Lung cancer and the eroded self: identity challenges and mental well-being - a narrative review

Lung cancer remains a leading cause of cancer-related mortality worldwide, but its psychological burden often receives less attention than its physical toll. Unlike other cancers, lung cancer carries a significant stigma, frequently linked to smoking and lifestyle choices. This stigma contributes to internalized guilt and shame, which can profoundly disrupt a patient's sense of self. The diagnosis often triggers an identity crisis, where individuals struggle to reconcile their pre-illness identity with their new reality, leading to heightened emotional distress, self-stigmatization, and social withdrawal. As the disease progresses, patients frequently experience role loss in their personal and professional lives due to physical limitations, altered appearance, and reduced functional capacity. These disruptions contribute to a fractured sense of identity and diminished self-worth. The unique psychosocial landscape of lung cancer often includes higher rates of anxiety, depression, and suicidal ideation compared to other cancer populations. Unfortunately, identity-based psychological suffering is rarely addressed in standard oncology care, leaving many patients without the support they need to navigate these challenges. Emerging interventions - such as narrative therapy, dignity therapy, and acceptance-based approaches - offer promising avenues to help patients reconstruct their identity, reclaim meaning, and improve psychological resilience. Addressing the erosion of self in lung cancer patients is critical for delivering holistic, patient-centered care. By confronting stigma, validating patients' experiences, and integrating mental health support into routine oncology practice, we can foster healing not only of the body but of the self.