A cancer diagnosis can be overwhelming, confusing and scary. Cancer patients face constant physical, psychological, and emotional challenges from the time leading up to diagnosis, throughout treatment and during remission. However instead of compassion and support, lung cancer patients are more likely to be greeted with, “Well, did you smoke?”
Lung cancer is the most common cancer among Canadians (1). Each year, more people die from lung cancer than breast, prostate, and colon cancer combined (1). Yet, lung cancer research programs remain significantly underfunded, resulting in a lack of advancements in diagnostics and treatment options.
So, why are we ignoring the number one cancer killer?
The usual reaction to lung cancer, whether intentional or not, is to blame someone for smoking. Yet, this stigma also exists for long-time quitters and non-smokers. Society’s perception of lung cancer is harmful in multiple ways: heightened anxiety and shame among patients, and a lack of research funding. Both consequences are detrimental to a patient’s health and contributes to the poor prognosis often associated with this disease.
Patients may feel like they deserve their diagnosis due to past or present behaviors and addictions. Cigarette smoking is the leading risk factor for lung cancer, among many other diseases. But we fail to recognize that cigarette smoking is not just a bad habit – it’s one of the most difficult addictions to overcome without financial resources and social support. Other types of cancer that are also associated with one’s behavior are not perceived the same way. For example, about 90% of skin cancers are associated with exposure to ultraviolet radiation (2). While a stigma is still present, we may be less quick to judge because many of us have experienced a couple of bad sunburns, oftentimes from our own neglect. In addition, 10-25% of people diagnosed with lung cancer have never smoked (3), yet these patients may still face some degree of judgement. This is because the embedded association between smoking and lung cancer is so strong and publicized.
Researchers assessing lung cancer stigma found that 95% of lung cancer patients felt negative judgement from friends and family, medical providers and society in general (4). For the majority of patients, these feelings led to thoughts of self-blame, anger and regret. This can lead to harmful consequences such as social isolation, increased stress, difficulty coping, and can sometimes even persuade people to not seek treatment.
Lung cancer is the leading cause of cancer death in Canada (5). Even though lung cancer is clearly a major health concern, research on this disease only receives a fraction of the funding compared to other types of cancers. One study found that lung cancer was the most under-funded malignancy when compared to the burden it imposes on society (6). Importantly, this study showed that society’s perception of a disease directly impacts the funding and subsequent research it receives. The lack of financial support severely limits the progress that can be made in improving diagnostic techniques and treatments.
The good news is we can overcome these social attitudes, ultimately leading to patients living longer and healthier lives. Other diseases, like HIV/AIDS, have also faced heavy stigma. Through public education, awareness and combating stereotypes, the health and well-being of these patients has improved.
No cancer patient should have to deal with stigma, fear of judgement, and self-blame. No one deserves lung cancer – it is not a punishment, for smokers and non-smokers alike. Instead of judgement and false assumptions, patients deserve to be met with kindness, support, and compassion. This begins with changing the conversation about lung cancer.
References
1. Brenner et al. Projected estimates of cancer in Canada in 2022. Canadian Medical Association Journal. 2022. https://www.cmaj.ca/content/194/17/E601
2. Kim and He. Ultraviolet radiation-induced non-melanoma skin cancer: Regulation of DNA damage repair and inflammation. Genes & Diseases. 2014. https://www.sciencedirect.com/science/article/pii/S2352304214000178?via%3Dihub
3. Couraud et al. Lung cancer in never smokers – a review. European Journal of Cancer. 2012. https://www.sciencedirect.com/science/article/pii/S0959804912002523?via%3Dihub
4. Hamann et al. Stigma among patients with lung cancer: A patient-reported measurement model. Psychooncology. 2014. https://onlinelibrary.wiley.com/doi/10.1002/pon.3371
5. Statistics Canada. 2022. https://www.statcan.gc.ca/o1/en/plus/238-lung-cancer-leading-cause-cancer-death-canada
6. Kamath et al. Comparison of Cancer Burden and Nonprofit Organization Reveals Disparities in Funding Across Cancer Types. Journal of. The National Comprehensive Cancer Network. 2019. https://jnccn.org/view/journals/jnccn/17/7/article-p849.xml