The Pearl Ribbon

the social stigma of lung cancer and the ‘pearl’ ribbon campaign

Everyone knows about those darn ‘awareness’ ribbons… Red for HIV/AIDS, pink for breast cancer..  But since November is Lung cancer month – I’d like to address the hypocrisy of the lung cancer ribbon(s) and our [society’s] treatment of patients with lung cancer.  While not specifically endorsed by the American Lung Association, there is a division within the ribbon awareness campaign – the gray ribbon versus the pearl ribbon.  For the uninitiated, gray is for smokers (or people who apparently deserve cancer) while the pearl ribbon is reserved for non-smokers (such as Dana Reeves.)  This isn’t just about ribbons – after all, few people even know that these specific ribbons exist.  It’s about the social stigma that surrounds lung cancer from all sides; from medical professionals, the media, family and friends of patients and the patients themselves.

The irony of this is that; this sense of responsibility or health (social) justice does not extend across the spectrum of health conditions; no one assigns the shame of untreated sexually transmitted infections to people suffering from infertility, or cervical cancer, nor should they.  Though it’s impossible to ignore the link between obesity and diabetes (thus heart and vascular disease) no one assigns blame or personal responsibility to the hundreds of millions of obese people with diabetes.  Will cell phone users feel the stigma if they develop brain cancer?  Doubtful.  While smokers, and smoking have become a handy target for social scorn – these other groups are fairly safe for scrutiny.  Why?  My guess is because while the pool of smokers diminishes every year (for multiple reasons), the huge numbers of people with an STD history, obesity or cell phone use (after all, who doesn’t use a cellular phone?) makes these groups immune to serious scrutiny, or discrimination.  Nowadays, smokers pay higher health insurance and life insurance rates, and can lose their jobs for smoking.  But when is the last time that a BMI of 40 or a diagnosis of diabetes increased someone’s co-pay*?

More disturbingly, this distinction divides us at a time when we need to stand together; to gain media attention (and research dollars.) Anyone (and everyone) facing lung cancer needs love, care and support. While many people may make distinctions to try and come to terms with a difficult diagnosis, at the end of the day – we need to erase these self-imposed boundaries, unify and make our voices heard:  Lung cancer is the number one killer of women in the United States – but breast cancer receives most of the money and all of the attention.  If even a fraction of the money designated for breast cancer research could be raised and directed towards lung cancer research for detection and treatment – regardless of smoking status, thousands of lives could be saved.

*Arizona is attempting to impose penalties on Medicaid recipients for both smokers and the obese in an attempt to salvage the struggling social program, but this is less about personal responsibility than a cost-saving maneuver.

Additional References:

American Lung Association – no one deserves lung cancer.

Lung Cancer Research

Lung Cancer Partnership

National Cancer Institute

The Stigma of Lung Cancer:

Cataldo, JK et. al. (2011). Measuring stigma in patients with lung cancer: psychometric testing of the caltaldo lung cancer stigma scaleOncol Nurs Forum. 2011 Jan 1;38(1):E46-54.

Chapple A, Ziebland S, McPherson A. (2004). Stigma, shame, and blame experienced by patients with lung cancer: qualitative study.  BMJ. 2004 Jun 19;328(7454):1470. Epub 2004 Jun 11.

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

Schönfeld N, Timsit JF. (2008).  Overcoming a stigma: the lung cancer patient in the intensive care unit. Eur Respir J. 2008 Jan;31(1):3-5.