A sense of rejection, shame and isolation can heighten depression in those who have lung cancer.
Lung cancer is often associated with smoking, so society considers it a “preventable” disease, leaving those who have it — whether they smoked or not — with a sense of shame, leading to increased rates of depression, according to new research at the Moffitt Cancer Center in Tampa, Fla.
“Patients may blame themselves for developing lung cancer and feel stigmatized,” said Paul B. Jacobsen, Ph.D., Moffitt’s associate center director of population sciences and co-author of the study. “Even lung cancer patients who have never smoked often felt — accurately or inaccurately — that they were being blamed for their disease by friends, loved ones and even health care professionals.”
The aim of the study was to identify psychosocial links for depression among lung cancer patients to develop interventions, according to study co-author Brian D. Gonzalez, M.A., of Moffitt’s Department of Health Outcomes and Behavior. The researchers also wanted to find out if this stigma could account for the variability of depressive symptoms in cancer patients.
Participants in the study were diagnosed with stage II, III or IV non-small cell lung cancer. Data was collected via questionnaire.
“We found that 38 percent of those in the survey suffered from depression,” said Gonzalez.
“That percentage was similar to other studies documenting depression in lung cancer patients (21 to 44 percent), but we found that greater levels of perceived stigma were related to greater levels of depression. Additionally, greater levels of depression were related to more avoidant coping, poorer social support and more dysfunctional attitudes.”
The researchers also examined rates of social rejection, financial insecurity, internalized shame, and social isolation.
“Documenting this link between stigma and depression is important because it adds further evidence to the growing body of research suggesting a link between illness-related stigma and the symptoms of depression,” concluded Jacobsen. “For example, studies on depression and HIV have found similar links between disease, stigma and depression.”
Gonzalez notes the findings suggest that psychotherapeutic approaches might be useful in alleviating or preventing depression among lung cancer patients.
“Many approaches to reducing perceived stigma focus on education of the public about lung cancer inaccuracies and stereotypes, and replacing those inaccuracies with facts,” he said.
“Instead, therapy that focuses on altering the patient’s thoughts and feelings associated with their perceptions of stigma may prove effective in reducing depressive symptoms. For example, emphasizing the addictiveness of tobacco products and the deception in tobacco industry advertising could help patients view themselves as being ‘wronged’ rather than as a ‘wrong-doers.’”
The study was published in a recent issue of Psycho-Oncology.
Source: Moffitt Cancer Center