A qualitative study of healthcare-related experiences of non-smoking women with lung cancer

Support Care Cancer. 2020 Jan;28(1):123-130. doi: 10.1007/s00520-019-04759-4. Epub 2019 Apr 15.

Abstract

Purpose: Lung cancer in non-smoking women is a distinct entity, but few studies have examined these patients' healthcare-related experiences.

Methods: Women with lung cancer and with no smoking history underwent a face-to-face semi-structured, audio-recorded interview that was analyzed with a qualitative inductive approach.

Results: Twenty-three patients were interviewed, and three themes emerged. The first theme centered on a delay in cancer diagnosis. One patient described, "The whole initial diagnostic process just fills me with rage… I didn't actually get my Tarceva® until the last week in April." Second, the diagnosis of lung cancer seemed especially challenging in view of patients' non-smoking history and otherwise good health; these factors seem to have contributed to the diagnostic delay. One patient explained, "Well, I was just so adamant that I didn't like smoking… maybe if I had been a smoker, they [the healthcare providers] would've been more resourceful." Finally, the stigma of a smoking-induced malignancy was clearly articulated, "Yeah. Because it's a stigma, and I had read that, too -- people go, 'Well, it's your own damn fault because you were a smoker.'" CONCLUSIONS: Non-smoking women with lung cancer appear to endure a long trajectory from symptoms to cancer diagnosis to the initiation of cancer therapy. An awareness and acknowledgement of this long trajectory might help healthcare providers render more compassionate cancer care to these patients.

Keywords: Lung cancer; Smoking; Stigma; Women.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Delayed Diagnosis / statistics & numerical data
  • Empathy
  • Female
  • Health Personnel / psychology
  • Health Personnel / standards
  • Health Personnel / statistics & numerical data
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / psychology
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Non-Smokers* / psychology
  • Non-Smokers* / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data*
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Qualitative Research
  • Social Stigma
  • Surveys and Questionnaires
  • Time-to-Treatment / standards
  • Time-to-Treatment / statistics & numerical data