Lung Cancer Partnership (now Free to Breathe), and a physician who has done a lot of research on the stigma of lung cancer, surveyed primary care physicians in Wisconsin with some saddening results.

Though the physicians stated that the type of cancer was not a factor in their referral decisions, results showed that:

  • When hypothetical patients were presented as having advanced cancer, physicians were less likely to refer lung cancer patients to an oncologist than they were to refer breast cancer patients.
  • More physicians were aware that chemotherapy improves survival in advanced breast cancer than with advanced lung cancer.
  • Breast cancer patients were more likely to be referred for further therapy, whereas lung cancer patients were often referred only for symptom control.

Lung Cancer Patient’s Perceived Stigma

Those who are diagnosed with lung cancer experience more embarrassment than those with prostate cancer or breast cancer and individuals tend to feel stigmatized whether they smoked or not. Some people have even concealed their diagnosis leading to negative financial consequences and lack of social support. On the other side of the equation, some people with lung cancer have felt embarrassed with their health care providers and feared that their care may be negatively affected because of their history of smoking.

In a focus group of lung cancer patients, common emotions expressed relating to the stigma included guilt, self-blame, anger, regret, and alienation with regard to family and society interactions.

At the same time, non-smokers tend to believe those who develop lung cancer after smoking feel more guilt. If you are thinking this way it may be helpful to step into their shoes.

They are probably too busy living and trying to live than to spend their days perseverating on what they could have done differently ages ago. None of us can change the past, but we are in control of today.

Funding for Lung Cancer Research vs Other Cancers

Sadly, even though lung cancer kills more people than breast cancer, prostate cancer, and colon cancer combined, federal funding lags behind. Funding from the private sector also pales in comparison to fund-raising efforts for some other cancers.

Clearly, lung cancer carries a stigma that extends from the government down to the individual. That said, we won’t move forward by pointing the finger and blaming ourselves, physicians, the public, and the government.

Each of us can make a difference by supporting those with lung cancer as we would support someone with any other form of cancer. Whether you are a lung cancer survivor, the loved one of someone living with lung cancer or a professional working with those with lung cancer, we need to raise awareness.

Those living with lung cancer need and deserve our care, love, and support, not an evaluation of the possible causes of the disease.

A Word From Verywell on the Stigma of Lung Cancer

The stigma of lung cancer is one of the most challenging aspects of living with the disease, but that's beginning to change. In the last decade, the face of lung cancer has revealed itself in the public. People with lung cancer may be older, or they may be a 20 year old college student. They may be a 50 year old woman who smoked in college, or a woman diagnosed in pregnancy who never smoked. The public is slowly learning that anyone with lungs can get lung cancer.

Why is this important? If we think of our mothers, sisters, and daughters, we think of breast cancer. But our mothers, sisters, and daughters are more likely to die from lung cancer, whether or not they smoked. The same holds true with prostate cancer. We fear the disease in our fathers, brothers, and sons, but in actuality, lung cancer is much more likely to take their lives. Understanding this is important because lung cancer has not been funded at all to the degree of breast cancer or prostate cancer. And our loved ones are dying from the disease.

As a last note, it's critical that we draw together as a lung cancer community and not separate out "smokers lung cancer" from "nonsmokers lung cancer." We need better treatments for lung cancer, and our efforts need to combine everyone for the good of everyone.

Sources:

Chapple A, Zieband S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. British Medical Journal. 2004. 328(7454).

Kehto, R. Patient views on smoking, lung cancer, and stigma: A focus group perspective. European Journal of Oncology Nursing. 2014. 18(3):316-322.

LeConte NK, Else-Quest NM, Eickhoff J, Hyde J, Shiller JH. Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer. Clinical Lung Cancer. 2008. 9(3):171-8.

Wassenarr TR, Eickhoff JC, Jarzemsky DR, Smith SS, Larson ML, Shiller JH. Differences in primary care clinicians’ approach to non-small cell lung cancer patients compared with breast cancer. Journal of Thoracic Oncology. 2007. 2(8):722-8.