Lung cancer stigma: A concept with consequences for patients

Abstract

Background: Patients with lung cancer (LC) report lower quality of life (QoL) and higher levels of psychological distress compared with other cancer populations. Lung cancer stigma (LCS) may in part explain these findings. Aim:We investigated the prevalence of patient-perceived lung cancer stigma (LCS) and its relationships to symptom burden/severity, depression, and deficits in healthrelated quality of life (HR-QoL). Methods:In this descriptive, observational, and cross-sectional study, 201 participants were sent questionnaires. These included the Cataldo Lung Cancer Stigma Scale (CLCSS), the Lung Cancer Symptom Scale, the Centre for Epidemiologic Studies-Depression Scale, and the Quality of Life Inventory.Results: Participants were on average 69 years old, 52% women, 95% ever smokers, and 18.5% current smokers. The mean total CLCSS score was 53.

Variables associated with distress amongst informal caregivers of people with lung cancer: A systematic review of the literature

“…The symptom burden of people with lung cancer has been reported as greater than that experienced with other types of cancer, 3 and is associated with impaired functioning and a concomitant negative impact on quality of life 4 . In addition, lung cancer is associated with high levels of distress 5,6 and an increased suicide risk, 7 compounded by perceived stigma and shame related to smoking behaviours 8 …”

“…4 In addition, lung cancer is associated with high levels of distress 5,6 and an increased suicide risk, 7 compounded by perceived stigma and shame related to smoking behaviours. 8 As lung cancer patients are frequently investigated and treated as outpatients whenever possible, 9 informal caregivers may face considerable duties and responsibilities. 10 For example, compared to other cancer types, patients with lung cancer report long-term effects on daily functioning and higher levels of physical and daily living support needs.…”

Did you smoke? Addressing stigma in lung cancer

“…2 Sadly, research also demonstrates that a lack of empathy and stigmatization can lead people to delay seeking diagnostic interventions and accessing treatment early and/or people can cease treatment prematurely. 2,5 'Knock on' effects of these delays and actions can influence decreased quality of life, greater psychological distress, avoidance in disclosing the illness and decreased engagement with support groups. 2,3,5 In the lung cancer population, higher levels of perceived shame, guilt and nihilism are reported in patients with a smoking history than in their never smoked counterparts, creating division between those who smoke or formerly smoked and those who have never smoked.…”

Lung cancer stigma is a predictor for psychological distress: A longitudinal study. Lung cancer stigma is a predictor for psychological distress

“…The disease can be highly stigmatised, 2,3 and compared to other cancer types, people with lung cancer report higher levels 4–6 . Experiences of lung cancer stigma may vary, and can be exacerbated by characteristics such as gender, age and smoking history 7–11 …”

“…People with lung cancer report high levels of psychological distress 15 . In particular, lung cancer stigma has been found to be associated with a number of outcomes related to psychological distress such as depression, poor health‐related quality of life, low coping self‐efficacy and greater symptom burden 11,16–19 . Findings from longitudinal studies of lung cancer populations suggest psychological distress can be enduring or heightened over the cancer trajectory.…”