Understanding the impact of stigma in lung cancer: an exploration of patient experiences

Lung cancer is the leading cause of cancer-related deaths in Australia and globally. Despite the severe burdens associated with lung cancer, it remains relatively under-researched compared to other cancer types. The disease is associated with significant psychological, physical and social challenges for individuals. However, the stigma of lung cancer is another potential and noteworthy feature that can adversely contribute to patients’ experiences. The evidence in relation to the stigma of lung cancer for patients is emerging, however there are many facets that are not yet understood. The majority of lung cancer studies have predominantly focused on examining associations with psychological factors. Broadening explorations towards other aspects of patients’ experiences such as treatment-related and social factors is important to enable a more comprehensive understanding of the impacts of lung cancer stigma. As much of the research to date has been cross-sectional, longitudinal research is needed to complement what is known and provide additional context to lung cancer stigma and how it may manifest. Such information will be important to observe trends and identify approaches to support this vulnerable population. This thesis by publication examines lung cancer stigma to explore patient’s multi-faceted experiences and highlight potential targets for enhanced care and support. The five papers that comprise this thesis examine the following key questions in relation to lung cancer stigma: What are the known correlations of stigma among people with lung cancer, and what factors (if any) are unique to lung cancer ? (Paper 1);Is lung cancer stigma associated with patients’ expectations and preferences for treatment? (Paper 2); Is lung cancer stigma associated with supportive care service use? (Paper 3); Is there a causal relationship between lung cancer stigma and psychological distress? (Paper 4); and What is the longitudinal course of lung cancer stigma, and are there latent trajectories? (Paper 5).