Gibbon Lecturer Will Confront Shame and Blame of Lung Cancer Stigma

The negative stigma sometimes associated with a lung cancer diagnosis can have unintended consequences, including disease-related distress and poor outcomes.

Jessica S. Donington, MD, MSCR, FACS, a cardiothoracic surgeon who treats the full spectrum of lung, esophageal, and mediastinal conditions, will discuss how myths and misperceptions affect a patient’s experience with lung cancer and offer strategies for enhanced public education during today’s John H. Gibbon Jr., Named Lecture, (9:45 am in Room 154 Upper Mezzanine South).

While lung cancer mortality has significantly decreased due to advances in screening and an enhanced systemic approach to treatment—including chemotherapy, immune checkpoint inhibitors, and oncogene-directed targeted therapies—these innovations are relatively recent developments.

“Lung cancer treatment went through a long period of stagnation from the 1970s to 2005. Without many research advances during that period, survival rates were only 15% in the US,” said Dr. Donington, a professor of surgery and chief of the Section of Thoracic Surgery at The University of Chicago in Illinois.  “We are now in an era where lung cancer is rapidly evolving and survival is improving year after year.”

A key facet of this evolution occurred in 2013, when the US Preventive Services Task Force recommended low-dose computed tomography screening for lung cancer in high-risk individuals. As a result, malignancies were diagnosed at earlier stages and survival rates improved, as demonstrated by randomized trials. By 2018, the proportion of cases diagnosed at stage I had increased to 36%, and median all-cause survival had increased to 28 months.

While important clinical advances continue to emerge, the shame associated with a lung cancer diagnosis endures, isolating patients who may struggle with seeking treatment.

“A central theme of my talk is the incredible negative impact of stigma on lung cancer mortality, as tobacco-related malignancy research funding and care are directly impacted by bias, shame, and nihilism,” explained Dr. Donington. “Lung cancer research is dramatically underfunded compared to many less common and far less deadly malignancies. This stigma also completely ignores lung cancer in never smokers, which represents 15% of lung cancer patients in the US.”

Another common misconception fueling this stigma in the patient population: lung cancer is an automatic death sentence.

“As the pool of survivors slowly grows, it truly changes how people see and view lung cancer. We now have effective screening technologies, efficacious treatments, and a highly personalized therapeutic approach. These simultaneous advances have had impressive impact on lung cancer mortality,” said Dr. Donington. “But in my opinion, the most important change is in the increasing number of lung cancer survivors, which is showing the world that lung cancer is not just about smoking—and that guilt, blame, and stigma only get in the way of improving cure rates for this incredibly common and deadly cancer.”

The John H. Gibbon Jr., Lecture, sponsored by the Advisory Council for Cardiothoracic Surgery, will be available for on-demand viewing shortly after the live presentation.