How to Get Over Your Lung Cancer Guilt

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If you’re a current or former smoker, this has probably happened to you: You tell people you've been diagnosed with lung cancer and they in turn ask about your smoking habits. "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. So it's no surprise that many people with lung cancer who have a history of smoking feel stigmatized.


An Unfair Pressure

"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.

What's more, the stigma facing lung-cancer patients correlates with a lower quality of life, as well as more depression and anxiety, according to researchers from the University of California, San Francisco. And that's really not fair. Keep reading to learn how to let go of guilt and focus on what really matters: your health.


Recognize That Cancer Can Have Many Triggers

Sure, you may have smoked, and while that may likely have contributed to your disease, the operative word is "may." "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."

So your particular lung cancer might have more to do with the chemicals you've been exposed to at work, for instance. And since you don't know for sure and neither does your oncologist, stop beating yourself up—and move on to the next item on this list.


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Take Control of the Conversation

Since no one can know exactly what caused your cancer, it’s time to educate people who think they do. When someone asks if you smoked, answer, “'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.

Boerckel says this strategy empowers you to do what’s next: Enlighten folks on the various ways people can get lung cancer. Case in point: Radon gas is the second-leading cause.


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Redirect Negative Feelings

Dr. Antonoff tells her patients: "There's nothing we can do about the past. Let's focus our energy on what we can do moving forward." What does that mean for you? First, stop smoking (or don’t restart) so you lower the chances of developing another cancer or complications associated with treatment. Then...


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Double Down on Good Habits

Eat a healthy diet. In particular, get lots of protein to speed healing after surgery and maintain muscle mass during chemo and radiation, Dr. Antonoff advises. Another one of her recommendations: Walk every day to make sure that you're 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.'" That guilt may not be warranted, but using it for something positive sure is.


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Find Your Tribe

Developing any cancer is isolating—but because of its stigma, lung cancer is a "deeper, smaller, tighter box," says Boerckel. Joining a support group puts you in contact with people going through the same thing, and can help you move on.

"The stigma is left outside the door, and people are much more interested learning more about cancer, treatments, and how other patients are coping," he says. Check with the hospital or your oncologist for groups near you, or go to CancerCare.org; they have online groups as well as ones in IRL.


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Shine a Light on Your Disease

Your first priority is getting better. But once you do, you may want to think about joining some sort of advocacy group, like LUNGevity. You can lobby or fundraise for new treatments or research. Or simply get involved in a lung-cancer walk to raise money and awareness.

“It’s similar to joining a support group, although a little less formal,” says Boerckel. And your help is needed: Lung cancer is the leading cause of deaths by cancer for both men and women, but compared to, say, breast cancer, it’s inadequately funded, says Dr. Antonoff. That’s partly because many organizations that normally would get involved with a fundraiser shy away because of the stigma.


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Encourage Family Members to Find Support, Too

If your partner or kids begged you stop smoking in the past and you didn't, they may be angry or resentful. That's tension at home that you don’t need right now—and one that can trigger depression and up the odds that you smoke again, according to a Canadian pilot study involving eight couples and published in the journal, Current Oncology. Better for family members to work through all their emotions by joining a caregivers group or going to counseling, says Boerckel. And better for you: The higher your sense of shame, the more alienated you'll feel from your partner at a time when you need the most support, researchers found.


Stay In the Moment

When you have cancer, it’s nearly impossible to stop yourself from spinning all sorts of worst-case scenarios. But that’s not good for your stress levels (or your sleep!).

Two strategies that help: Having a mantra or phrase that can bring your focus back to today, or using guided imagery to get to a safe place when you’re feeling most vulnerable. “I worked with one fellow who’d snap a rubber band on his wrist," says Boerckel. "When I asked him whether that hurt, he said, ‘Yeah, but it's today's pain,’ and explained that it helped him work on the things that he had to do today." For meditation specifically geared with cancer patients, well, there’s an app for that: CancerCare’s Meditation.