There is a new interview over at Medscape that examines the stigma of a diagnosis of Lung Cancer. During the interview, Dr. Joan H. Schiller, MD,(Chief, Division of Hematology/ Oncology at the University of Texas Southwestern Medical Center, Dallas, Texas) discusses her work in examining biases and attitudes regarding lung cancer and patients with lung cancer. Most importantly, the study included participants who work in the medical field (doctors, clinicians etc).
To participate in her ongoing study, click here for the Lung Cancer Project.
Doctors as study participants
Lung cancer patients aren’t just stigmatized by friends and neighbors. They are also shamed by some of the very people that are supposed to take care of them; doctors, nurses and other healthcare personnel.
For example, this well-known Oncologist expresses concern that “CT scans will be used as a crutch by smokers” that will give smokers a false sense that medicine can ‘fix’ problems caused by smoking.
While I certainly understand that as an Oncologist who sees advanced stage cancers in her practice every day – she may be emotionally exhausted and disheartened by the amount of smoking-related cancers in her practice, I think that ANY diagnostic technique that allows us to find/ and diagnose cancers at early stages – when there is a better chance for successful treatment – is not a crutch*. In truth, even with early detection only a tiny fraction can be “cured.”
I doubt that any smoker says, “Oh, well.. I can smoke because they can always do a CT scan..” Of course we should encourage smoking cessation – in all our patients, but shaming, stigmatizing and punishing our patients who have a history of tobacco use is counter-productive and unworthy of us as health professionals..
As we discussed in a previous post, the stigma of a lung cancer diagnosis is a distinct entity in comparison to other cancers, and causes divisions among lung cancer patients themselves (former smokers versus never-smokers).
With lung cancer as the number one cancer killer in the United States, as well as new screening recommendations for the early detection of lung cancer being endorsed by several major health agencies and organizations – it is time we tackle this stigmatization and marginalization of people with lung cancer.
* I do agree with her recommendations for smoking cessation, and using taxes from cigarette sales to pay for CT scans.. Or maybe some of the tobacco settlement funds.
References
“The Stigma of Lung Cancer” – Medscape article by Joan H. Schiller, MD, Alice Goodman, MA.
Suzanne K Chambers, Jeffrey Dunn, Stefano Occhipinti, Suzanne Hughes, Peter Baade, Sue Sinclair, Joanne Aitken, Pip Youl, Dianne L O’Connell (2012). A systematic review of the impact of stigma and nihilism on lung cancer outcomes. BMC Cancer. 2012; 12: 184. Published online 2012 May 20. doi: 10.1186/1471-2407-12-184. Review of previous studies on stimatization, and quality of life outcomes in patients with lung cancer.
Janine K. Cataldo, Thierry M. Jahan, Voranan L. Pongquan (2012). Lung cancer stigma, depression, and quality of life among ever and never smokers. Eur J Oncol Nurs. 2012 July; 16(3): 264–269. Published online 2011 July 30
Janine K. Cataldo, Robert Slaughter, Thierry M. Jahan, Voranan L. Pongquan, Won Ju Hwang (2011). Measuring Stigma in People With Lung Cancer: Psychometric Testing of the Cataldo Lung Cancer Stigma Scale. Oncol Nurs Forum. 2011 January 1; 38(1): E46–E54. doi: 10.1188/11.ONF.E46-E54. Scale and survey measuring stigma & shame, isolation, discrimination and smoking among patients with lung cancer using a tool adapted from HIV stigma studies.
Ping Yang (2011). Lung Cancer in Never Smokers. Semin Respir Crit Care Med. 2011 February; 32(1): 10–21. A general overview of lung cancer in never smokers as well as the stigma of lung cancer in this group.
A Chapple, S Ziebland, A McPherson (2004). Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. BMJ. 2004 June 19; 328(7454): 1470. doi: 10.1136/bmj.38111.639734.7C UK study looking at the stigmatization of patients with lung cancer. Some of the statements in the article by patients being interviewed are quite marked, as well as the dramatic isolation of these patients from friends, families and neighbors.
JML Williamson, IH Jones, DB Hocken (2011). How does the media profile of cancer compare with prevalence? Ann R Coll Surg Engl. 2011 January; 93(1): 9–12. The role of the media in the public’s perception of cancer, and over/ underrepresentation of certain types of cancer in the UK. (Article does not specifically mention lung cancer).
Rory Coughlan (2004). Stigma, shame, and blame experienced by patients with lung cancer: Health promotion and support groups have a role. BMJ. 2004 August 14; 329(7462): 402–403. doi: 10.1136/bmj.329.7462.402-b short comment.
Thoracic Surgery 