Lung cancer stigma across the social network: patients' and caregivers' perspectives

To examine the personal experiences of people with lung cancer and of their caregivers and how stigma manifests throughout the patient's social network.Qualitative thematic analysis conducted on interviews with 28 lung cancer patients and caregivers. Telephone interviews were conducted and transcribed verbatim. Data analysis was guided by contemporary stigma theory.Patients and caregivers reported high levels of felt stigma and concomitant psychological distress in response to the diagnosis of lung cancer. Three overarching themes emerged: the nexus of lung cancer and smoking; moralization; attacking the link between lung cancer and smoking. Stigma was inevitably linked to smoking and this formed the hub around which other themes were organised. Caregivers reported feeling invisible and noted a lack of support systems for families and caregivers. As well, there was evidence that caregivers experienced stigma-by-association as members of the patients' close networks. Both groups responded ambivalently to stigmatizing antismoking advertisements.The qualitative analysis demonstrated the complex interplay of the social and the personal domains in the experience and outcomes of stigma in lung cancer. There is a significant potential for caregivers of lung cancer patients to experience exacerbations of psychosocial distress as a consequence of widely shared negative views about lung cancer and its prognosis. It remains for researchers and practitioners to incorporate such complexity in addressing stigma and psychosocial distress in both patients and caregivers.