Lung cancer leads to more deaths than any other cancer in the United States.
The American Cancer Society estimate that about 235,760 people in the U.S. will receive a new diagnosis of lung cancer in 2021. Around 131,880 people in the country will die from the condition this year alone.
Lung cancer can affect mental well-being in addition to physical health. The condition is widely stigmatized due to its association with smoking. This only adds to the challenges that people with lung cancer face.
“Lung cancer is the one type of cancer that people tend to be blamed for because of a lifestyle choice or behavior that they made,” Dr. Lisa Carter-Harris, Ph.D., APRN, ANP-C, FAAN, told Medical News Today.
Dr. Carter-Harris is the director of the Tobacco Cessation Research Program in the Department of Psychiatry & Behavioral Sciences at the Memorial Sloan Kettering Cancer Center (MSK) in New York City, NY.
“That can lead to the person blaming themselves or experiencing stigma and bias from those external to them. Either of those can lead to depression, anxiety, and social isolation,” she added.
Read on to learn more about how lung cancer stigma affects people with this condition.
Efforts to reduce the social acceptance of smoking have helped lower smoking rates in the U.S. However, anti-smoking campaigns may have led to the unintentional “demonization” of lung cancer, Dr. Carter-Harris said.
Cigarette smoking is the leading risk factor for lung cancer. Approximately
However, the link between smoking and lung cancer is not a one-to-one relationship. Many environmental and genetic factors also affect a person’s risk of this condition.
Many people who currently smoke may want to quit, but the addictive properties of tobacco make that difficult. One 2017 study found that about half of adults who smoke said that they had tried to quit in the past year, but only 1 in 10 had successfully done so.
Dr. Carter-Harris told MNT that whether or not someone has smoked, “nobody deserves cancer.” Self-blame and blame from others can make it harder for a person to cope with the condition and get the care they need.
Some research suggests that many people with lung cancer face negative judgments from friends, family members, or healthcare professionals. They may internalize stigma as feelings of self-blame and shame. This raises the risk of mental health challenges.
“Higher lung cancer stigma is associated with higher symptoms of depression and anxiety, poorer quality of life, and bothersome physical symptoms,” said Dr. Timothy J. Williamson, Ph.D., MPH.
Dr. Williamson is a co-chief postdoctoral research fellow in the Department of Psychiatry & Behavioral Sciences at MSK.
Dr. Williamson and colleagues have found that even people with no history of smoking experience lung cancer stigma.
“We have shown, unfortunately, that more than 50% of people […] with lung cancer experience clinically meaningful levels of lung cancer stigma,” he said. “This is true regardless of [their] smoking history.”
The stigma that lung cancer carries may lead to critical delays in treatment.
“Part of the reason was they worried about going to the doctor and being blamed because they either still smoked or they had a history of smoking,” she said. “The other component with some individuals is that they blame themselves. They felt like they deserved it, and so why should they go?”
A 2019 review of research also found that stigma, blame, shame, and guilt led to delays in seeking treatment for people with lung cancer.
When people with lung cancer do seek help, stigma may negatively affect their relationships with healthcare professionals.
“Individuals who have sought care […] do report feeling stigmatized from people they encounter within the healthcare system,” Dr. Carter-Harris said. “Sometimes it’s a perceived stigma,” she continued, “and sometimes it’s a very real stigma that they’re experiencing, with comments made to them like, ‘You shouldn’t have smoked,’ or things that are pointing fingers.”
A 2016 study linked lung cancer stigma to worse patient-professional communication. However, the study authors do not know if stigma led to worse communication or if poor communication increased stigma.
Some experts suspect that lung cancer stigma may contribute to gaps in research funding.
The National Cancer Institute invested nearly $575 million in breast cancer research in 2018. They invested only $350 million in lung cancer research that year.
Research disparities exist in other countries as well. A global analysis found that lung cancer accounted for roughly 20% of cancer deaths but only 5.6% of cancer research output in 2013.
Experts do not know for certain whether or not stigma contributes to lung cancer funding gaps. Some health experts in a Canadian study said that they believe it does, but others disagreed.
Dr. Carter-Harris said that educating people about the effects of lung cancer stigma is important for reducing it. It is also important to teach healthcare professionals to communicate in nonjudgmental and empathetic ways.
Dr. Williamson and colleagues are currently testing an empathic communication skills training program for cancer care teams. The goal is to teach them how to ask questions about tobacco use without making people with lung cancer feel as though they are to blame for their diagnosis.
Drs. Carter-Harris and Williamson both encourage people to use person-first language when talking about smoking. One example of this is describing someone as “a person who formerly smoked” rather than “a former smoker.”
“By labeling someone as a smoker, you’ve depersonalized them, and you’ve identified them by a behavior that’s stigmatized,” Dr. Carter-Harris said.
Dr. Williamson and colleagues are also testing a program to help people with lung cancer cope with the painful emotions that stigma causes.
Lung cancer is the number one cause of cancer-related death. The condition carries stigma due to its association with smoking.
Lung cancer stigma may raise a person’s risk of mental health challenges and reduce their quality of life. It may also affect someone’s willingness to seek medical help for lung cancer symptoms.
Educating healthcare professionals and other community members about lung cancer stigma can help reduce it. Also, using empathetic language may help people with lung cancer feel that they have more support.