Lung cancer is the second most commonly diagnosed form of cancer in the United States disproportionately affecting Black Americans, who are less likely to be diagnosed early, less likely to receive surgical treatment, and more likely to not receive any treatment, according to the American Lung Association.
Although smoking is the number one cause of lung cancer, there are other ways to develop the disease. In fact, you can still develop lung cancer if you've never smoked a day in your life.
Despite this, many people automatically associate lung cancer with smoking, which unfortunately means you may have to deal with the often-asked question: "Did you smoke?"
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As someone who has smoked before, this type of stigma can cause you to feel guilty or blame yourself for your diagnosis. Imagine turning to someone for support about your diagnosis and the first thing they do is draw a correlation between your smoking history and your diagnosis. This further adds to the guilt you may already be feeling.
"As a society, we treat the correlation between smoking and lung cancer much more harshly than we do any other disease," says Mara Antonoff, M.D., an assistant professor of thoracic and cardiovascular surgery at MD Anderson Cancer Center in Houston.
"We know that there are certain dietary factors that contribute to things like colon cancer, for instance, yet we don't accuse those patients of being the cause of their illness," Dr. Antonoff explains. "And frankly, I just think it’s not fair," adds Dr. Antonoff.
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While initial guilt is normal, dwelling in it can lead to a lower quality of life, as well as more depression and anxiety, according to researchers from the University of California, San Francisco.
Here's how to let go of the guilt.
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1. Recognize That Lung Cancer Has Many Triggers
A history of smoking may or may not have contributed to your diagnosis, but it is important to remember that there are several contributing factors to lung cancer.
"Sometimes the factors that cause our illnesses are related to things that we can't help at all—environmental exposures, congenital problems, familial issues, and even bad luck," says Dr. Antonoff. "Lung cancer is multifactorial, and we don't know for any one individual exactly what caused their tumor cells to grow."
Although there may be clues, no one (not even your oncologist) can know exactly what caused your cancer, so stop beating yourself up.
2. Take Control of the Conversation
One surefire way to manage your guilt is to control the conversation and educate those around you. The next time someone asks you if you smoked respond with, “''Yes, I did. Why do you ask?' That puts the questioner on the defensive, and puts you in control of the dialogue,” says Winfield Boerckel, the lung cancer program coordinator for CancerCare in New York City, a national nonprofit that supports patients and their families.
This strategy empowers you to enlighten others on the various ways people can get lung cancer, Boerckel notes.
3. Redirect Your Negative Feelings
"There's nothing we can do about the past. Let's focus our energy on what we can do moving forward," Dr. Antonoff says.
What does this mean? Redirect your attention to things that will lower your chances of developing another cancer or complications associated with treatment. The first place to start is by quitting smoking (if you haven't already).
4. Double Down on Good Habits
Piggybacking off of the last step, you want to focus your attention on the things that will keep you healthy. Dr. Antonoff advises focusing on getting a lot of protein to speed healing after surgery and maintain muscle mass during chemo and radiation. You should also walk every day. Walking will keep you as strong as possible for treatment.
"The people who feel the guiltiest are often the ones who say, ‘I'm going to do everything I can now because I want to be around for my family,'" Dr. Antonoff adds. Think of it as using your guilt for something positive.
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5. Find Your Tribe
Due to the stigma we mentioned earlier, lung cancer is a "deeper, smaller, tighter box," according to Boerckel.
One way to combat the feeling of isolation is by joining a lung cancer support group.
"The stigma is left outside the door, and people are much more interested learning more about cancer, treatments, and how other patients are coping," Boerckel adds.
Your hospital or oncologist may be able to help you find groups near you. CancerCare.org is also a good resource for online groups or in-person groups.
6. Shine a Light on Lung Cancer
What better way to shift the guilt you may be feeling than shining a light on lung cancer? Joining an advocacy group, like LUNGevity, fundraising for new treatments or research, or simply getting involved in a lung cancer walk to raise money and awareness are great ways to pay it forward to others impacted by lung cancer.
Due to stigma, lung cancer is the leading cause of death by cancer for both men and women, but compared to, say, breast cancer, it’s inadequately funded, says Dr. Antonoff. So, think of it this way: you'll be playing a part in erasing the stigma around lung cancer.
7. Find Support For Your Family Members
According to a Canadian pilot study involving eight couples and published in the journal, Current Oncology, tension at home from a family member that urged you to stop smoking can lead to depression and up your odds of picking up another cigarette.
Because you'll need your family during this difficult time, a therapist or counselor can help you and your family work through your emotions.
8. Stay in the Moment
Your head may be spinning with the worst of scenarios, but try not to let your mind go there. Spiraling isn't good for your health or stress levels.
So what can you do to combat this?
Any of these may help:
- Mantras or phrases can bring your focus back to today
- Guided imagery can bring you back to a safe place when you’re feeling most vulnerable
- Mediation. CancerCare’s Meditation app offers meditation specifically geared toward cancer patients
