Community and government action to improve outcomes for cancer patients in developed countries has resulted in a marked shift in societal views about people affected by cancer. However, the identity shift from sufferer or victim to survivor has not occurred evenly across patient groups. In the case of lung cancer, health-related stigma and therapeutic nihilism appear to have persisted as key characteristics of this disease experience, despite advancements elsewhere. Further, despite the evidence that stigma and nihilism may amplify distress in lung cancer patients and carers, to date interventions that seek to reduce psychosocial distress in this patient group have not included stigma in their study frameworks.
Interventions to address stigma in other diseases such as tuberculosis, leprosy, obesity and HIV Aids have approached this problem at multiple levels: government; health settings; general community; the affected group; and the affected individual. Drawing on this experience a multi-level approach to reducing health-related stigma in lung cancer may be needed; and at each level there will be a tension between competing priorities.