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Hammond N, Chantry A, Cheeseman M, Peng A. Disrupted biographies and gendered identities: A qualitative study exploring sexuality and blood cancer. Eur J Oncol Nurs 2024; 70:102544. [PMID: 38513454 DOI: 10.1016/j.ejon.2024.102544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE This study examines how blood cancer impacts patients' sexuality and sense of gendered identity. METHODS An interpretive epistemological framework necessitated a qualitative study design. Participants (6 male and 6 female), recruited from a hospital Haematology department in a large Northern English City, took part in semi-structured in-depth interviews to gather rich data about their subjective experiences. RESULTS A key theme from the qualitative data was a sense of disruption in relation to several aspects of their gendered identities and sexual life. Participants explained disruption to their sexual function and sexual sense of self. They narrated concerns about future imagined relationships. The emotional burden of sexuality related concerns was strongly articulated. A gendered perspective enabled the similarities and differences between men and women to be explored. CONCLUSION This study, drawing on rich qualitative data, documents the sexuality concerns of blood cancer patients; for some such concerns arise many years post treatment. The findings highlight the need for gender appropriate care around sexuality which should continue to be accessible well after diagnosis and treatment phases have ceased.
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Andreasson J, Johansson T, Danemalm-Jägervall C. Men's Achilles' heel: prostate cancer and the reconstruction of masculinity. CULTURE, HEALTH & SEXUALITY 2023; 25:1675-1689. [PMID: 36794869 DOI: 10.1080/13691058.2023.2175911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to investigate how Swedish men diagnosed with prostate cancer understand the effects of their treatment in relation to sexual health and masculinity. Utilising a phenomenological and sociologically informed approach, the study involved interviews with 21 Swedish men who experienced problems following treatment. The results showed that participants' initial response post-treatment, involved the development of new bodily understandings and socially informed strategies to handle incontinence and sexual dysfunction. Due to impotence and the loss of ejaculatory ability following treatments such as surgery, participants re-articulated the meaning of intimacy, as well as their understanding of masculinity and themselves as ageing men. Unlike in previous research, such a re-articulation of masculinity and sexual health is understood as taking place within rather than in opposition to hegemonic masculinity.
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Affiliation(s)
| | - Thomas Johansson
- Department of Education, Communication and Learning, University of Gothenburg, Gothenburg, Sweden
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Kragh-Furbo M, Hutton D, Stewart H, Singleton V, Ashmore L. The ambivalence of radiotherapy: Re-framing effects and their temporalities in treatment for gynaecological cancer. Soc Sci Med 2023; 336:116183. [PMID: 37797541 DOI: 10.1016/j.socscimed.2023.116183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/12/2023] [Accepted: 08/14/2023] [Indexed: 10/07/2023]
Abstract
Within the biomedical paradigm, treatment effects are typically split into primary and secondary effects with temporality playing a key role in this separation. Yet, this kind of ordering of effects with some effects understood as happening on the 'side', secondary and temporary, does not fit with how they are experienced by many patients who undergo treatment for cancer. Drawing on empirical data from a research project that gathered narratives of women's experiences of radiotherapy for gynaecological cancer, we observe radiotherapeutic effects that are experienced as ambivalent and temporally diverse and as overlapping demands that the women endure and manage. We propose Derrida's concept of pharmakon as a relevant and useful analytic for understanding radiotherapy treatment, thus bringing into focus the ambivalent effects of radiotherapy - it is both therapeutic and toxic. Pharmakon, we argue, offers a way of disrupting the logics that govern current practices of therapeutic radiotherapy, and provides a way to re-negotiate the ordering and temporal understandings and practices of therapeutic efficacy, outcome and accountability of radiotherapy treatment - away from a temporal fragmentation of treatment effects and patients' bodily experiences to a focus on how best to support the whole patient in living with the ambivalent, temporally diverse and overlapping effects and demands of treatment.
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Affiliation(s)
- Mette Kragh-Furbo
- Lancaster Medical School, Lancaster University, Sir John Fisher Drive, Bailrigg, Lancaster, LA1 4YW, United Kingdom.
| | - Daniel Hutton
- The Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, Wirral, CH63 4JY, United Kingdom
| | - Hilary Stewart
- Lancaster Medical School, Lancaster University, Sir John Fisher Drive, Bailrigg, Lancaster, LA1 4YW, United Kingdom
| | - Vicky Singleton
- Department of Sociology, Bowland College, Lancaster University, Lancaster, LA1 4YT, United Kingdom
| | - Lisa Ashmore
- Lancaster Medical School, Lancaster University, Sir John Fisher Drive, Bailrigg, Lancaster, LA1 4YW, United Kingdom
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Salifu Y, Almack K, Caswell G. 'Out of the frying pan into the fire': a qualitative study of the impact on masculinity for men living with advanced prostate cancer. Palliat Care Soc Pract 2023; 17:26323524231176829. [PMID: 37266393 PMCID: PMC10230602 DOI: 10.1177/26323524231176829] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023] Open
Abstract
Background Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men's experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men's experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context. Objective To explore how advanced prostate cancer impacts on men's masculine identity from the perspective of patients and their caregivers. Methods A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the 'frying pan into the fire'. Conclusion This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men's masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.
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Affiliation(s)
| | - Kathryn Almack
- Professor of Family Lives and Care, Centre for
Future Societies Research Communities, Young People and Family Lives Centre
for Research in Public Health and Community Care, School of Health and
Social Work, University of Hertfordshire, Hatfield, UK
| | - Glenys Caswell
- Independent Social Researcher and Death Studies
Scholar, Nottigham, UK
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Cluley V, Burton JO, Quann N, Hull KL, Eborall H. Biographical dialectics: The ongoing and creative problem solving required to negotiate the biographical disruption of chronic illness. Soc Sci Med 2023; 325:115900. [PMID: 37084703 DOI: 10.1016/j.socscimed.2023.115900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 04/23/2023]
Abstract
Here we propose the term 'biographical dialectics' as a sister term to 'biographical disruption' to capture the ongoing problem solving that characterises the lives of many people living with life limiting chronic illnesses. The paper is based on the experiences of 35 adults with end-stage kidney disease (ESKD) in receipt of haemodialysis. Photovoice and semi-structured interviews showed that ESKD and the use of haemodialysis was widely agreed to be biographically disruptive. In talking about and showing disruption through photographs the participants' ongoing problem solving was universal across their diverse experiences. 'Biographical disruption' and Hegalian dialectical logic, are drawn on to make sense of these actions and to further understand the personal and disruptive experience of chronic illness. Based on this, 'biographical dialectics' captures the work that is required to account for and manage the enduring and biographical impact of chronic illness that follows the initial disruption of diagnosis and continues as life progresses.
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Affiliation(s)
- Victoria Cluley
- School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham, UK.
| | - James O Burton
- Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicester, UK; John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Niamh Quann
- Leicester Clinical Trials Unit, College of Life Sciences, University of Leicester, Leicester, UK; John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Katherine L Hull
- Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicester, UK; John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Helen Eborall
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
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Brown A, Yim J, Jones S, Tan A, Callander E, Watt K, De Abreu Lourenco R, Pain T. Men's perceptions and preferences regarding prostate cancer radiation therapy: A systematic scoping review. Clin Transl Radiat Oncol 2022; 38:28-42. [PMID: 36345391 PMCID: PMC9636414 DOI: 10.1016/j.ctro.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy. METHODS A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including "prostate cancer," "radiotherapy," "radiation therapy," "radiation oncology," "patient preferences," "patient perceptions" and "patient experience." The resultant studies were mapped and grouped according to the emergent themes and pathway stages. RESULTS A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review. CONCLUSION There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research.
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Affiliation(s)
- Amy Brown
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia,Corresponding author at: Townsville University Hospital, PO Box 670, Queensland 4815, Australia.
| | - Jackie Yim
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia,Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Scott Jones
- Radiation Oncology Princess Alexandra Hospital Raymond Terrace, Metro South Health Service, South Brisbane, Queensland, Australia
| | - Alex Tan
- James Cook University, Townsville, Queensland, Australia,Radiation Oncology, Genesis Cancer Care, Nambour, Queensland, Australia
| | | | - Kerrianne Watt
- James Cook University, Townsville, Queensland, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Tilley Pain
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia
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Schultze M, Breuning M, von der Heyde M, Kaiser M, Müller-Nordhorn J, Holmberg C. Presenting scientifically-derived illness experiences online - Evaluation of the use of the DIPEx Germany website. PATIENT EDUCATION AND COUNSELING 2022; 105:2328-2337. [PMID: 34823923 DOI: 10.1016/j.pec.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the real-time usage of krankheitserfahrungen.de, a website providing scientifically collected and analyzed experiences of persons with various chronic illnesses. METHODS Web analytics of website use of www.krankheitserfahrungen.de in 2016. Qualitative content analysis of the 150 most and least opened video/audio clip titles in 2018-19. RESULTS In 2016, krankheitserfahrungen.de had 19,703 unique visits, of which 3925 were returning visits. Between new and returning visits, the latter were characterized by more actions and more time spent on the website. Thematic pages were clicked more often during new visits and person pages were more frequented during returning visits. In 2018-19, video/audio clip titles related to topics around uncertainties and/or decision making were most often clicked, whereas the least clicked clips dealt with topics like illness management, problem-solving, giving advice to others and emotionally difficult topics such as suffering, death and burden for the family. CONCLUSION A website with balanced, scientifically collected and analyzed patient experiences attracts a sufficient number of users and is used for further explorations. PRACTICE IMPLICATIONS Using multiple formats, broad topics and diverse personal experiences being accessible through themes or persons is necessary when a scientifically based website on patients' experiences is designed.
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Affiliation(s)
- Martin Schultze
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Breuning
- University of Education Freiburg, Department of Public Health and Health Education, Germany
| | | | - Maleen Kaiser
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
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van der Kamp J, Betten AW, Krabbenborg L. In their own words: A narrative analysis of illness memoirs written by men with prostate cancer. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:236-252. [PMID: 34855224 PMCID: PMC9300072 DOI: 10.1111/1467-9566.13412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 06/03/2023]
Abstract
By drawing on a narrative analysis of 11 autobiographical illness memoirs, this article investigates the complexities of what it means to live with prostate cancer over a period of time. Acknowledging how cancer disrupts everyday life, we focus on the day-to-day experiences and struggles that take place inside and outside the hospital. By building on illustrative quotes from the memoirs, we discuss different facets of cancer as a lived experience. Our findings show that men reconstruct their identity in the memoirs in response to the disruptive nature of cancer by including various identities from previous times. They describe a relationship with their cancer that is fluid and fitful and often depends on place, time and circumstances. We also found that the 'not knowing' of prostate cancer creates uncertainty, which can take different forms, transcends time and is shaped through medical technologies, continual testing and disagreeing doctors. Prostate cancer is often seen as easily treatable, but our findings call for a different way of looking at its impact. We argue that memoirs, written by men themselves, make it palpable what it means to live with cancer. As such, illness memoirs offer a way to advance our sociological understanding of cancer-as-a-lived experience.
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Affiliation(s)
- Jill van der Kamp
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
| | - Afke Wieke Betten
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
| | - Lotte Krabbenborg
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
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Muermann MM, Wassersug RJ. Prostate Cancer From a Sex and Gender Perspective: A Review. Sex Med Rev 2021; 10:142-154. [PMID: 34108132 DOI: 10.1016/j.sxmr.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Factors influencing patient behavior regarding risk of prostate cancer (PCa) and outcomes of PCa treatments are poorly understood. Similarly, how PCa treatments affect patient sexual function and sense of their masculinity has not been fully investigated. A better understanding of the relationship between sex and gender for patients with PCa could significantly improve their care and quality of life. OBJECTIVES To review how concerns about sex and gender influence men's attitudes toward PCa screening, diagnosis, and treatment. To explore how PCa influences sexual function and self-perceived masculine identity. To examine contexts for PSA screening for transgender individuals. METHODS We reviewed biomedical and sociological literature exploring the impact of PCa on patient sexual function and self-perceived masculinity using OVID, PubMed, and other databases. We similarly reviewed how masculine gender norms influence patient willingness to engage with PCa screening, diagnoses, and treatment. RESULTS Gender norms and sexual function concerns influence patient engagement in all aspects of PCa care. This includes PSA screening, digital rectal examinations, active surveillance, and androgen deprivation therapy (ADT) amongst others. ADT is particularly challenging to sexual function, self-esteem, and masculine identity. Our research suggests that sex and gender are not separate concepts, but rather tightly intertwined, particularly when dealing with the realities experienced by patients with PCa. CONCLUSION Interventions to help patients deal with the challenges of PCa and its treatment are likely to be most effective if they concurrently address patients' sexual needs and understanding of gender norms. PSA screening should be considered for transgender individuals who are at greater risk of cancer and on long-term hormone therapy. More research is needed on how concerns over sex and gender influence PCa screening, diagnosis, and treatment. There is also a need for long term data on the oncological outcomes of prolonged exposure to hormone therapy for patients who are transgender. Muermann MM, Wassersug RJ. Prostate Cancer From a Sex and Gender Perspective: A Review. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Martin M Muermann
- School of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Wassersug
- Cellular & Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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