A lung cancer diagnosis often carries stigma and assumptions that place an added emotional burden on patients. In this powerful conversation, Dr. Narjust Florez of Dana-Farber Cancer Institute and Harvard Medical School explores how stigma shapes patient experiences, why many patients hesitate to share their diagnosis, and how society can shift toward compassion, understanding, and meaningful support.
Through personal and clinical insights, she offers guidance for patients, families, and communities on responding to lung cancer with empathy rather than blame.
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Transcript
Dr. Narjust Florez:
I think stigma is a very unique challenge for patients with lung cancer. I’m going to give you something as an example, as a reference. When somebody says, I was diagnosed with breast cancer, the first response of the person getting the information is like, I’m so sorry this happened to you.
When a patient with lung cancer discloses the diagnosis, the first question they get back is, did you smoke? So, do you see the blaming starts at the moment. And that’s why a lot of patients do not want to explain their cancer, or do not want to share their cancer. My own father has a cancer that is often associated with tobacco use. He is a non-tobacco user, that was induced by a virus. So, I have seen it firsthand how he retracts from sharing the diagnosis, because he’s exhausted of explaining that his cancer also happens to people that don’t use tobacco.
It’s exhausting. He’s like, I don’t have the energy, I just went through treatment and shut down. What happens? That brings an additional burden to patients. Because you feel like you also have to educate people about your cancer, that you have to eliminate that boundary. And this, I’m going to take the responsibility away from the patient, and I’m going to give the responsibility to the entire society. And this goes to medical assistants, nurses, the people at the grocery store. Nobody deserves to get cancer, no matter what cancer it is. Nobody deserves to get cancer. Yes, tobacco is a common cause of lung cancer, but tobacco is an addiction. It has been proven over and over that it’s harder to quit tobacco use than cocaine.
So, it is up to the society to remove the stigma. If somebody tells you they have lung cancer, your answer should be, I’m so sorry or, tell me more if you want to. Instead of, do you smoke? Because you are adding to that burden of that patient. And you’re supposed to support, you know, your friends or who you know who felt confident to share so deeply and personal as a cancer diagnosis. What changed my career was this, because I had a young woman that her first question to me was, please do not tell my family. And 3 years of treatment, 3 years of work, she still didn’t tell her family. And when she died, her obituary said it was breast cancer.
So, I picked this as a battle to eliminate the stigma of lung cancer because nobody should have an additional burden for a cancer that nobody deserves. And if you’re a patient, and somebody asks you, do you smoke? You can answer and say, that is not the best way for you to reply. Or, I do not feel comfortable with that comment. That’s a very unfair question.
I understand that you associate lung cancer with tobacco use. However, at this point, we need to talk about what I need, not what I may have done in the past.