La stigmatisation de la maladie physique: le cas du cancer.

The literature shows ample evidence of stigmatization of mental illness and infectious diseases. Although cancer does not fall under any of the above categories, it has been stigmatized because of the deleterious consequences of its course and treatment. In fact, in the 21st century, cancer remains a dreaded disease associated with social representations of death, impairment, disfigurement, suffering, and pain. The objectives of this paper are twofold: first, to review theoretical elements that can help understand the stigma associated with physical illness, by defining the concept of stigma, presenting the different theoretical models of stigmatization of physical illness, and describing the psychosocial functions of stigma for both the stigmatized and stigmatizing individuals. Second, to focus on the specificity of cancer-related stigma, with particular reference to the cultural aspects of coping strategies used by oncological patients to address illness and the related stigma, through practices based on popular medicine. As part of the conclusion, it is suggested that cancer-related stigma has undergone several changes during history, from being a fatal disease to being a chronic disease. However, its initially silent course, alarming epidemic behaviour (still uncontrollable despite scientific advances), and treatment characteristics favour negative social representations of cancer (as conviction, sentence of death, suffering, deterioration, pain, affliction, and guilt), which act as iatrogenic factors in the health-disease process, interfering especially in the decision making regarding effective treatments and leading patients to prefer alternative methods based on popular medicine, even if those methods imply risks for their health and quality of life. © 2012 Springer-Verlag France.