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For Lung Cancer Sufferers, The Added Burden Of Judgment

Dr. Lecia V. Sequist: "Because one of the strongest risk factors for lung cancer is smoking, our society has come to the conclusion that people diagnosed with lung cancer somehow deserve it, that it was brought on by their own ‘bad’ behavior." Pictured: A healthy set of lungs. (aidan_jones/Flickr)closemore
Dr. Lecia V. Sequist: "Because one of the strongest risk factors for lung cancer is smoking, our society has come to the conclusion that people diagnosed with lung cancer somehow deserve it, that it was brought on by their own ‘bad’ behavior." Pictured: A healthy set of lungs. (aidan_jones/Flickr)

My patient, “Judy,” is one of more than 224,000 Americans this year who will be diagnosed with lung cancer. And like most of her fellow lung cancer patients, she is struggling not only to learn all she can about her diagnosis and treatment options, but also to adjust to the overwhelming burden of shame and stigma that plagues this disease. When asked who is providing her with support, Judy said she is ashamed to admit her metastatic, incurable cancer diagnosis to loved ones, and that she is bearing the burden alone. Because one of the strongest risk factors for lung cancer is smoking, our society has come to the conclusion that people diagnosed with lung cancer somehow deserve it, that it was brought on by their own ‘bad’ behavior.

What many people don’t realize is that about 60 percent of all new lung cancer diagnoses are among people who have never smoked or are former smokers, many of whom quit several decades ago.

Tell a friend or colleague that your aunt just found out she has lung cancer. Almost always the response will be, “Did she smoke?” Then tell someone else that your aunt just found out she has breast cancer, or colon cancer, or any other type of cancer you can think of. This time the response will be pure sympathy, without any blame attached.

The feeling that lung cancer patients should somehow be held liable for their cancer diagnosis is often the only notion people have about the disease. It is the deadliest cancer, responsible for more than 27 percent of all cancer deaths. It kills roughly twice as many women as breast cancer, and almost three times as many men as prostate cancer. What many people don’t realize is that about 60 percent of all new lung cancer diagnoses are among people who have never smoked or are former smokers, many of whom quit several decades ago. Just last year, the World Health Organization declared air pollution as a leading cause of lung cancer. In short, anyone with lungs, anyone who breathes air, can get lung cancer.

Researchers are on the verge of a seismic shift in our ability to diagnose and treat lung cancer. In the last five years, researchers have learned that some lung cancers are remarkably sensitive to a new class of cancer treatment – one that comes in pills and is targeted specifically toward the genetic defects that make that particular cancer “tick.”

In clinics across the country, oncologists are testing their lung cancer patients to find out which type of gene the cancer carries so they can know which type of targeted therapy will work best. As a result, some patients are living longer, with fewer side effects and improved quality of life compared to traditional therapies. In addition, in the last two years, researchers have started to learn how to harness the immune system to attack lung cancer, and have seen some patients with advanced disease go into prolonged remission; sometimes lasting long after the immune therapy is stopped. These types of successes in lung cancer treatments would have been unimaginable 10 years ago.

...for every woman that dies of breast cancer, more than $26,000 in federal research funding is devoted to breast cancer research. But for every woman that dies of lung cancer, just over $1,000 federal dollars are invested. The difference is staggering.

Scientists are deeply committed to broadening and improving therapy options until there is an effective treatment for all lung cancer patients. Unfortunately, the stigma associated with lung cancer has translated to a massive inequality in research funding. When analyzing the combined 2012 cancer research dollars granted by federal organizations, for every woman that dies of breast cancer, more than $26,000 in federal research funding is devoted to breast cancer research. But for every woman that dies of lung cancer, just over $1,000 federal dollars are invested. The difference is staggering.

November is national lung cancer awareness month. Let’s reject the tendency to blame lung cancer patients for their disease, so that the crushing weight of stigma and guilt that, for some, can be as bad as the cancer itself, is one less burden to bear. Let’s hope, too, that as that stigma lifts, so research will increase and more lives be saved. This is my wish for Judy, and for lung cancer patients everywhere who are too ashamed to mention it.


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Lecia V. Sequist Cognoscenti contributor
Dr. Lecia V. Sequist is a medical oncologist at the Massachusetts General Hospital Cancer Center, associate professor of medicine at Harvard Medical School and a member of LUNGevity Foundation’s Scientific Advisory Board.

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