Stigma surrounds lung cancer patients who are cared for by family members, says a new report, which warns that these attitudes can prevent patients from receiving adequate health care.
Lung cancer stigma is a social phenomenon that labels patients as "tainted or less desirable," and responsible for their own illness, writes Michelle Lobchuk, an associate professor of nursing at the University of Manitoba.
Lobchuk's report is part of the Cancer Advocacy Coalition of Canada's "Report Card on Cancer in Canada," which was released Wednesday.
She writes that a number of factors contribute to that stigma, including highly successful public health campaigns that have linked smoking to lung cancer in an effort to encourage smokers to kick the habit.
With that link in mind, the general public sees the outward signs of a smoker -- nicotine-stained clothing, clothes that smell of smoke -- and marks "the individual with lung cancer as deviant."
According to Lobchuk, caregivers are not immune to stigmatizing even their own family members with lung cancer, especially when the patients continued to smoke.
In her study of 304 pairs of lung cancer patients and their caregivers, she found that when patients continued to smoke after their initial diagnosis, "caregivers attributed more judgment and anger toward the patient thus leading to less engagement in empathic helping behaviour."
In a separate article, Annette Schultz offers further evidence that lung cancer patients are stigmatized, by others and by themselves. This can lead to suboptimal care.
"Stigmatized people are less likely to seek health care, which is linked to a sense of personal responsibility and unworthiness to receive health care services," writes Schultz, also an associate professor of nursing at the University of Manitoba.
According to Schultz, "When a person living with lung cancer is stigmatized within the family, health care decisions are often less collaborative and tend not to reflect the patient's needs."
In her essay, Lobchuk says it's worth noting that between 10 and 20 per cent of lung cancer patients never smoked.
Of the patients whose cancer can be attributed to smoking, between 13 and 22 per cent continue to smoke after their initial diagnosis.
Schultz writes that ongoing tobacco use during cancer treatment results in poorer health outcomes, including risk of developing heart or lung diseases or secondary tumours, a higher risk of infection and compromised immune system function.
But survival rates for lung cancer patients are improving, thanks to better diagnostic tests and earlier detection, she writes.
All of these factors make it imperative to help lung cancer patients kick the habit.
"There are many reasons to offer tobacco dependence treatments as part of the full spectrum of health care services for lung cancer patients; at the very least, to enhance patients' response to cancer treatment regimes and improve their survivorship trajectory."
