Culturally shaped self-stigma among lung cancer survivors in Japan

This study aimed to clarify the experiential structure of social stigma among lung cancer survivors in Japan. We pay particular attention to culturally shaped identity and interpersonal experiences. The experience of being stigmatized refers to a situation in which the individual feels that they are being viewed as "lung cancer patients," and the feelings, thoughts, and actions that accompany this experience.

The participants were 17 lung cancer survivors. Semi-structured interviews were conducted to explore their experiences of cancer-related stigma. Data were analyzed using the Modified Grounded Theory Approach, to generate concepts and categories and to clarify the structure of stigma-related experiences among lung cancer survivors.

The storyline begins with "sensing an atmosphere in which life has eroded" in terms of the relationship with others. This led to the emergence of a "generation of a self-image tainted by cancer," identified as the core category influencing subsequent psychosocial responses that influenced the outcome. Participants experienced both heightened awareness of death and altered self-identity. Through this process, they developed coping strategies described as "living while making concessions," in which they gradually reinterpreted their self-image. Notably, strong self-stigma was observed even in the absence of explicit social discrimination.

Japanese lung cancer survivors experienced a culturally influenced process of internalized stigma centered on a cancer-tainted self-image. These findings highlight the importance of nursing assessment and psychosocial support that explicitly address culturally embedded self-stigma, identity disturbance, and coping processes in survivorship care.