Cancer Shame in Marginalized Communities
By Gina Michiko Craig
Have you heard of cancer shame? Cancer shame can impact a variety of people from different circumstances, but it occurs in some patient groups more than others. Here’s a look at cancer shame, how it can impact cancer detection and outcomes, and how patients and healthcare providers can help diminish cancer shame.
What Is Cancer Shame?
Unfortunately, cancer shame is a real phenomenon. Shame is both a complex and painful emotion. Feelings of shame can be more common in certain population groups, but these feelings can also occur with any individual who was raised with inflexible expectations that have a tremendous impact on how they perceive their self-worth. The feelings of some athletes can illustrate one example of shame. Some professional athletes have stated that they felt shame when they didn’t meet their personal expectations, and some athletes who experienced extreme bouts of shame have committed suicide when they couldn’t handle intense pressure. In many East Asian cultures, shame originates from deep-rooted traditions and beliefs about karma. Karma is believed to be accumulated by individuals and families through positive and negative causes made in lifetime after lifetime. And differing from guilt, shame is focused on the feelings of being unworthy of affection, fortune, or other valued ideals – whereas guilt focuses on past behaviors that bring on feelings of guilt or of being a bad person. Cancer shame is a specific type of shame that can impact a patient in all phases of cancer and their cancer journeys.
How Cancer Shame Impacts Cancer Detection and Outcomes
How can cancer shame actually impact patients? Shocking as it may be to some, cancer shame can impact everything from cancer screening, diagnosis, treatment, and beyond. Some people are so paralyzed with fear of receiving a cancer diagnosis that they refuse to get cancer screening at all to avoid the possibility that they could bring shame to both themselves and their family. A cancer that could be easily detected in early stages then goes undiagnosed and can result in death if detected in very late stages. Cancer statistics show the health disparities that result from this cancer shame as well. A 2017 report from the Centers for Disease Control and Prevention showed that cancer was the leading cause of death in Asian Americans and Pacific Islander Americans, and Asian Americans show the lowest rate of cancer screening among all ethnic and racial groups in the U.S.
Many patients from East Asian backgrounds have gone through cancer treatment and haven’t even shared their cancer stories with anyone outside of their immediate family – and sometimes not with anyone besides their spouse. Some cancer patients who shared their diagnosis with friends had the experience of being shunned by friends after sharing about their cancer. And still other patients may not share their diagnosis with others due to feelings of shame about body parts or behaviors that are linked to certain cancers like lung cancer, colorectal cancer, breast cancer, and gynecological cancer.
Ways to Diminish Cancer Shame
Now that more is understood about cancer shame, there are ways that patients and healthcare professionals can work together to help reduce cancer shame and its negative impacts. Chinese American breast cancer survivor Yvonne Liu serves as a prime example of how patients and survivors can help diminish cancer shame. After learning about hesitancy to get mammograms and other cancer stigma with her friends, Liu took an incredible 28 years to finally share the secret of her breast cancer. It took her that many years to gather her courage to share her story with her church community, and she was relieved to hear other women reveal their cancer secrets after she shared hers. To honor Liu and others who have spoken up to help their communities, some actions that can be taken to reduce cancer shame include:
More cancer patients from all ethnic and racial backgrounds can share their experiences of their cancer journeys.
Healthcare professionals can take the time to learn about their patients’ cultural and religious beliefs about cancer and cancer care.
Friends from similar backgrounds can encourage each other to get their screenings for cancer prevention.
Healthcare professionals can consider working in alternative and complementary medicine into patient care.
People who still feel too paralyzed with fear to get cancer screenings can talk to their doctor, friends, or someone else they trust about the roots of their fears to try to move past it.
Healthcare professionals can educate patients who have shared about their fears of shame that cancer is not their fault.
It is possible for beauty to bloom from the dark places of cancer shame. Marginalized communities can decide to take positive and proactive actions to improve the health and longevity of their friends and loved ones in their communities. These actions toward stamping out cancer shame will help ensure longer and healthier lives for all to spend with their loved ones – a hopeful goal for the future of cancer care.
Sources
Yvonne Liu. Why Cancer Stigma for Asian Americans Is So Dangerous. NBC website. Accessed December 2, 2022. https://www.nbcnews.com/think/opinion/why-cancer-stigma-asian-americans-so-dangerous-ncna1282160
Meredith Begley. Coping With Shame Related to Cancer. Memorial Sloan-Kettering Cancer Center website. Accessed December 2, 2022. https://www.mskcc.org/news/coping-shame-related
Marya Shegog, PhD, MPH, CHES. Having Cancer Is Not Something To Be Ashamed Of. Lazarex Cancer Foundation website. Accessed December 2, 2022. https://lazarex.org/having-cancer-is-not-something-to-be-ashamed-of/
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