Skin Cancer: The Stigma of "It's Your Fault"
There are some diseases, such as skin cancer, where the patient is blamed for their own disease, at least partially. When you disclose your diagnosis, friends and relatives might look at you with sympathy, but wonder how much your own behavior contributed to your cancer. Some might even say things such as:
“Did you sunbathe a lot when you were younger?”
“You did always like to be tan.”
“Didn’t you use sunscreen?”
These remarks are not only insensitive but they are ignorant. They imply that you somehow intentionally chose to get skin cancer because of your behavior. It is difficult enough to deal with a diagnosis of cancer without having to also suffer from the self-blame and guilt that goes along with this type of thinking.
Cancer isn’t your fault
“The reality is that only a minority of cancer is caused by a specific cause, and our ability to prevent it is relatively modest. Most people who get cancer simply have the wrong combination of genetic predisposition, exposure and bad luck,” states Nathan Pennell, MD, of the Cleveland Clinic. While Pennell was talking specifically about lung cancer, the statement is accurate for skin cancer as well.
There are certainly risk factors that increase your risk of developing skin cancer, such as overexposure of the sun, but this isn’t the only determining factor. There are many people who spend years out in direct sunlight, working or enjoying the outdoors, and they don’t all end up with skin cancer. Some even live a long life without any signs of skin cancer.
While it is important to use sunscreen, take precaution to avoid sunburns and stay out of the direct sunlight during the heat of the day. This is typically between 10am and 4pm, with the sun being at its strongest between 12 and 1pm. Other cancers carry the stigma of “It’s your fault.” Lung cancer, for example, his highly linked to smoking. But up to 15 percent of lung cancer patients have never smoked, according to the American Cancer Society. Similarly, sun exposure is just one of the risk factors for skin cancer. Genetics, the immune system and other factors all contribute to your risks for developing the condition.
Taking care of what’s in your control
If you did something to “deserve” your cancer, what does that mean? Does it mean you deserve what you get? That you deserve to suffer? Does it mean you shouldn’t get sympathy from others? Does it mean you should get substandard treatment because you did this to yourself?
Blaming yourself for your cancer is not helpful. You need to focus on treating your cancer rather than blaming yourself. No one deserves to get cancer, no one deserves to suffer and you didn’t ask for your cancer, no matter your previous behaviors.
Cancer is scary
Skin cancer is one of the most common types of cancer in the United States, with 3.3 million Americans diagnosed with basal and squamous cell carcinomas each year. However, many types of skin cancer are highly treatable. Researchers are also making progress in finding new ways to treat melanoma, the deadliest form of skin cancer. But even so, the word cancer is scary.
Part of the fear behind cancer is the sense of the unknown. We like things with more certainty. We like to know that we are in control of our lives and our health. Cancer reminds us that we are not. We aren’t yet sure why some people get cancer and why others do not. We know there are risk factors that increase your chance of developing cancer but we don’t yet know how to prevent it.
One of the reasons people may hear insensitive remarks about a diagnosis is because the people saying these things want to reassure themselves that they will not get cancer. If you run into an old friend and talk about your skin cancer, she might silently start calculating how much time you spent in the sun together - did you spend more time than her? Did you forget sunscreen? Did you prefer to get a tan and skip the sunscreen altogether? She might be doing so to reassure herself that her risk is lower than yours; that she isn’t going to be faced with the same fate. She is trying to gain some control over an uncontrollable situation. Her remarks are simply a way to allay her own fears.
Dealing with the stigma of skin cancer
Dealing with insensitive remarks and facing the stigma of skin cancer can hurt, but there are some ways you can successfully manage it.
Remember it is your choice who you talk to about your diagnosis and how much you share.
When telling someone about your cancer, talk about the facts. If needed, enlist their help but try to be specific, such as “I could really use help grocery shopping,” or, “It would be nice to have some company on Thursday.” Giving people a specific task can help to move the conversation from pity or blame to practical needs.
Look for support.
You might already have a local support group or you might seek out one online. Reaching out to others who are experiencing similar situations be a great source of strength.
Surround yourself with positive, supportive people.
If you have friends or relatives who are more judgmental than supportive, it is your right to limit the amount of time you spend with them. Develop a circle of people that remain positive and offer support rather than criticism and blame.
Do what you love.
Think about activities that you enjoy and make you feel relaxed. Continue to engage in these activities, even if you need to modify them during treatment. Keeping up with activities that make you feel happy will boost your mood.
Understand your diagnosis and treatment options.
If you have questions or don’t understand something, ask. Keep a notebook of questions and bring it with you to your doctor’s office so you don’t forget any questions. Learn as much as you can about all treatment options so you can make informed decisions. Choose one or two loved ones to share the information with so you have help making decisions when needed.
Let go of the blame and guilt.
Cancer is not your fault. Cancer is caused by a multitude of factors, only some of which you might have had control over. Focus your energy instead on getting well.