Lung Cancer

FOR RELATED ARTICLE, SEE PAGE 2040Lung cancer is a devastating disease. Despite the new targeted and immunotherapies, 5-year survival still 20% or lower, incidence-based mortality has only improved 3% over 10-year span.1Howlader N. Forjaz G. Mooradian M.J. et al.The effect of advances in lung-cancer treatment on population mortality.N Engl J Med. 2020; 383: 640-649Crossref PubMed Scopus (301) Google Scholar,2Siegel R.L. Miller K.D. Jemal A. Cancer statistics, 2020.CA Clin. 70: 7-30Crossref (10050) Scholar Lung patients, like all are overwhelmed with anxiety, depression, fear—fear unknown, loss life, family, finances. however, have an additional burden. Because lung results from tobacco use most cases, it associated stigma being self-induced. 2040 Most patients report experiencing stigma.3Hamann H.A. Ostroff J.S. Marks E.G. al.Stigma among cancer: patient-reported measurement model.Psychooncology. 2014; 23: 81-92Crossref (80) Although less well studied, been found to be more than other cancers.4Marlowlow L. Does attract greater types?.Lung Cancer. 2015; 88: 104-107Abstract Full Text PDF (53) This puts at further disadvantage because serious negative psychological behavioral consequences. Stigma shown not impact how feel about themselves their health condition (internalized stigma), but also treated by others (enacted stigma).5Hamann Ver Hoeve E.S. Harris L.C. Studts J.L. Multilevel opportunities address aross control continuum.J Thorac Oncol. 2018; 13: 1062-1075Abstract (50) In context cancer, fear stigmatized—and related feelings shame guilt—can lead depression,6Williamson T.J. Martin C.M. al.Evaluating relationships between stigma, depressive symptoms absence empathic presented during routine clinical consultations [Published online ahead print August 11, 2020].Patient Educ Couns. https://doi.org/10.1016/j.pec.2020.08.005Crossref (2) denial,7Voss M. Putter H. van Houwelingen al.Denial social emotional outcomes patients: protective denial.Lung 2011; 72: 119-124Abstract (35) decreased quality life,8Ernst J. Mehnert Dietz al.Perceived stigmatization its life: large register-based study including breast, colon, prostate patients.BMC 2017; 17: 741Crossref (29) constrained disclosure,5Hamann delays medical help-seeking behavior seeing specialist,9Ganti Borghae Real-world patterns access specialist care United States, 16th World Conference International Association for Study Cancer, Denver, CO2015Google poor adherence. Is this warranted? generally defined as mark disgrace particular circumstance, quality, identity. case usually smoking, even though roughly half never smoked quit. Many causes possible around smoking. Stigmatization may unintended consequence anti-smoking campaigns run 1960s; these ads relied heavily stereotypes portray people who smoke ugly deformed so discourage ultimately giving rise association conditions smoking.10Riley K.E. Ulrich M.R. Hamann Decreasing smoking increasing stigma? anti-tobacco campaigns, public health, care.AMA Ethics. 19: 475-485Crossref (40) long dismissed self-induced eye, companies aggressively advertised very addictive product both before after effects were recognized. acknowledged major promoter role big inducing adequately recognized “they did themselves” vernacular. It was easy start smoking; US government gave away cigarettes free GIs WWII Korean war; decades portrayed sexy media; advertising malleable youth particularly problematic, many teenagers thought they could stop when wanted to. much harder stop; nicotine fourth drug, cocaine, heroin, alcohol, methamphetamine.11Staff E. 5 Addictive Drugs. American Addiction Centers, 2020Google research has, importantly, focused extensively targets important consider 2perpetuates stigma. We know that can result societal attitudes (as campaigns), expressed interpersonally. Care providers, given exposure pivotal treatment, likely (even inadvertently) express unconscious bias toward perpetuating stigma.12Sriram Mills Lang al.Attitudes versus breast cancer.PLoS One. 10e0145715Crossref (21) fact, approximately oncology health-care providers.3Hamann The reported Banerjee colleagues13Banerjee S.C. Haque Schofield E.A. al.Oncology provider training communication skills reduce stigma.Chest. 2021; 159: 2040-2049Abstract (5) issue CHEST addresses some issues developing Empathic Communication Skills (ECS) module, education-based invention professionals (OCPs) . goal promote OCPs’ discussions history patients—an experience trigger shame, blame, guilt, highly stigmatized nature cancer. ECS didactic involved learning recognize patients’ emotions experiences, responding empathy understanding, offering support, which intended mitigate distress often experienced assessments. An experiential role-playing paradigm provided OCPs practice standardized trained coders assessed uptake pre-post training. Patients perceptions OCP empathy, satisfaction communication, perceived degree investigators skills, stigma-mitigating general breadth significantly increased training, suggesting (particularly relate stigma) developed practice. Standardized patient actors feeling satisfied post-training. Patients’ demonstrate statistically significant changes post-training, finding discordance effectiveness measurements. researchers suggest routinely practicing implementing multi-level stigma-reducing interventions (eg, psychosocial support internalization yield robust effects. To our knowledge, first develop test OCP-focused, intervention kind; thus, findings several domains increase benefit promising preliminary evidence feasible efficacious method enhancing mitigating induced assessment care. Oncology Provider Training Reduce StigmaCHESTVol. 159Issue 5PreviewEmpathy-based, assessments cessation smoking-related cancers. These dissemination testing model best practices engagement currently delivery. Full-Text