Something In the Air
When a Smoker Gets Lung Cancer, Sympathy Is Stained With Blame
Tuesday, December 16, 2008; Page HE01
It took me a while to figure out why my dad refused the free blanket in the cancer ward.
The lady from the Cancer Society came into his room wheeling a cart stacked with colorful blankets. Crocheted by volunteers, they offered homespun comfort to folks recovering from surgeries that had cut out tumors, lesions, slabs of skin, pieces of colon, entire breasts or, in my father's case, a lobe of his left lung.
"No, not for me," said my father, a rugged brick mason who kicked his 45-year, pack-a-day smoking habit two months before the surgery.
I took one of the blankets for him, but for days it lay untouched on the chair in his hospital room. "That's for the other people," he said, pointing to rooms where cancer battles were also being fought.
My answer about his blanket aversion came a couple of days later. The stitches were bothering him, he was sick of the hospital food, but most of all, the 63-year-old fly fisherman who bicycles to work was furious at being debilitated. He offered the entire ordeal's one bit of analysis in his thick Eastern European accent.
"All these years of smoking. I had all that pleasure," he said. "Now, I pay."
He had been beating himself up for having lung cancer. And the rest of us in the family, though we didn't want to admit it, weren't exactly showering him with forgiveness.
It's a common syndrome for this particular type of cancer, which is consistently marginalized, stigmatized, under-funded and under-studied, even though it kills more people in the United States every year than breast, prostate, colon, liver, kidney and melanoma cancers combined, according to the Lung Cancer Alliance, an advocacy group in Washington.
It is becoming clear to patient advocates that the mental health of lung cancer patients -- who rarely get the positive reinforcement, unfettered support and kindness of society -- is also worth defending.
"The blame is a double burden on people. It's bad enough to have lung cancer; now they are getting blamed for it. And now they're saying, 'If I had only not smoked, I would not be in this spot,' " said Jimmie Holland, a psychologist at New York's Memorial Sloan-Kettering Cancer Center who is the founding president of the American Psychosocial Oncology Society. Holland is often heralded as the mother of the movement to elevate the importance of psychological counseling for cancer patients, and she is particularly interested in the plight of lung cancer patients.
Of course, all lung cancer patients are not former smokers. And that is one of the campaign themes that advocacy groups are hitting hard.
"It's a huge issue. We so deeply stigmatize lung cancer as a society. We so closely bundle it with tobacco use," said Beth Ida Stern, executive director of LUNGevity, an advocacy group in Chicago. "We were taught for a very long time that if we do smoke, we bring it on ourselves. . . . The world looks at the patients and says, 'You did this to yourself.' So people feel so stigmatized, they may not seek support."