Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

The stigma of cancer

A Lazare MD

University of Massachusetts Medical School, Worcester, MA,

Patients are often ashamed of their illness and humiliated during and as a result of their treatment(s). They may regard their illness as a sign of weakness, and then have to expose themselves physically and psychologically to their physicians. With such attitudes, Patients often delay seeking treatment or withhold vital information from their physician. Cancer patients are at particular risk for suffering from these emotions. We commonly use the word malignant which, in itself, is offensive. Patients may be blamed for being ill, on account of their state of mind or because of what they eat. Manifestations of this disease as well as treatment are often disfiguring and otherwise difficult for patients and their families to bear (ileostomies, masectomies, throat and facial surgery, loss of hair, loss of ovarian function). Even obituaries talk about the "battle" in which the patients are the losers. This talk will discuss the meaning of shame and humiliation as it relates to all medical illness. It will then discuss the extent and implications of shame and stigma in cancer patients. With sensitivities to these matters, physicians can provide better care for their patients.

KEY WORDS: shame humiliation.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on G Haidak memorial lecture.