Genentech Sponsored Study Reveals Hidden Stigma of Lung Cancer

January 21, 2016
By Alex Keown, BioSpace.com Breaking News Staff

CHICAGO – A new study sponsored by biotech giant Genentech confirms a long-held suspicion among some oncologists of a stigma surrounding patients with lung cancer that doctors were not seeing in patients battling other types of cancer.

Joan Schiller, chief of the Hematology/Oncology Division at University of Texas Southwestern and Deputy Director of the Harold C. Simmons Cancer Center, told BioSpace in an exclusive interview that the study definitely showed there have been some hurdles for lung cancer patients. Sometimes, she said, patients were being told that it was not worthwhile to seek treatment because of the life expectancy associated with the disease. Because many cases of lung cancer are brought on by years of smoking cigarettes, Schiller, one of the study’s authors, said many of the patients felt a sense of shame as if the disease were self-inflicted.

“That is not something we see in treating other diseases. In treating cardiovascular patients, the first question out of a doctor’s mouth is not ‘how many Big Macs did you eat?’” she said.

Because of that shame, patients were not seeking treatment for their condition. Those anecdotal stories prompted Schiller and her colleagues to conduct the study, called The Lung Cancer Project to better understand the social psychology of lung cancer in order to change the way people think about the disease. Schiller said the study, which had more than 7,000 participants, compared societal attitudes to lung cancer in comparison to breast cancer, which had a social stigma several decades ago, but has managed to “break away” from that. The study confirmed that people have a significantly negative bias and associate blame and hopelessness with lung cancer when it was compared to breast cancer, Schiller said.

Lung cancer is the most commonly diagnosed cancer worldwide and is the leading cause of cancer deaths in the United States. More Americans die from lung cancer each year than breast, colon and prostate cancer combined. Approximately 85 percent of lung cancer patients have been smokers, Schiller said. However, research has shown many people with advanced lung cancer never receive cancer care, far more than any other type of cancer, so there is a need to understand factors that may have an effect on treatment decisions.

Schiller said there are a few reasons for lung cancer not being as high profile as breast cancer, including a lack of advocacy for the disease and a sense of nihilism. A lack of advocates boils down to the high mortality rate of lung cancer.

“It has an 85 percent mortality rate and there have been few people to advocate for it,” she said. But now that there are several effective treatments, such as Merck ’s Keytruda, AstraZeneca ’s newly-approved Tagrisso and Bristol Myers Squibb ’s Opdivo. In December, the U.S. Food and Drug Administration approved Genentech’s Alecensa for the treatment of people with anaplastic lymphoma kinase (ALK)-positive, metastatic non-small cell lung cancer.

“With all the new drugs that have come out, we are making significant steps and we’re seeing people live a lot longer,” Schiller said.

Schiller said now that the study has shown a bias against lung cancer, the next steps are to encourage survivors to advocate for lung cancer research.

“We have to be able to show that this made a difference,” Schiller said.

Schiller said other fatalistic diseases such as AIDS had stigmas associated with them, but better treatments helped reverse the attitude toward those with the disease.

“Better treatments for lung cancer will help raise its profile, and we’re now seeing its profile raised in the media,” Schiller said.