Stigmas Faced by Patients With Lung Cancer

Patients with lung cancer often face smoking-related stigma, which can impact their overall cancer journey, as an expert explained in a recent interview with CURE.

CURE sat down for an interview with Patricia I. Moreno, who holds a Ph.D. and is a licensed clinical psychologist and lead of evidence-based survivorship and supportive care at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System.

CURE: What are some stigmas that patients with lung cancer face, and how can these affect patients?

Moreno: The biggest source of stigma is the strong association with smoking and lung cancer. So, smoking is a risk factor for lung cancer, but lung cancer is a very complex interplay of environment and genes. It's not just among people who have smoked, but very often, people feel stigmatized by their smoking status, whether or not they did smoke. If they didn't smoke, they are constantly being asked if they smoked, whereas when most people share that they have a cancer diagnosis, people respond with empathy and concern.

Oftentimes, for people who are diagnosed with lung cancer, the very first question off the back is, “Do you smoke?” Or, “Did you smoke?” which really pulls focus away from their need for support and kindness in that moment.

And then, people who do have history of smoking or do currently smoke, on the other hand, feel really stigmatized by feeling blamed by this idea of having brought something upon yourself, which is not the case. Most people who smoke never develop lung cancer, but it is a risk factor, and so it's just much more complicated.

And lung cancer, of course, is rising among people who have never smoked, as a result of air quality and other environmental exposures that are also associated with lung cancer.

How can this stigma impact patients’ overall quality of life and their treatment journey?

Cancer is stressful and it usually it impacts your emotional well-being in different ways for different people. Oftentimes there's a lot of concern, anxiety, kind of depressed mood or changes in mood that is even more heightened among people who feel stigmatized for their cancer, so you see even higher levels of distress and sometimes a sense of isolation or lack of support from other people.

That's one of the most important things for people who have cancer, to feel like they have a strong sense of support around them and a strong sense of consideration for what they're going through, and if you're blaming someone for their cancer, of course, that completely erodes this idea of them feeling cocooned in support.

If someone feels stigmatized in this way, it’s probably very isolating.

I think that that's why people who have lung cancer oftentimes really want to connect, not only with other people with cancer, but specifically with people who have lung cancer, because they know that it's different.

Lung cancer is the second-most common cancer in the U.S. among men and women, the most common being breast for women and prostate for men. But it's the leading cause of cancer death in the U.S., which just means it can be a deadly cancer. Although there have been a lot of advances in the last few years, and now there are more treatments, and there are great options for immunotherapy and targeted therapy, there's something really particular about knowing others who have lung cancer, just because of the type of treatments you get, the type of decisions you're making about your treatment, and again, combating this stigma and potentially feeling like you're being treated differently than other people with cancer.

So, that sense of community or even a connection to a support group of other lung cancer patients or survivors is really important.

What are some other things that patients can do if they are feeling stigmatized and isolated?

One of the things that comes up is their experience with their medical care, or the team of oncologists who are taking care of them. And so, one of the things that I think is important, because cancer treatment has become so specialized, is, if possible, to specifically seek a thoracic oncologist, someone who specializes in lung cancer, because then you don't have to worry about whether they're treating you differently than anybody else, because that's their area of focus, and everyone they treat has lung cancer. And so, the ability to connect and to provide support, both in terms of care you're getting, but also the emotional support that you oftentimes receive from your care team, your physicians, your nurses, I think will feel different when they are so intimately connected to this particular diagnosis.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.