Lung cancer stigma interferes with care

Canadians with lung cancer face a barrage of negative attitudes from caregivers, friends and relatives that interfere with caring behaviour, a cancer patient advocacy group says.

Nicotine-stained skin, fingers and teeth, foul-smelling clothes, a smokers cough and premature aging tend to provoke "repulsion" against smokers, but the reality is that 10 to 20 per cent of lung cancer patients never smoked, said Michelle Lobchuk, author ofa report card on cancer in Canada that wasreleasedWednesday by the Cancer Advocacy Coalition.

Widespread messages in society favour those judgments, even by health-care providers, research shows.

One woman in Manitoba recalled her "livid" reaction to her husbands lung cancer, telling him to, "Fill your boots. Kill yourself if you want. Thats what youre doing," when she went to buy him a carton of cigarettes after his diagnosis.

Lobchuck, a nursing professor at the University of Manitoba and Manitoba Research Chair in Caregiver Communication, and her colleagues studied 304 pairs of lung cancer patients and their family caregivers, she also discovered that when patients continued to smoke, caregivers showed more judgment and anger toward patients. The caregivers were then less likely to show empathic helping behaviour, the researchers found.

Lack of guidelines on supportive care

But evidence on quitting smoking says social support is vital to offset feelings of guilt when trying to quit smoking, Lobchuk noted.

"One thing that we can do now to de-stigmatize the lung cancer experience is to ask yourself, 'Why do I need to know whether the patient with lung cancer smoked?' If it comes from a desire to blame, you may be doing more harm than good."

As a nurse, Lobchuk said shes concerned about the lack of medical guidelines that focus on supportive care for patients and families trying to cope with lung cancer stigma.

At a news conference in Toronto, the group's speakers also made the case for:

• Banning smoking in multi-unit housing like apartments and condominiums.
• Adopting a national approach to molecular tests to prescreen people forcancer treatments.
• Changing how tobacco dependence is treated in hospitals.
• Debating the pros and cons of mammogram screening for women in their 40s.

The non-profit advocacy group for patients is largely funded by donations from drug companies.