Lung cancer after the genomic turn: From the biopolitics of ‘lifestyle’ to the transcorporeality of breath

Abstract

The lungs serve as a site of interchange between the bodily and environmental, an interface between the internal and external world, enacted through breath. We draw on the primacy of this exchange to explore the complexities of living with lung cancer amidst the enduring social challenge of stigma and the advent of ‘targeted therapies’ at the cutting edge of precision medicine. Lung cancer’s association with smoking and resulting stigmatisation of those with lung cancer has been well documented – positioning those with lung cancer as failed subjects of a biopolitics of lifestyle. However, recent developments in ‘precision medicine’ have drawn attention to alternate, genetic causes of lung cancer, disrupting easy equivalences between deviant cells (malignancy) and deviant conduct (smoking). Despite this, and drawing on interviews with 32 people receiving targeted therapy for lung cancer in Australia, we identify enduring resonances of deviance and stigma which still foreground individual lifestyle and blame, even for those – like many participants in this study – who have never smoked. Even in the context of uncertain causal origins and genetic mutations, the stigma of lung cancer and the figure of ‘the smoker’ as an object of abjection and disavowal persists. We find Alaimo’s concept of transcorporeality instructive for moving away from this biopolitics of lifestyle, toward greater recognition of the collective, though unequal, conditions of ‘carcinogenic capitalism’ in which we all must live and breathe. In turn, our analysis of the specificities of lung cancer may inform broader sociological approaches to tackle stigma at a structural level.