SHIFT: Why do we shame people with cancer?

There are lots of reasons people develop cancer, but none of them make us blame-worthy.

Lisa Machado 7 minute read August 9, 2021
Patient sitting in hospital ward

Sometimes well-meaning friends and family can make a cancer diagnosis seem like it's entirely your own fault. Getty

“Geez, I guess you were a little late on throwing out all the plastic.”

My friend was standing in the front doorway of my house, her arms loaded with glass containers full of cooked dinners, a bag of oranges and a bottle of wheatgrass juice.

Word had started to get out that I had a rare blood cancer. She had come to offer meals, advice and unhelpful commentary — like reminding me of my pre-cancer purge of all plastic things that contained bisphenol A (BPA), a potential health hazard.

“And the lack of sleep,” she tried to shake her head as she used her chin to balance the wheatgrass. “I told you it was going to catch up with you.”

And so it began: well-meaning people blaming my diagnosis on getting too much sun, not eating enough carrots, my hairspray, my house’s proximity to a busy, fume-filled street, my father’s work at a nuclear power plant or my love of burnt red peppers. (There was also the one who tried to tie my cancer to “excessive” breastfeeding, but that’s a whole other story.)

Apparently, there were a thousand reasons why I developed a life-threatening disease, most of which hadn’t even crossed my mind. And all of them were my fault.

About a month later, I was at a patient support meeting and I met a young woman living with lung cancer. She was young, fit and fresh-faced.

“The worst is when people ask me how many packs a day I smoked,” she said quietly, sounding winded, her breath a little raspy. “I never smoked, but does it even matter? I am dying here.”

Apparently it does matter. Earlier this week, we learned that comedian Kathy Griffin has lung cancer, and in almost every interview there was mention of the fact that she has never smoked a day in her life — you know, just in case you were maybe thinking that she somehow brought the diagnosis on herself by lighting up once in awhile. And with that, we were suddenly judging, instead of focusing on what’s most important — supporting a fellow human who is facing a life-threatening disease.

While lung cancer tends to be easily stigmatized given its well-known connection to smoking, it’s not the only type of cancer that comes with emotional baggage — think skin cancer (“you weren’t careful with the sunscreen”) and HPV-related cancers (“you have had too much sex”). For the record, there are lots of reasons people develop cancer, and usually they are things we don’t have much control over, such as exposure to toxins like radon, asbestos and pollution, crappy genetics or simply bad luck.

The NFL saw its own version of the cancer blame game a couple of weeks ago after Ron Rivera — the coach of the Washington Football Team who is also immunodeficient after receiving treatment for skin cancer last year — complained that just over half of players have been vaccinated, despite the league’s mandate stating that a COVID-19 outbreak could lead to forfeits.

His comments unleashed criticism from former NFL safety T.J. Ward (grammar errors are his):

“Don’t blame the players for your life long health decisions,” Ward said in a since-deleted post on social media. “At some point you gotta pay for them vices. Cancer runs in my family like many American families. But also bad diets and cigarettes do as well. (Accept) responsibility. Don’t blame and be disappointed in your 23 year olds cus they have they own bodies and opinions about there health.”

So what is it that compels us to cancer-shame — to essentially kick someone when they are down — besides the fact that people can occasionally be jerks?

Sometimes it’s our own anxiety. If we can find a reason for something bad happening to someone we love, it makes us feel safer and gives us a sense of control. After all, acknowledging that a scary disease like cancer can just happen randomly means that it could happen to us too. And then there’s our weird and dark tendency to believe that when bad things happen to others, it must be payback for some awful deed.

“I think that in one part, there is a fundamental assumption in our society that the world is a just place, and that bad things don’t happen to good people,” Gerald Devins, a stigma researcher and senior scientist at the Ontario Cancer Institute in Toronto, told Slate. “And I think when bad things happen to good people, it’s threatening to everybody.”

But are we really so relentless in our pursuit of control — or some semblance of it — that we let our own insecurities cloud our sympathy and compassion?

Um, well, yes. In fact, experts call this the “just-world hypothesis.” Coined in the 1970s by University of Waterloo psychologist Melvin Lerner, it follows the assumption that “people get what they deserve.” Blame is how we rationalize the suffering of others. We even have lots of fun ways of referring to it, like, “you got what was coming to you,” “what goes around comes around,” and “chickens come home to roost.”

Of course, we all know that very bad things happen to very good people all the time. Yet, as a society, we remain fixated on placing blame.

And for the record, it’s not like people with cancer are lacking in the self-blame department. In fact, we do a pretty good job of feeling guilt and shame all on our own.

For some, this might look like experiencing deep wallowing regret for their lifestyle choices — whether real, or made up. Others fear that “it is the harvest of bad seeds sown,” writes Reverend Percy McCray Jr., the director of Faith-Based Programs at the Cancer Treatment Centers of America. “They have sinned and now God — or fate or karma or the universe — has given them exactly what they deserve.”

And then there are people like Mary (not her real name). She was a fifty-ish woman who I would see regularly in the cancer clinic waiting area. Undergoing treatment for breast cancer, she had lived for years with debilitating side effects from her medication like bowel incontinence, paralyzing fatigue, and lung complications that required fluid to be drained every few months. When her doctor offered her a newer drug with less side effects, she declined, saying that having cancer was “her lot in life.”

Of course, cancer isn’t the only disease that can create suffocating feelings of being less-than while evoking the painful dumping of unhelpful tips and observations from those around you. From liver disease (“you must drink too much”) and diabetes (“too much sugar”), to obesity (“too much junk food”) and mental health (“you are weak”), people are often made to feel embarrassed and guilty about the state of their health.

And as if having a life-threatening illness wasn’t difficult enough, the consequences of feeling guilty about it can be dire. According to the Canadian Cancer Society, people facing the stigma of lung cancer tend to delay treatment or choose not to have treatment for fear of being blamed; they find it harder to talk about their illness with their doctor; and they believe they get a lower quality of care. They also withdraw from family and friends, experience more depression and anxiety and have a lower quality of life. But these often devastating impacts are not unique to people with lung cancer: if you have an illness that is perceived as self-inflicted, or you are made to feel that it is so, you know exactly what the sting of stigma can do.

To be clear, you might have every risk factor for cancer and never develop it. You can also follow all the “rules” of a healthy lifestyle, get regular medical checkups, and even have great genes, and still find yourself facing down terminal illness. So what’s one to do? Well, take care of yourself the best you can.

And if you happen to know someone who is sick, give empathy a shot, along with a little compassion. Can’t muster it? Then at least keep your opinions to yourself.

This story originally appeared in the Healthing Weekend. Subscribe here.