Background: Radiotherapy is often the common treatment modality for patients with nasopharyngeal carcinoma (NPC). However, it is not without its side effects, such as appearance alterations and speech and swallowing difficulties. These visible side effects can contribute to emotional and social repercussions. In this study, we sought to understand various aspects of cancer-related shame, stigma and regret experienced by individuals living with NPC.
Methods: A cross-sectional study was conducted at a general hospital in Singapore involving patients (N= 89) diagnosed with NPC who had received radiotherapy (RT) between October 2023 to August 2024. Participants provided informed consent before they self-completed a set of self-reported questionnaires. We examined the descriptive information around the Shame and Stigma Scale (Kissane et al., 2011) and its subscales and their correlation to demographic factors.
Results: The majority were below 65 years (61%; M= 59, SD= 11), of Chinese descent (98%), male (74%), non-smokers (70%) and married (71%). A minority (20%) were unemployed. The highest subscale score was Regret (M= 21.30, SD= 21.93), followed by Social/speech concerns (M= 18.15, SD= 21.62), Shame with appearance (M= 12.50, SD= 14.67) and Sense of stigma (M= 6.81, SD= 12.28). Younger age was associated with Regret (r= 0.27, p= 0.01) and Sense of stigma (r= 0.26, p= 0.01), while being female was associated with Shame with appearance (r= 0.28, p= 0.02).
Discussion: The subscale scores from our study are lower than results from Kissane’s validation study conducted on patients with oral cancer, except for the subscale Social and speech concerns. There are several demographic risk factors that were identified to be related to feelings of stigma and shame. These findings point to the importance of early identification of those who may benefit from support, with attention to gender and age.