I’m not proud of it. However, when someone I know, personally or professionally, is diagnosed with cancer -- and, unlike me, practices a health behavior associated with increased risk for that cancer -- my sadness contains just a kernel of relief. I don’t smoke two packs of cigarettes a day, which means I should be safe from lung cancer. Right?
The cigarettes may have nothing to do with this particular lung cancer, and, in fact, the ACS estimates that 16,000 to 24,000 lung cancer deaths a year occur in people who have never smoked. But I prefer a more comfortable universe that makes sense, where certain behaviors connect consistently to particular consequences. If I simply avoid those behaviors, I stay in control and “cancer-proof” myself. Easy!
Not so easy, of course, for the smoker and even nonsmoker with the new diagnosis of lung cancer. The smoker may feel guilty and as if he/she has received just desserts. Both smokers and nonsmokers report severe distress from being blamed and stigmatized by friends, family, and even healthcare workers. This doesn’t improve the cancer experience a single iota.
There’s another aspect to this “blaming the victim,” one that surfaced for me after a breast cancer diagnosis. I was female, with some family history, but no other known risk factors. I was young, slender, practiced a generally healthy lifestyle, had my babies early and breast fed them. So, what caused my breast cancer? In a reasonable universe, there must be something I could have done to avoid this.
Lacking an obvious outside villain, I started looking for something within. The old Woody Allen line comes to mind: “I don’t get angry, I grow a tumor instead.” Did I need this cancer for some reason? Did it fill some kind of emptiness within? Was I too nice, or did I have another personality type or emotional failing that made me to blame for this cancer? Family and friends sometimes piled on, believing that they could help me by pointing out possible emotional shortcomings. My breast cancer support group sisters experienced similar internal and external pressures.
Cancer patient Treya Killam Weber began probing for psychological causes when her mother received a cancer diagnosis. After her own diagnosis, Treya gave a speech entitled "What Kind of Help Really Helps?":
When my mother was sick, I was motivated by fear and a desire for self-protection. When I got cancer myself, my theorizing was initially fueled by the "you create your own reality" philosophy, which generated guilt about my past and a feeling that others must think I had failed in some way by getting cancer. This philosophy also bred the magical hope that if I could find "the cause," I could correct it, root out the mistake, cleanse my past, change my future and, hopefully, thus cure myself. This philosophy also implied that the only proof of success at creating my own reality would be if I got well physically.
Counseling and self-awareness can certainly assist many people with and without cancer. Who knows -- it may make a survival difference for some or help prevent the disease in others.
But we truly do not know enough about the causes of most cancers to lay an additional emotional burden of responsibility on the patient (or on ourselves) after a cancer diagnosis. It wasn’t too long ago that people confidently attributed epilepsy to demonic possession and tuberculosis to an "artistic personality"!
So I’m making a concerted effort to avoid blaming anyone for "causing" a cancer. Will you join me?