Coping with a Cancer Diagnosis and Your Treatment Options
The insidious problem with early to mid-stage cancer is that there may be no overt symptoms—and, therefore, the diagnosis may come as a complete shock. Alternatively, an individual may recognize the symptoms but feel too afraid to get biopsied. Medical treatment modalities often include surgery, radiation, and/or chemotherapy (all of which may have potentially serious side-effects). Consequently, patients are usually advised to carefully consider all the options in consultation with the people who are closest to them (as well as in tandem with their healthcare providers). In bringing a same-sex spouse, intimate partner, or friend to the medical appointment, a homophobic or ignorant attitude can scare an LGBT person from wanting to engage with that medical professional—even if that physician is the most capable and knowledgeable in terms of successful treatment outcomes.
As you are probably (and fully) aware, the post-diagnosis time period is a psychologically vulnerable one for most people diagnosed with cancer—and a time when obtaining emotional support from a partner, friends, and family members can relieve the stress (and, thereby, enable the diagnosed person to make clearer decisions regarding the options presented by medical staff). The ‘coming out’ process—as most of us know—is also typically stressful, so not something that anyone would want to do when coping with decisions related to cancer treatment.
For those LGBT people whose family members do not know that person’s sexual orientation, psychological stress can be exponentially increased if family become involved. Therefore, the simple suggestion from a healthcare provider to talk it over with family can be quite emotionally ‘charged’ advice that worsens—rather than improves—the level of depression, anxiety, and overall stress associated with cancer treatment decision-making. In turn, stress is associated with a host of health disorders (e.g., irritable bowel syndrome, high blood pressure, and lowered immunity).
Persons living with HIV/AIDS are at higher risk of developing certain cancers. According to the National Cancer Institute, HIV-positive men have a 25-fold higher risk of developing anal cancer, and HIV-positive women have a five-fold higher risk of cervical cancer. Meanwhile, HIV-positive people have a 70-fold higher risk of non-Hodgkin’s lymphoma (and 10-fold higher risk of Hodgkin’s lymphoma); 25-fold higher risk of liver cancer, and three-fold risk of lung cancer[i]. For HIV-positive LGBT persons coping with cancer, the combined burden of dealing with health professionals who are both homophobic and judgmental of HIV-infected people can present a monumental obstacle to pursuing the treatment regimen and follow-up care.
Remember that just because a researcher on LGBT health publishes an article including population-based risk factors, this does not mean that you—as an individual—are at higher risk for that specific cancer or treatment outcome! Your genes, environmental factors, and lifestyle choices (e.g., smoking) have much more to do with your personal “risk”. However, recent studies on LGBT health have shown that gays and lesbians avoid getting healthcare due to homophobia (and discomfort due to ignorance) on the part of health practitioners[ii],[iii]. Therefore, your very existence as a cancer survivor who interfaced with doctors proves that you are courageous!
[i] National Cancer Institute. HIV Infection and Cancer Risk. [online fact-sheet] Webpage: http://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hiv-fact-sheet
[ii] Dibble SL, and Roberts SA. (2003). Improving Cancer Screening Among Lesbians Over 50: Results of a Pilot Study. Oncology Nursing Forum 30(4). [online article] Webpage: http://www.ncbi.nlm.nih.gov/pubmed/12861329
[iii] Blosnich JR, et al. (2014). Health Inequalities Among Sexual Minority Adults: Evidence from Ten U.S. States, 2010. Am J Prev Med 46(4): 337-349. Webpage: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102129/