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Castaldelli-Maia JM, Blaas IK, Gimenes GK, Suartz CV, Okassova A, Ventriglio A, Torales J. Masculinity stigma and metastatic prostate cancer: A review with a focus on Latin America. Urol Oncol 2024; 42:321-330. [PMID: 38866641 DOI: 10.1016/j.urolonc.2024.05.001] [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: 01/25/2024] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND This review examines the impact of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer, particularly in Latin America. It aims to provide insights into the influence of masculinity stigma on patient outcomes and inform strategies to address this issue. METHODS A comprehensive search was conducted in electronic databases (PubMed, PsycINFO, CINAHL and LILACS) using relevant keywords and controlled vocabulary related to metastatic prostate cancer, masculinity, stigma, diagnosis, and treatment up to April 2023. The search strategy was developed in consultation with a medical librarian to ensure its comprehensiveness. Thirty-three studies that investigate the role of masculinity stigma in the diagnosis and treatment of metastatic prostate cancer were included. RESULTS Our findings highlight the unique sociocultural influences in Latin America that shape prostate cancer stigma. It emphasizes the impact of cultural beliefs, gender norms, and social expectations on stigma. Notions of masculinity, such as strength and invulnerability, contribute to the stigmatization of prostate cancer. Machismo culture and religious/spiritual beliefs further compound the challenges and hinder open communication about the disease. Cultural taboos, limited awareness, and misconceptions perpetuate the stigma. CONCLUSIONS These sociocultural factors shape the experiences and challenges faced by individuals with and at risk of prostate cancer in Latin America.
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Affiliation(s)
| | - Israel Kanaan Blaas
- Clinics Hospital, Medical School, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gislaine Koch Gimenes
- Clinics Hospital, Medical School, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Caio Vinicius Suartz
- Division of Urology, Institute of Cancer of São Paulo - University of São Paulo, São Paulo, SP, Brazil
| | - Ainur Okassova
- Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | - Julio Torales
- School of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay
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Wu S, Li K, Zhang Y, Wang L, Zhu B, Wang W. Men's symptom experience throughout androgen deprivation therapy for prostate cancer: A systematic review and meta-aggregation. Int J Nurs Stud 2024; 157:104796. [PMID: 38824718 DOI: 10.1016/j.ijnurstu.2024.104796] [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: 12/26/2023] [Revised: 03/20/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Androgen deprivation therapy is a common treatment for men with advanced prostate cancer. They have experienced many complex symptoms that affect their quality of life. However, qualitative reviews that synthesize the symptom experience for men with prostate cancer are lacking. OBJECTIVE To explore the men's symptom experience throughout androgen deprivation therapy for prostate cancer. DESIGN A qualitative evidence synthesis using meta-aggregation. DATA RESOURCES Published and unpublished literature between January 2001 and August 2023 were identified from PubMed, Embase (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, ProQuest, Google Scholar, China National Knowledge Infrastructure (CNKI), Wang Fang, and VIP. REVIEW METHODS Two reviewers independently conducted screening, study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institutes Critical Appraisal Checklist for Qualitative Research. Data synthesis was conducted using meta-aggregative approach. RESULTS 24 articles of moderate to high methodological quality were included. A total of 98 findings were extracted with 59 unequivocal or equivocal findings eligible for meta-aggregation, aggregated into nine categories, and developed four synthesized findings: (1) production of symptoms: unrecognized and underestimated, (2) perception of symptoms: varied and complicated, (3) meaning of symptoms: threatened and affected, and (4) response to symptoms: push and pull. CONCLUSIONS Men throughout androgen deprivation for prostate cancer experience the four crisis-packed stages in their symptomatic journey. Health care provider need to understand the men's thoughts whether in the process of shared decision-making or in the course of the chosen therapy. Future research should develop individual suitable interventions and offer practical strategies for managing symptom. PROSPERO registration: CRD42023449129.
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Affiliation(s)
- Siyuan Wu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kun Li
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Zhang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Ogunsanya ME, Kaninjing E, Ellis TN, Morton DJ, McIntosh AG, Zhao J, Dickey SL, Kendzor DE, Dwyer K, Young ME, Odedina FT. Health-related quality of life in ethnically diverse Black prostate cancer survivors: a convergent parallel mixed-methods approach. Qual Life Res 2024:10.1007/s11136-024-03718-9. [PMID: 39008143 DOI: 10.1007/s11136-024-03718-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE This study examined the health-related quality of life (HRQoL) among ethnically diverse Black men (BM) with prostate cancer (CaP) in the United States. METHODS A convergent parallel mixed-methods design, employing both qualitative and quantitative research, involved recruiting Black CaP survivors through multiple channels. The target population was native-born BM (NBBM), African-born BM (ABBM), and Caribbean-born BM (CBBM). QoL for all men was assessed using The Functional Assessment Cancer Therapy-Prostate (FACT-P) measure, which includes five domains: physical- (PWB), emotional- (EWB), social-(SWB), and functional-wellbeing (FWB), and a CaP subscale (PCS). A subset of men completed qualitative interviews. Demographic and clinical characteristics were also collected. RESULTS Black CaP survivors aged 49-85 participated in the study (n = 108), with a subset (n = 31) completing a qualitative interview. Participants were mainly NBBM (72.2%) and treated with radiotherapy (51.9%). The FACT-P scale total mean score (± SD) was 114 ± 24.1 (theoretical range 0-156), with lower scores reported on the SWB, FWB, and EWB domains. The mixed-methods findings approach included meta-inferences derived from integrating the corresponding quantitative and qualitative data, covering all the domains within the FACT-P. CONCLUSION Black CaP survivors experienced significant burdens that impacted their overall HRQoL. The analysis revealed impacts on physical, social, and emotional well-being, with variations among ethnic groups suggesting the need for culturally tailored interventions. EWB was also profoundly impacted by CaP treatment, with universal emotional burdens emphasized across all groups. Healthcare providers must recognize and address these multifaceted needs to promote better outcomes and HRQoL for Black CaP survivors.
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Affiliation(s)
- Motolani E Ogunsanya
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
- Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
- iCCaRE for Black Men Consortium, Jacksonville, FL, USA.
- Prostate Cancer Transatlantic Consortium (CaPTC), Jacksonville, FL, USA.
| | - Ernest Kaninjing
- School of Health and Human Performance, Georgia College & State University, Milledgeville, GA, USA
- iCCaRE for Black Men Consortium, Jacksonville, FL, USA
- Prostate Cancer Transatlantic Consortium (CaPTC), Jacksonville, FL, USA
| | - Tanara N Ellis
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Daniel J Morton
- Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
- Department of Pediatrics, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Andrew G McIntosh
- Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
- Department of Urology, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Jian Zhao
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Sabrina L Dickey
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Kathleen Dwyer
- Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Mary Ellen Young
- Community Health Collaborative and Minority Health & Health Equity Research Support Services, Mayo Foundation for Medical Education and Research, Jacksonville, FL, USA
- iCCaRE for Black Men Consortium, Jacksonville, FL, USA
| | - Folakemi T Odedina
- iCCaRE for Black Men Consortium, Jacksonville, FL, USA
- Prostate Cancer Transatlantic Consortium (CaPTC), Jacksonville, FL, USA
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, USA
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Hawley WR, Cancilla BA, Barnes JL, Morrow GD. Social Perceptions of Masculinity and Sexual Esteem Are Impacted by Viagra Use, Testosterone, and Sexual Performance. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2473-2488. [PMID: 38740630 DOI: 10.1007/s10508-024-02880-y] [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: 11/04/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
Sexual behaviors play a role in the social construction of masculinity. Moreover, this stereotype has been capitalized upon by pharmaceutical companies, as well as those that sell products not approved by the U.S. Food and Drug Administration, for purposes of marketing sexual medicines. Stereotypical notions of masculinity, however, also emphasize the importance of self-reliance, which may cause some to look unfavorably upon the use of sexual medicine. Consistent with this notion, a male target was viewed as more masculine when his female partner consistently reached orgasm, unless he had no history of erectile dysfunction (ED), but was taking Viagra anyway (Experiment 1; N = 522). In addition, when his partner consistently reached orgasm, ratings of his sexual esteem were also lower if he used Viagra than if he did not, but only if he had no history of ED. In Experiment 2 (N = 711), although there was no effect of a male target's use of testosterone, social perception of his masculinity and sexual esteem increased as his "natural" levels of testosterone increased. In addition, exploratory analysis revealed that if the male target had low (but not normal or high) "natural" levels of testosterone, ratings of his masculinity were higher if his female partner consistently had an orgasm, which suggests that female orgasm served to "rescue" masculinity. Because expectations about drugs drive their use, it is important to address preconceived notions about the use of sexual medicines for purposes of enhancing masculinity and sexual esteem, as the social perception of their use is much more complex.
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Affiliation(s)
- Wayne R Hawley
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA.
| | - Bryn A Cancilla
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
| | - Julia L Barnes
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
| | - Gregory D Morrow
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
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5
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Green R. Experiences and management of urinary incontinence following treatment for prostate cancer: Disrupted embodied practices and adapting to maintain masculinity. Health (London) 2024; 28:489-506. [PMID: 37391939 DOI: 10.1177/13634593231185266] [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] [Indexed: 07/02/2023]
Abstract
This article explores men's experiences of and management strategies for urinary incontinence (UI) following treatment for prostate cancer. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored their post-treatment experiences. Drawing on a conceptual toolkit connecting theories of masculinities, embodiment, and chronic illness, this paper identifies older men's experiences and strategies for managing UI and explores how these are shaped by their masculinities. This article identifies interdependence between managing stigma for UI and maintaining masculinity. Men's embodied practices for engaging in activities in public, crucial to masculine identity, were disrupted. In response, they adopted new reflexive body techniques to manage and resolve their UI, and thereby address the threat to their masculine identities, characterised in three strategies: monitoring, planning, and disciplining. The new embodied practices men described suggest three factors as important components for adopting new reflexive body techniques: routine, desire, and unruliness.
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Talvitie AM, Ojala H, Tammela T, Pietilä I. Prostate cancer-related sexual dysfunction - the significance of social relations in men's reconstructions of masculinity. CULTURE, HEALTH & SEXUALITY 2024; 26:763-777. [PMID: 37665659 DOI: 10.1080/13691058.2023.2250410] [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: 04/17/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
Narrating illness experiences in a culturally acceptable manner is essential for retaining quality of life after the disruptive event of being diagnosed for prostate cancer. Psychological pressures caused by treatment side-effects such as erectile dysfunction require reinterpretation of the meanings and impacts of these side-effects on masculinity. This helps maintain coherence in men's lives. We studied how men employ culturally available discursive strategies (compensation, redefinition, recontextualisation, and normalisation) in reconstructing masculinity and sexuality. Our data consists of 22 interviews of heterosexual Finnish prostate cancer patients who had undergone surgery. The aim was to analyse the ways in which various life situations and social relations shaped and limited the use of these strategies. Discourse analysis revealed that older age, a supportive spouse, children, supportive male friends, and good health - were key elements men used in reconstructing a coherent new self-image and conception of life following cancer treatment. Men with sexually active male friends, men without families, younger men and men with new intimate relationships struggled to develop a new version of their masculinity. Being able to effectively utilise certain aspects of one's life situation in re-constructing masculinity is important in maintaining quality of life despite troublesome treatment side-effects.
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Affiliation(s)
| | - Hanna Ojala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Teuvo Tammela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ilkka Pietilä
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
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7
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Dickstein DR, Edwards CR, Rowan CR, Avanessian B, Chubak BM, Wheldon CW, Simoes PK, Buckstein MH, Keefer LA, Safer JD, Sigel K, Goodman KA, Rosser BRS, Goldstone SE, Wong SY, Marshall DC. Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus. Nat Rev Gastroenterol Hepatol 2024; 21:377-405. [PMID: 38763974 DOI: 10.1038/s41575-024-00932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/21/2024]
Abstract
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine R Rowan
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Bella Avanessian
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health at Temple University, Philadelphia, PA, USA
| | - Priya K Simoes
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael H Buckstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie A Keefer
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Stephen E Goldstone
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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8
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Ogunsanya ME, Kaninjing E, Ellis TN, Bamidele OO, Morton DJ, McIntosh AG, Dickey SL, Kendzor DE, Dwyer K, Young ME, Odedina FT. Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach. J Cancer Surviv 2024:10.1007/s11764-024-01619-x. [PMID: 38805150 DOI: 10.1007/s11764-024-01619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. METHODS In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. RESULTS Participants were thirty-four men aged 49-84 years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. CONCLUSION The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. IMPLICATIONS FOR CANCER SURVIVORS Black CAP survivors experience significant burdens and challenges that impact their overall quality of life. Understanding the factors that impact the complex survivorship journey can inform design and implementation of interventions to address the multiple challenges and thus improve quality of life.
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Affiliation(s)
- Motolani E Ogunsanya
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
| | - Ernest Kaninjing
- School of Health and Human Performance, Georgia College & State University, Milledgeville, GA, USA
| | - Tanara N Ellis
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
| | - Olufikayo O Bamidele
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Daniel J Morton
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Andrew G McIntosh
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sabrina L Dickey
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kathleen Dwyer
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Mary Ellen Young
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
| | - Folakemi T Odedina
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
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9
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Ogunsanya M, Kaninjing E, Ellis T, Bamidele O, Morton D, McIntosh A, Dickey S, Kendzor D, Dwyer K, Young ME, Odedina F. Quality of Life Assessment Among Ethnically Diverse Black Prostate Cancer Survivors: A Constructivist Grounded Theory Approach. RESEARCH SQUARE 2024:rs.3.rs-3941497. [PMID: 38464107 PMCID: PMC10925397 DOI: 10.21203/rs.3.rs-3941497/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the US, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. Methods In-depth interviews were conducted with 34 participants: Native-born BM (NBBM) (n=17), African-born BM (ABBM) (n=11), and Caribbean-born BM (CBBM) (n=6) CaP survivors recruited through QR-code embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the US. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Results Participants were thirty-four men aged 49-84 years (mean±SD, 66±8). Most were married (77%), likely to be diagnosed at Stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. Conclusion The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices.
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10
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Gupta N, Zebib L, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Schofield E, Loeb S. Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer. Urology 2024; 184:19-25. [PMID: 38160766 DOI: 10.1016/j.urology.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners. METHODS We conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semistructured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners. RESULTS Overall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists. CONCLUSIONS To our knowledge, this is the largest study to date on female partners' unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.
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Affiliation(s)
- Natasha Gupta
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY.
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nataliya Byrne
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Tatiana Sanchez Nolasco
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Elizabeth Schofield
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
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11
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Murray C, Mitchell L, Tuke J, Mackay M. Revealing patient-reported experiences in healthcare from social media using thedesign-acquire-process-model-analyse-visualise framework. Digit Health 2024; 10:20552076241251715. [PMID: 38757085 PMCID: PMC11097732 DOI: 10.1177/20552076241251715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Understanding patient experience in healthcare is increasingly important and desired by medical professionals in a patient-centred care approach. Healthcare discourse on social media presents an opportunity to gain a unique perspective on patient-reported experiences, complementing traditional survey data. These social media reports often appear as first-hand accounts of patients' journeys through the healthcare system, whose details extend beyond the confines of structured surveys and at a far larger scale than focus groups. However, in contrast with the vast presence of patient-experience data on social media and the potential benefits the data offers, it attracts comparatively little research attention due to the technical proficiency required for text analysis. In this article, we introduce the design-acquire-process-model-analyse-visualise framework to provide an overview of techniques and an approach to capture patient-reported experiences from social media data. We apply this framework in a case study on prostate cancer data from /r/ProstateCancer, demonstrate the framework's value in capturing specific aspects of patient concern (such as sexual dysfunction), provide an overview of the discourse, and show narrative and emotional progression through these stories. We anticipate this framework to apply to a wide variety of areas in healthcare, including capturing and differentiating experiences across minority groups, geographic boundaries, and types of illnesses.
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Affiliation(s)
- Curtis Murray
- School of Mathematical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Lewis Mitchell
- School of Mathematical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Jonathan Tuke
- School of Mathematical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Mark Mackay
- College of Public Heath, Medical and Veterinary Scienc, James Cook University, Townsville, QLD, Australia
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12
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Koops TU, Andresen JB, Graugaard C, Briken P, Bahnsen MK, Andersson M, Frisch M. Associations between recalled childhood gender nonconformity and adult sexual dysfunction in Denmark: baseline assessment in the Project SEXUS cohort study. J Sex Med 2023; 20:1451-1458. [PMID: 37812247 DOI: 10.1093/jsxmed/qdad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/16/2023] [Accepted: 09/01/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Sexual dysfunctions may negatively affect an individual's self-perceived womanhood or manhood, but whether gender nonconformity in childhood or adolescence can influence adult sexual functioning has not been examined so far. AIM To explore the possible link between recalled childhood gender nonconformity and sexual dysfunctions in adulthood in a large sample. METHODS We analyzed baseline questionnaire data from Project SEXUS, a nationally representative cohort study on sexual health among 15- to 89-year-old Danish citizens. Our sample included sexually active participants aged ≥18 years who were queried about gender nonconformity in childhood or adolescence (N = 21 390). To capture sexual dysfunctions, we assessed (1) difficulties with lubrication, orgasm, vaginal cramps precluding sexual intercourse, and/or genital pain during partnered sexual activity in women and (2) difficulties with erection, premature ejaculation, orgasm, and/or genital pain during partnered sexual activity in men. Furthermore, we assessed whether such difficulties were perceived as problematic. The 6-item Female Sexual Function Index and the 5-item International Index of Erectile Function served as standardized measures. Polytomous logistic regression analyses yielded demographically weighted adjusted odds ratios (aORs) with 95% CIs for associations between childhood gender nonconformity and sexual dysfunctions, controlling for age, sociodemographics, health-related factors, and other potential confounders. OUTCOMES Sexual difficulties and dysfunctions, as well as scores on the Female Sexual Function Index and International Index of Erectile Function. RESULTS Age-adjusted odds ratios indicated that sexual dysfunctions were significantly more common among childhood gender-nonconforming than conforming participants. After controlling for additional potential confounders, most sexual dysfunctions-notably, vaginal cramps in women (aOR, 2.12; 95% CI, 1.25-3.60) and genital pain dysfunction in men (aOR, 2.99; 95% CI, 1.79-4.99)-remained significantly increased among childhood gender-nonconforming respondents. CLINICAL IMPLICATIONS Findings suggest that self-perceived gender nonconformity in childhood or adolescence may negatively affect sexual functioning in adult life. If confirmed by future studies, they may warrant a clinical emphasis on such issues in sexologic treatment and care. STRENGTHS AND LIMITATIONS Our study is the first to report associations between childhood gender nonconformity and adult sexual dysfunction, building on data from a large-scale, nationally representative cohort study. The retrospective assessment of childhood gender nonconformity via one item might have neglected significant dimensions of this construct. CONCLUSION The present study is the first to show that individuals who recall being gender nonconforming in childhood or adolescence may be at a greater risk of experiencing sexual dysfunctions, particularly sexual pain disorders, as adults.
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Affiliation(s)
- Thula U Koops
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, D-20246 Hamburg, Germany
| | - Josefine Bernhard Andresen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, D-20246 Hamburg, Germany
| | - Mikkel Kjær Bahnsen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Mikael Andersson
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Morten Frisch
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
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13
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Walther A, Rice T, Eggenberger L. Precarious Manhood Beliefs Are Positively Associated with Erectile Dysfunction in Cisgender Men. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3123-3138. [PMID: 37351710 PMCID: PMC10684399 DOI: 10.1007/s10508-023-02640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/24/2023]
Abstract
The notions that manhood is hard to attain, easy to lose, and needs to be proven via public action constitute precarious manhood beliefs (PMB). PMB is a new concept and it remains unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection remains considered as a cornerstone of masculinity and sexual performance can be conceived as a proof of one's masculinity. In this context, ED can be received as sexual failure and a threat to a man's masculinity and sense of adequacy. For these reasons, the hypothesis that PMB are associated with ED warranted empirical testing. In an anonymous online survey focusing on men's mental health conducted in German-speaking countries of Europe, 507 cisgender men (Mage = 44.2, SDage = 15.2) completed measures on PMB, sexual function, self-stigma, social desirability, and conformity to traditional masculinity ideology (TMI). Multilinear regression analysis with stepwise introduction of relevant covariates evaluated potential associations between PMB and ED. Of a 507 cisgendered male sample, 63.1% reported an increased risk for ED based on previously established cutoff points. Elevated levels of PMB endorsement among the men predicted reduced sexual and erectile function in all models, even when accounting for relevant control variables such as age, education, self-stigma, social desirability, or conformity to TMI. Group comparisons revealed that the men suffering from ED showed higher levels of PMB endorsement but not self-stigma nor TMI relative to men without ED. PMB are significantly associated with ED. While determining causality will require further study, our results may support the hypothesis that higher levels of PMB endorsement may lead to increased tension to perform sexually, resulting in increased psychological pressure and a higher risk to develop ED.
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Affiliation(s)
- Andreas Walther
- Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland.
| | - Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lukas Eggenberger
- Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland
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14
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Hill TD, Garcia-Alexander G, Sileo K, Fahmy C, Testa A, Luttinen R, Schroeder R. Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence. Violence Against Women 2023:10778012231174348. [PMID: 37211748 DOI: 10.1177/10778012231174348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.
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Affiliation(s)
- Terrence D Hill
- Department of Sociology, One UTSA Circle, University of Texas at San Antonio, San Antonio, TX, USA
| | | | - Katelyn Sileo
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Chantal Fahmy
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, San Antonio, TX, USA
| | - Rebecca Luttinen
- Department of Demography, University of Texas at San Antonio, San Antonio, TX, USA
| | - Ryan Schroeder
- Department of Criminal Justice and Criminology, Georgia Southern University, Statesboro, GA, USA
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15
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Pan S, Wang L, Zheng L, Luo J, Mao J, Qiao W, Zhu B, Wang W. Effects of stigma, anxiety and depression, and uncertainty in illness on quality of life in patients with prostate cancer: a cross-sectional analysis. BMC Psychol 2023; 11:129. [PMID: 37098648 PMCID: PMC10131473 DOI: 10.1186/s40359-023-01159-6] [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: 10/01/2022] [Accepted: 04/04/2023] [Indexed: 04/27/2023] Open
Abstract
PURPOSE Although much work has been carried out on stigma, anxiety and depression, and quality of life(QoL) in cancer patients, far less work has been done to examine their associations. This study explores the effects of stigma, anxiety and depression, and uncertainty in illness on QoL in prostate cancer patients. METHODS A cross-sectional study surveyed levels of stigma, anxiety and depression, QoL, and uncertainty in illness in 263 people diagnosed with prostate cancer from the First Affiliated Hospital, Zhejiang University School of Medicine. The main study variables were analyzed by structural equation modeling. RESULTS Anxiety and depression were significantly negatively related to QoL, with a standardized regression coefficient (β=-0.312, S.E. =0.478, p < 0.05), which means that participants reporting higher levels of anxiety reported decreased levels of QoL. Stigma was positively related to anxiety and depression (β = 0.135, S.E. =0.203, p < 0.001) and uncertainty in illness (β = 0.126, S.E. =2.194, p < 0.05). Stigma has direct effects on QoL (β=-0.209, S.E. =1.655, p < 0.001), but in the presence of a third variable (anxiety and depression overall), direct effects are reduced, as indirect effects emerge through the variable anxiety and depression overall, with an indirect effect size of - 0.054. CONCLUSIONS Stigma impacts mental health, such as anxiety and depression, uncertainty in illness, and QoL. Health care professionals may help patients alleviate feelings of anxiety, depression, and uncertainty in illness to improve QoL outcomes.
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Affiliation(s)
- Shucheng Pan
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Zheng
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Luo
- Department of Urology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinjiao Mao
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenbo Qiao
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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16
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McInnis MK, Pukall CF. Sexual script flexibility after a prostate cancer diagnosis: Implications for sexual satisfaction. J Psychosoc Oncol 2022; 41:267-276. [PMID: 36017974 DOI: 10.1080/07347332.2022.2102958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE To investigate the relationship among sexual functioning, sexual script flexibility, and sexual satisfaction in individuals diagnosed with prostate cancer. DESIGN Cross-sectional online survey. PARTICIPANTS Sixty-one men diagnosed with localized prostate cancer. METHODS Online survey of sexual functioning, sexual script flexibility, and sexual satisfaction. Ordinal logistic regression investigated predictors of sexual satisfaction. FINDINGS Greater sexual script flexibility was associated with a greater likelihood of being sexually satisfied. CONCLUSIONS Helping patients explore different ways of being sexual after treatment could help with sexual satisfaction maintenance. IMPLICATIONS Patients' sexual satisfaction may benefit from discussions of issues related to sexuality and ways to work around treatment-related sexual dysfunction with healthcare providers.
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Affiliation(s)
- Meghan K McInnis
- Department of Psychology, Queen's University, Kingston, ON, Canada
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17
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Body talk and resilience: Aging men's experiences with mastectomy and prostatectomy. J Aging Stud 2022; 61:101010. [DOI: 10.1016/j.jaging.2022.101010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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18
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Mitchell E, Ziegler E. Sexual Dysfunction in Gay and Bisexual Prostate Cancer Survivors: A Concept Analysis. JOURNAL OF HOMOSEXUALITY 2022; 69:1119-1139. [PMID: 33818298 DOI: 10.1080/00918369.2021.1905384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual dysfunction is a common side effect of prostate cancer (PCa) treatment, yet it remains poorly defined in the literature. Current definitions are based on heteronormative assumptions which do not consider the unique experiences of gay and bisexual (GBM) PCa survivors. The purpose of this paper is to use Walker and Avant's method to conduct a concept analysis of sexual dysfunction among GBM in the context of PCa survivorship. The review included 46 articles published between 2002-2019. The following attributes were identified: (1) erectile dysfunction, (2) ejaculatory change (anhedonia/anejaculation), (3) urinary incontinence/climacturia, and (4) anodyspareunia. For GBM PCa survivors, sexual dysfunction involves reduced or abnormal functioning of four core elements of a sexual encounter, which inhibit GBM from engaging in and being satisfied with sexual activity.
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Affiliation(s)
- Evan Mitchell
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Erin Ziegler
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
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19
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Bowie J, Brunckhorst O, Stewart R, Dasgupta P, Ahmed K. Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis. J Cancer Surviv 2022; 16:95-110. [PMID: 33963973 PMCID: PMC8881246 DOI: 10.1007/s11764-021-01007-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. METHODS A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. RESULTS Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. CONCLUSIONS Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. IMPLICATIONS FOR CANCER SURVIVORS This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
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Affiliation(s)
- Jessica Bowie
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
- Department of Urology, King's College Hospital, London, UK.
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20
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Terrier JE, Ruffion A, Hamant C, Rousset V, Kalecinski J, Baudot A, Dumas A, Chauvin F, Bourmaud A. Patient Education for Radical Prostatectomy: Development of a Program Tailored to the Needs of Prostate Cancer Patients. Am J Mens Health 2021; 15:15579883211063317. [PMID: 34923862 PMCID: PMC8721889 DOI: 10.1177/15579883211063317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/24/2022] Open
Abstract
In all, 30% to 90% of prostate cancer patients undergoing radical prostatectomy (RP) recover their erectile capacity. No effective post RP erectile rehabilitation program exists to date. The aim of this exploratory qualitative study is to explore the needs of these patients and to develop a patient education program (PEP) which meets these needs. Interviews were carried out by a socio-anthropologist with prostate cancer patients treated by RP within the 6 previous months. The needs and expectations identified led to the choice of a logical model of change for the construction of the PEP. Nineteen patients were included in the study; 17 of them were living with a partner. Two categories of patients appeared during the interviews: informed patients resigned to lose their sexuality and patients misinformed about the consequences of the surgery. The tailored program was built on the Health Belief Model and provides six individual sessions, including one with the partner, to meet the needs identified. This study designed the first program to target comprehensively the overall sexuality of the patient and his partner, and not only erection issues. To demonstrate the effectiveness of this program, a controlled, multicentric clinical trial is currently ongoing.
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Affiliation(s)
- Jean-Etienne Terrier
- Department of Urology, Centre Hospitalier Lyon Sud, Lyon, France
- Health Services and Performance Research Unit, EA 74 25, Lyon 1 University, Lyon, France
| | - Alain Ruffion
- Department of Urology, Centre Hospitalier Lyon Sud, Lyon, France
| | - Chloé Hamant
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Vanessa Rousset
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Julie Kalecinski
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Amandine Baudot
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | | | - Franck Chauvin
- Health Services and Performance Research Unit, EA 74 25, Lyon 1 University, Lyon, France
- Hygée Center, University Hospital of Saint Etienne, Saint Etienne, France
| | - Aurelie Bourmaud
- INSERM U1123 ECEVE, Paris, France
- Robert Debré University Hospital, Paris, France
- Université de Paris, Paris, France
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21
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Stark BA, Obedin-Maliver J, Shindel AW. Sexual Wellness in Cisgender Lesbian, Gay, and Bisexual People. Urol Clin North Am 2021; 48:461-472. [PMID: 34602168 DOI: 10.1016/j.ucl.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cisgender sexual minority persons have sexual wellness needs that go well beyond disease prevention. Despite historical asymmetries in research and clinical attention to sexual wellness in cisgender lesbian, gay, and bisexual persons, a growing body of evidence exists on how to optimally care for these populations. Additional research and development is warranted.
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Affiliation(s)
- Brett A Stark
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, 10th Floor, Box 0132, San Francisco, CA 94158, USA
| | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Stanford University, 1701 Page Mill Road, Palo Alto, CA 94304, USA
| | - Alan W Shindel
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite A-610, San Francisco, CA 94143-0738, USA.
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22
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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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23
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East L, Jackson D, Manias E, Dunning T, Hutchinson M. Patient perspectives and experiences of sexual health conversations and cardiovascular disease: A qualitative study. J Clin Nurs 2021; 30:3194-3204. [PMID: 33931920 DOI: 10.1111/jocn.15820] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/28/2021] [Accepted: 04/06/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to explore the experiences of individuals discussing sexual well-being with healthcare professions within the context of their cardiac illness to determine their sexual health information needs. BACKGROUND Cardiovascular disease is the leading cause of morbidity and mortality worldwide and known to have a detrimental impact on sexual health. Despite sexual health being recognised as a fundamental component of well-being, it may be a neglected aspect of care within the context of cardiovascular disease. DESIGN A qualitative exploratory study conducted in accordance with COREQ guidelines. METHODS We conducted semi-structured interviews with participants (n = 13) aged between 30-77 years who had been diagnosed with a cardiovascular disease. Data were transcribed and subject to thematic analysis. RESULTS/FINDINGS Analysis revealed two major themes-Sexual healthcare information and expectations: I expect them to tell me and Experiences of sexual adversity: it's really scary. Although participants expected and welcomed information in relation to their illness and sexual health, this was rarely received. Subsequently, when some participants experienced sexual adversity including erectile dysfunction, they felt anxious and distressed which impacted their intimated relationships. It was often when participants sought information associated with adversity that information was provided and this was primarily in relation to medication associated with assisting dysfunction. CONCLUSION Individuals who have cardiovascular disease may require sexual health care. Nurses are well placed to provide information and education associated with cardiovascular disease and associated sexual well-being to promote positive outcomes for individuals and minimise distress around sexual adversity. RELEVANCE TO CLINICAL PRACTICE Findings highlight the importance of providing clear and accurate information about sexual well-being and function to patients experiencing cardiovascular disease. Provision of information should be considered an essential and routine aspect of care with patients being afforded opportunities to discuss concerns associated with their sexual well-being.
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Affiliation(s)
- Leah East
- Faculty of Medicine and Health, School of Health, University of New England/Hunter New England Health, Armidale, New South Wales, Australia
| | - Debra Jackson
- Susan Wakil School of Nursing, University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth Manias
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Trisha Dunning
- Centre for quality and Patient safety Research, School of Nursing and Midwifery, Deakin University Barwon Health Partnership, Geelong, Victoria, Australia
| | - Marie Hutchinson
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales, Australia
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Sutton E, Lane JA, Davis M, Walsh EI, Neal DE, Hamdy FC, Mason M, Staffurth J, Martin RM, Metcalfe C, Peters TJ, Donovan JL, Wade J. Men's experiences of radiotherapy treatment for localized prostate cancer and its long-term treatment side effects: a longitudinal qualitative study. Cancer Causes Control 2021; 32:261-269. [PMID: 33394204 PMCID: PMC7870600 DOI: 10.1007/s10552-020-01380-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/04/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate men's experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. METHODS A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. RESULTS Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. CONCLUSIONS These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.
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Affiliation(s)
- E. Sutton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - J. A. Lane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, Canynge Hall, 39 Whatley Road, Clifton, Bristol, BS8 2PS UK
| | - M. Davis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - E. I. Walsh
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - D. E. Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - F. C. Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - M. Mason
- Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - J. Staffurth
- Department of Oncology, Cardiff University, Cardiff, UK
| | - R. M. Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - C. Metcalfe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - T. J. Peters
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - J. L. Donovan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Trust, Bristol, UK
| | - J. Wade
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
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Watson E, Wilding S, Matheson L, Brett J, McCaughan E, Downing A, Wright P, Cross W, Selby P, Butcher H, Glaser A, Gavin A, Wagland R. Experiences of Support for Sexual Dysfunction in Men With Prostate Cancer: Findings From a U.K.-Wide Mixed Methods Study. J Sex Med 2021; 18:515-525. [PMID: 33642238 DOI: 10.1016/j.jsxm.2020.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Men with prostate cancer (PCa) often experience sexual dysfunction following diagnosis and treatment, yet little is known about the support they receive to deal with this. AIM To explore men's experiences of support for sexual dysfunction following PCa diagnosis. METHODS This study included a U.K.-wide survey of men 18-42 months post-diagnosis of PCa, identified through cancer registries. The survey measured sexual function and the extent to which men perceived sexual dysfunction to be a problem (Expanded Prostate Cancer Index Composite-26), access to and experience of medications, devices, and specialist services for sexual dysfunction, and included a free-text question for further comments. Analysis focussed on men who reported poor sexual function, which they considered a moderate or big problem. Descriptive statistics explored the characteristics of men offered intervention and those that found this helpful. Free-text responses were analyzed using thematic analysis. OUTCOME The main outcome of this study was to assess access to and experience of medications, devices, and specialist services for sexual dysfunction. RESULTS 39.0% of all survey respondents (13,978/35,823) reported poor sexual function, which they considered a moderate or big problem. 51.7% of these men were not offered any intervention to aid sexual functioning. 71.9% of those offered an intervention reported trying it, of whom 48.7% found the intervention helpful. Men treated with surgery or brachytherapy were most likely to be offered an intervention. Medication was the most commonly offered intervention and 39.3% of those who tried medication found this helpful. Although offered less often, approximately half of the men who tried devices or attended specialist services found the intervention helpful. Free-text responses indicated that barriers to accessing support included inadequate information and support from healthcare professionals, embarrassment, negative views about treatment options, concerns about side effects and safety, and inconsistencies between secondary and primary care. Barriers to continuing use included limited effectiveness of treatments, inadequate ongoing support, and funding constraints. Drivers of sexual recovery included patient proactivity and persistence with trying different treatment options and ongoing support from health professionals. CLINICAL IMPLICATIONS There is an urgent need to ensure that all men are offered, and have equal access to, sexual care support, with referral to specialist services when required. STRENGTHS & LIMITATIONS This study presents data from a large, U.K.-wide, population-based study of men with PCa and includes quantitative and qualitative findings. The possibility of non-response bias should, however, be considered. CONCLUSION There are significant shortcomings in the support offered to U.K. men with sexual dysfunction following diagnosis and treatment for PCa which need to be addressed. Watson E, Wilding S, Matheson L, et al. Experiences of Support for Sexual Dysfunction in Men With Prostate Cancer: Findings From a U.K.-Wide Mixed Methods Study. J Sex Med 2021;18:515-525.
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Affiliation(s)
- Eila Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK.
| | - Sarah Wilding
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK; School of Psychology, University of Leeds, Leeds, UK
| | - Lauren Matheson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Jo Brett
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Eilis McCaughan
- Institute of Nursing and Health Research, Ulster University, Coleraine, N.Ireland, UK
| | - Amy Downing
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | | | - Peter Selby
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Hugh Butcher
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Adam Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University, Belfast, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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26
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Prostate cancer and sexual consequences among men who have sex with men. Int J Impot Res 2021; 33:473-479. [PMID: 33408346 DOI: 10.1038/s41443-020-00392-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/16/2020] [Accepted: 12/01/2020] [Indexed: 01/28/2023]
Abstract
Prostate cancer and its treatment frequently lead to sexual side effects that negatively impact personal identity, sexual function, and intimate relationships. The sexual consequences of prostate cancer treatment on men who have sex with men (MSM) differ in some ways from what is observed in heterosexual men. This review summarizes literature from the past two decades exploring how MSM are affected by, and adapt to, prostate cancer treatment. The evidence on whether prostate cancer has a lower prevalence in MSM is unclear but lower screening rates are well-documented within this population. Prostate cancer treatment affects urinary, bowel, and sexual function in both MSM and heterosexual men. These changes may have different sexual and psychological ramifications in MSM when compared to heterosexual men. A common concern among MSM treated for prostate cancer is absence of support, both from the medical profession and in some cases from their own communities. Many MSM with prostate cancer have developed coping strategies and altered sexual practices to accommodate side effects. Lessons learned from this population may have relevance to sexual wellness in non-MSM prostate cancer survivors. Concise recommendations for caring for MSM with prostate cancer are provided.
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McInnis MK, Pukall CF. Sex After Prostate Cancer in Gay and Bisexual Men: A Review of the Literature. Sex Med Rev 2020; 8:466-472. [DOI: 10.1016/j.sxmr.2020.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
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Amarasekera C, Wong V, Jackson K, Yura E, Patel M, Manjunath A, Kundu S. A Pilot Study Assessing Aspects of Sexual Function Predicted to Be Important After Treatment for Prostate Cancer in Gay Men: An Underserved Domain Highlighted. LGBT Health 2020; 7:271-276. [PMID: 32584648 DOI: 10.1089/lgbt.2018.0245] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Existing questionnaires assessing sexual function after prostate cancer (PCa) were developed in predominantly heterosexual male cohorts and may measure function incompletely in gay men. We sought to determine if there are sexual function domains relevant to gay men that are not captured by the Expanded Prostate Cancer Index Composite (EPIC) sexual function assessment. Methods: Fifty-three gay men with PCa responded to an online survey regarding the applicability of the sexual function domain in the validated EPIC questionnaire. They were then queried about whether the prostate is a source of sexual pleasure and the importance of measuring sexual satisfaction as it relates to receptive anal intercourse. Results: A majority of gay men with PCa found the EPIC sexual function tool to be applicable when measuring erectile function (76.5%). Of the men queried, 64.2% felt that the prostate is a source of sexual pleasure and 52.8% felt it important to measure sexual satisfaction associated with receptive anal intercourse. A larger proportion of gay men who engaged in receptive anal intercourse, compared with those who did not engage in receptive anal intercourse, felt that the prostate is a source of sexual pleasure (100% vs. 57.1%), and thought it important to measure sexual satisfaction as it relates to receptive anal intercourse after PCa treatment (90.0% vs. 45.2%). Conclusions: Our findings highlight the need to create a validated questionnaire to measure sexual satisfaction from receptive anal intercourse to help care for men engaging in receptive anal intercourse after PCa treatment.
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Affiliation(s)
- Channa Amarasekera
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Vincent Wong
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Kathryn Jackson
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Emily Yura
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Mehul Patel
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Adarsh Manjunath
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Shilajit Kundu
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Abstract
Prostate cancer is the second most common cause of cancer-related death in men in the USA, but the effect of prostate cancer diagnosis and treatment on men in a sexual minority group, including men who have sex with men and transgender women, is poorly understood. Efforts to study this population are complicated, as cancer registries do not routinely collect information on sexual orientation. As a result, epidemiological data regarding this population have come from small studies that have included disparate rates of prostate cancer screening, diagnosis and treatment. Qualitative studies indicate that prostate cancer is experienced differently by sexual minorities, with distinct health-care needs that arise owing to differences in sexual practices, social support systems and relationships with the medical community. Notably, sexual minorities have been reported to experience poorer health-related quality of life outcomes than heterosexual men, and tend to have less robust social support systems, experience increased psychological distress caused by sexual dysfunction (areas of which are unmeasured after treatment), experience isolation within the health-care system and express increased levels of dissatisfaction with treatment. The incidence of prostate cancer actually seems to be decreased in men from sexual minorities living with HIV, despite there being no differences in screening and treatment, with poor cancer-specific mortality. Although the literature on patients with prostate cancer in men from sexual minority groups has historically been sparse, peer-reviewed research in this area has grown considerably during the past decade and has become an important field of study.
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Rosser BRS, Hunt SL, Capistrant BD, Kohli N, Konety BR, Mitteldorf D, Ross MW, Talley KM, West W. Understanding Prostate Cancer in Gay, Bisexual, and Other Men Who Have Sex with Men and Transgender Women: A Review of the Literature. CURRENT SEXUAL HEALTH REPORTS 2019; 11:430-441. [PMID: 31929765 PMCID: PMC6953377 DOI: 10.1007/s11930-019-00234-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW a)Prostate cancer in sexual and gender minorities is an emerging medical and public health concern. The purpose of this review is to summarize the state of the science on prostate cancer in gay, bisexual, and other men who have sex with men (GBM) and transgender women (TGW). We undertook a literature review of all publications on this topic through February 2017. With 88 unique papers (83) on prostate cancer in GBM and 5 case reports of prostate cancer in TGW), a small but robust literature has emerged. RECENT FINDINGS b)The first half of this review critiques the literature to date, identifying gaps in approaches to study. The second half summarizes the key findings in eleven areas. In light of this admittedly limited literature, GBM appear to be screened for prostate cancer less than other men, but they are diagnosed with prostate cancer at about the same rate. SUMMARY c)Compared to other men, GBM have poorer urinary, bowel, and overall quality-of-life outcomes but better sexual outcomes after treatment; all these findings need more research. Prostate cancer in TGW remains rare and under researched, as the literature is limited to single-case clinical reports.
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Affiliation(s)
- B. R. Simon Rosser
- Division of Epidemiology & Community Health, School of
Public Health, University of Minnesota
| | - Shanda L. Hunt
- Education and Research Services, University of
Minnesota
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of
Minnesota, Minneapolis, MN
| | | | | | - Michael W. Ross
- Department of Family Medicine & Community Health,
Medical School, University of Minnesota, Minneapolis, MN
| | | | - William West
- Department of Writing Studies, University of
Minnesota
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Maharaj N, Kazanjian A. Exploring patient narratives of intimacy and sexuality among men with prostate cancer. COUNSELLING PSYCHOLOGY QUARTERLY 2019. [DOI: 10.1080/09515070.2019.1695582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Nandini Maharaj
- School of Population, University of British Columbia, Vancouver, Canada
| | - Arminée Kazanjian
- School of Population, University of British Columbia, Vancouver, Canada
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Wagland R, Nayoan J, Matheson L, Rivas C, Brett J, Collaco N, Alexis O, Gavin A, Glaser AW, Watson E. Adjustment strategies amongst black African and black Caribbean men following treatment for prostate cancer: Findings from the Life After Prostate Cancer Diagnosis (LAPCD) study. Eur J Cancer Care (Engl) 2019; 29:e13183. [PMID: 31642565 DOI: 10.1111/ecc.13183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore adjustment strategies adopted by Black African (BA) and Black Caribbean (BC) men in the UK as a response to the impact of PCa diagnosis and treatment effects. METHODS Men were recruited through the UK-wide 'Life After Prostate Cancer Diagnosis' (LAPCD) survey. Telephone interviews were conducted with men (n = 14) with BA and BC backgrounds between 18 and 42 months post-diagnosis. Data were analysed using a Framework approach. RESULTS Most men (n = 12) were born outside the UK, were married (n = 9) and employed (n = 9). Median age was 66 years (range: 55-85). Six overarching themes emerged: a strong reliance upon faith beliefs; maintaining a 'positive' front; work as distraction; non-disclosure of diagnosis even amongst family members, influenced by stigma and masculinity concerns; active awareness-raising amongst a minority and support-seeking from close community. A few men emphasised a need to 'pitch' awareness-raising messages appropriately. Potential links existed between faith beliefs, presenting a positive front, community support-seeking and local awareness-raising. CONCLUSION The provision of patient-centred care requires cultural sensitivity. Interventions that challenge stigma and men's reluctance to disclose problems associated with PCa and treatment may encourage help-seeking for symptom support. Research is needed to determine how best awareness-raising messages should be conveyed to black men.
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Affiliation(s)
| | - Johana Nayoan
- Health Psychology Research Group, University College London, London, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Carol Rivas
- Social Science Research Unit, University College London, London, UK
| | - Jo Brett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Nicole Collaco
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Green R. Maintaining masculinity: Moral positioning when accounting for prostate cancer illness. Health (London) 2019; 25:399-416. [PMID: 31144532 DOI: 10.1177/1363459319851555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores men's experiences following treatment for prostate cancer through the lens of chronic illness. Recent empirical work suggests prostate cancer may be better understood as a chronic illness. Prostate cancer offers a case study to examine how older men's masculinities are disrupted by chronic illness experience. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored prostate cancer and post-treatment experiences. Men's experiences are examined by drawing on the works of Steve Robertson and Kathy Charmaz for understanding masculinities in relation to health and illness. Aspects of chronic illness experience are identified in men's accounts, particularly concerns with loss of moral status resulting from ongoing and potentially stigmatising treatment side effects. Four forms of moral positioning are identified that align with Steve Robertson's empirically derived model theorising the relationship between health and hegemonic masculinity. These findings facilitate discussion of the interaction between chronic illness experience, morality and masculinities, providing insight into how older men maintain their masculinity in the wake of illness.
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Langelier DM, D'Silva A, Shank J, Grant C, Bridel W, Culos‐Reed SN. Exercise interventions and their effect on masculinity, body image, and personal identity in prostate cancer—A systematic qualitative review. Psychooncology 2019; 28:1184-1196. [DOI: 10.1002/pon.5060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/10/2019] [Accepted: 03/12/2019] [Indexed: 12/28/2022]
Affiliation(s)
- David Michael Langelier
- Clinical Neurosciences, Division of Physical Medicine and RehabilitationUniversity of Calgary Calgary
- Faculty of KinesiologyUniversity of Calgary Calgary
| | | | - Jena Shank
- Faculty of KinesiologyUniversity of Calgary Calgary
| | - Christopher Grant
- Clinical Neurosciences, Division of Physical Medicine and RehabilitationUniversity of Calgary Calgary
| | | | - S. Nicole Culos‐Reed
- Faculty of KinesiologyUniversity of Calgary Calgary
- Department of Psychosocial ResourcesTom Baker Cancer Centre Calgary
- Department of Oncology, Cumming School of MedicineUniversity of Calgary Calgary
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Wood A, Barden S, Terk M, Cesaretti J. Prostate cancer: the influence of stigma on quality of life and relationship satisfaction for survivors and their partners. J Psychosoc Oncol 2018; 37:350-366. [PMID: 30580663 DOI: 10.1080/07347332.2018.1489442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Prostate cancer (PCa) stigma and its relationship to quality of life (QoL) is a relatively new finding. As the experiences of couples facing PCa are shared, the study examined the relationship between of PCa stigma, QoL, and relationship satisfaction of PCa survivors and their spouses. DESIGN A correlational design with dyadic data was used. SAMPLE Participants (N = 80 dyads) were PCa survivors and their spouses sampled from an oncology center and PCa support groups. METHODS Structural equation modeling was used to assess how stigma related to the QoL and relationship satisfaction of participants. FINDINGS Stigma had a negative association with QoL, but not relationship satisfaction. There were no significant demographic differences in regards to stigma. CONCLUSION Overall, stigma has a relationship with the experience of couples, but not with every aspect of their experience. Implications for psychosocial providers: Implications for clinicians in regards to addressing PCa stigma with clients and areas for future research are discussed.
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Affiliation(s)
- Andrew Wood
- a School of Human Services , University of Cincinnati , Cincinnati , Ohio , USA
| | - Sejal Barden
- b Department of Child, Family, and Community Sciences , University of Central Florida , Orlando , Florida , USA
| | - Mitchell Terk
- c Southpoint Cancer Center , Jacksonville , Florida , USA
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Bamidele OO, E McGarvey H, Lagan BM, Chinegwundoh F, Ali N, McCaughan E. "Hard to reach, but not out of reach": Barriers and facilitators to recruiting Black African and Black Caribbean men with prostate cancer and their partners into qualitative research. Eur J Cancer Care (Engl) 2018; 28:e12977. [PMID: 30548713 DOI: 10.1111/ecc.12977] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 10/26/2018] [Accepted: 10/31/2018] [Indexed: 12/28/2022]
Abstract
Access and recruitment barriers may have contributed to the underrepresentation of Black African/Caribbean men and their partners in current psychosocial research related to prostate cancer survivors. Whilst some studies have explored recruitment barriers and facilitators from participants' perspectives, little is known from researchers' point of view. This paper aimed to address this gap in the literature. Recruitment strategies included the following: cancer support groups, researchers' networks, media advertisement, religious organisations, National Health Service hospitals and snowball sampling. Thirty-six eligible participants (men = 25, partners = 11) were recruited into the study. Recruitment barriers comprised of gate-keeping and advertisement issues and the stigma associated with prostate cancer disclosure. Facilitators which aided recruitment included collaborating with National Health Service hospitals, snowball sampling, flexible data collection, building rapport with participants to gain their trust and researcher's attributes. Findings highlight that "hard to reach" Black African/Caribbean populations may be more accessible if researchers adopt flexible but strategic and culturally sensitive recruitment approaches. Such approaches should consider perceptions of stigma associated with prostate cancer within these communities and the influence gatekeepers can have in controlling access to potential participants. Increased engagement with healthcare professionals and gatekeepers could facilitate better access to Black African/Caribbean populations so that their voices can be heard and their specific needs addressed within the healthcare agenda.
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Affiliation(s)
| | | | - Briege M Lagan
- Institute of Nursing and Health Research, Ulster University, Jordanstown, UK
| | - Frank Chinegwundoh
- Barts Health NHS Trust, London, UK.,School of Health Sciences: City, University of London, London, UK
| | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Eilis McCaughan
- Institute of Nursing and Health Research, Ulster University, Coleraine, UK
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Matthew A, Lutzky-Cohen N, Jamnicky L, Currie K, Gentile A, Mina DS, Fleshner N, Finelli A, Hamilton R, Kulkarni G, Jewett M, Zlotta A, Trachtenberg J, Yang Z, Elterman D. The Prostate Cancer Rehabilitation Clinic: a biopsychosocial clinic for sexual dysfunction after radical prostatectomy. ACTA ACUST UNITED AC 2018; 25:393-402. [PMID: 30607114 DOI: 10.3747/co.25.4111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The most prevalent intervention for localized prostate cancer (pca) is radical prostatectomy (rp), which has a 10-year relative survival rate of more than 90%. The improved survival rate has led to a focus on reducing the burden of treatment-related morbidity and improving the patient and partner survivorship experience. Post-rp sexual dysfunction (sdf) has received significant attention, given its substantial effect on patient and partner health-related quality of life. Accordingly, there is a need for sdf treatment to be a fundamental component of pca survivorship programming. Methods Most research about the treatment of post-rp sdf involves biomedical interventions for erectile dysfunction (ed). Although findings support the effectiveness of pro-erectile agents and devices, most patients discontinue use of such aids within 1 year after their rp. Because side effects of pro-erectile treatment have proved to be inadequate in explaining the gap between efficacy and ongoing use, current research focuses on a biopsychosocial perspective of ed. Unfortunately, there is a dearth of literature describing the components of a biopsychosocial program designed for the post-rp population and their partners. Results In this paper, we detail the development of the Prostate Cancer Rehabilitation Clinic (pcrc), which emphasizes multidisciplinary intervention teams, active participation by the partner, and a broad-spectrum medical, psychological, and interpersonal approach. Conclusions The goal of the pcrc is to help patients and their partners achieve optimal sexual health and couple intimacy after rp, and to help design cost-effective and beneficial rehabilitation programs.
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Affiliation(s)
- A Matthew
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - N Lutzky-Cohen
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - L Jamnicky
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - K Currie
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Gentile
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - D Santa Mina
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - N Fleshner
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Finelli
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - R Hamilton
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - G Kulkarni
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - M Jewett
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Zlotta
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - J Trachtenberg
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - Z Yang
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - D Elterman
- Department of Surgical Oncology, University Health Network, Toronto, ON
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Haack M, Kofahl C, Kramer S, Seidel G, von dem Knesebeck O, Dierks ML. Participation in a prostate cancer support group and health literacy. Psychooncology 2018; 27:2473-2481. [PMID: 30092120 DOI: 10.1002/pon.4854] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/13/2018] [Accepted: 07/30/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND To cope with prostate cancer (PC) and its consequences and to be certain about therapeutic alternatives, some patients seek mutual help in prostate cancer support groups (PCSGs), where they share information and find social support. Our study was intended to assess whether group participation is associated with health literacy (HL). METHODS We compared PCSG members (n = 441) with PC patients without support group experiences (n = 135) in a cross-sectional design. For this purpose, HL was operationalized through PC-specific knowledge, noncancer-specific knowledge about health care, guideline awareness, and skills needed to apply health information to meet own needs. Binary logistic regression models were calculated. Socio-demographic data and disease-related characteristics were used as control variables. RESULTS Knowledge about PC (OR, 2.2; CI, 1.3-3.7), the fact of having heard of guidelines (OR, 3.7; CI, 2.1-6.8) and having read one (OR, 5.1; CI, 2.8-9.4), and competencies regarding health service navigation (OR, 1.8; CI, 1.0-3.1) are associated with PCSG membership. No statistically significant associations could be found between PCSG membership and further skills questioned, as well as between membership and knowledge about noncancer-specific health care. CONCLUSION PCSG membership is associated with HL in some areas only. In particular, the groups seem to provide an important platform for information exchange in the field of PC. The potentially conflicting results on PC knowledge and the application skills may arise from the different forms of measurement-knowledge was tested; skills were self-assessed.
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Affiliation(s)
- Marius Haack
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Kramer
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Gabriele Seidel
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
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Perez S, Lambert SD, Lee V, Loiselle CG, Chan P, Gupta A, Lo K, Rosberger Z, Zelkowitz P. A fertility needs assessment survey of male cancer patients. Psychooncology 2018; 27:2747-2753. [PMID: 30176700 DOI: 10.1002/pon.4874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe fertility-related informational needs and practices, and to examine if demographic characteristics are related to these needs and practices. METHODS A needs assessment survey was conducted at three Canadian cancer centres. RESULTS 192 male cancer patients (Mage = 33.6) completed the survey. Most patients (70%) recalled having had a discussion with a health care provider regarding their fertility and 44% banked their sperm. Patients reported not getting all the information that they wanted, eg, the risk that a future child may have the same type of cancer (78%), and what was covered by insurance plans (71%). Barriers to sperm preservation were urgency to begin cancer treatment (49%), not planning to have a child in the future (47%) and worries that cancer could be passed on to future children (38%). Participants' age and being the parent of a child were significantly associated with having had a discussion about fertility. Participants' age, province, being the parent of a child and the desire for future children were significantly associated with fertility preservation. CONCLUSIONS Discussions with health care providers were more frequent, and fertility preservation rates were higher than in past studies, but still not all patients' questions were answered. Misconceptions about passing on cancer to one's child, and that sperm preservation will delay treatment, should be dispelled. Health care providers can ask patients if they have any desire to have children in the future as a way to initiate a discussion of fertility preservation. Key information gaps and psychosocial resource needs are suggested to fully meet male cancer patients' fertility-related concerns.
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Affiliation(s)
- Samara Perez
- Department of Psychiatry Montreal, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research Montreal, Montreal, QC, Canada
| | - Sylvie D Lambert
- School of Nursing Montreal, McGill University Ingram School of Nursing Montreal, Montreal, QC, Canada.,St. Mary's Research Centre Montreal, Montreal, QC, Canada
| | - Virginia Lee
- McGill University Health Centre, Montreal, QC, Canada
| | - Carmen G Loiselle
- School of Nursing Montreal, McGill University Ingram School of Nursing Montreal, Montreal, QC, Canada.,Segal Cancer Center Montreal, Jewish General Hospital, Montreal, QC, Canada
| | - Peter Chan
- McGill University Health Centre, Montreal, QC, Canada
| | - Abha Gupta
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Kirk Lo
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Zeev Rosberger
- Department of Psychiatry Montreal, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research Montreal, Montreal, QC, Canada.,Segal Cancer Center Montreal, Jewish General Hospital, Montreal, QC, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry Montreal, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research Montreal, Montreal, QC, Canada.,Department of Psychiatry Montreal, Jewish General Hospital, Montreal, QC, Canada
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40
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Alexis O, Worsley AJ. A Meta-Synthesis of Qualitative Studies Exploring Men’s Sense of Masculinity Post–Prostate Cancer Treatment. Cancer Nurs 2018; 41:298-310. [DOI: 10.1097/ncc.0000000000000509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Dewitt J, Capistrant B, Kohli N, Rosser BRS, Mitteldorf D, Merengwa E, West W. Addressing Participant Validity in a Small Internet Health Survey (The Restore Study): Protocol and Recommendations for Survey Response Validation. JMIR Res Protoc 2018; 7:e96. [PMID: 29691203 PMCID: PMC5941092 DOI: 10.2196/resprot.7655] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 01/16/2018] [Accepted: 01/31/2018] [Indexed: 01/12/2023] Open
Abstract
Background While deduplication and cross-validation protocols have been recommended for large Web-based studies, protocols for survey response validation of smaller studies have not been published. Objective This paper reports the challenges of survey validation inherent in a small Web-based health survey research. Methods The subject population was North American, gay and bisexual, prostate cancer survivors, who represent an under-researched, hidden, difficult-to-recruit, minority-within-a-minority population. In 2015-2016, advertising on a large Web-based cancer survivor support network, using email and social media, yielded 478 completed surveys. Results Our manual deduplication and cross-validation protocol identified 289 survey submissions (289/478, 60.4%) as likely spam, most stemming from advertising on social media. The basic components of this deduplication and validation protocol are detailed. An unexpected challenge encountered was invalid survey responses evolving across the study period. This necessitated the static detection protocol be augmented with a dynamic one. Conclusions Five recommendations for validation of Web-based samples, especially with smaller difficult-to-recruit populations, are detailed.
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Affiliation(s)
- James Dewitt
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - B R Simon Rosser
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
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42
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Perceptions of masculinity and body image in men with prostate cancer: the role of exercise. Support Care Cancer 2018; 26:3379-3388. [DOI: 10.1007/s00520-018-4178-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/23/2018] [Indexed: 11/25/2022]
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43
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McConkey RW, Holborn C. Exploring the lived experience of gay men with prostate cancer: A phenomenological study. Eur J Oncol Nurs 2018; 33:62-69. [PMID: 29551179 DOI: 10.1016/j.ejon.2018.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/12/2018] [Accepted: 01/30/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE Gay men with prostate cancer are an 'invisible species' in the research literature despite concerns that the impact of treatment may be more profound and in some ways unique compared to heterosexual men. The aim of this research is to explore the lived experience of gay men with prostate cancer. METHOD In-depth interviews were recorded and transcribed verbatim from a purposive sample of eight gay men treated for prostate cancer in Ireland. A qualitative methodological approach employing Giorgi's descriptive phenomenological method was used to collect and analyse data. FINDINGS Three key aspects emerged representing the essence of the participants lived experience; The experience of diagnosis, treatment decision making, and the impact of treatment, with sub-themes of shock of diagnosis, the generalist nature of information, sexual side effects and incontinence, and masculinity and gay identity. Secondly, the experience of the healthcare service with sub-themes of sexual orientation disclosure and communication with the healthcare team; and thirdly, sources of support and means of coping which included significant others, family & friends, cancer support groups, and gay resources and support services. CONCLUSION Gay men with prostate cancer have unmet information and supportive care needs throughout their prostate cancer journey, especially related to the impact of sexual dysfunction and associated rehabilitation, negatively impacting their quality of life. Issues associated with heteronormativity, minority stress, and stigma may influence how gay men interact with the health service, or how they perceive the delivery of care. Healthcare education providers should update prostate cancer education programmes accordingly.
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Affiliation(s)
- Robert W McConkey
- Urology Outpatient Department, Galway University Hospital, Galway, Ireland.
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44
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Blais RK, Monteith LL, Kugler J. Sexual dysfunction is associated with suicidal ideation in female service members and veterans. J Affect Disord 2018; 226:52-57. [PMID: 28961442 DOI: 10.1016/j.jad.2017.08.079] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 08/15/2017] [Accepted: 08/27/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide is a leading cause of premature death among military service members/veterans (SM/Vs). The Interpersonal Theory of Suicide (Joiner, 2007) proposes that higher thwarted belonging, perceived burdensomeness, and acquired capability confer increased risk for suicide. However, no studies have examined the association of sexual dysfunction, a possible component of thwarted belonging and perceived burdensomeness, with suicidal ideation. The present study explored whether sexual dysfunction was associated with suicidal ideation when accounting for mental health, demographic, and military characteristics among female SM/Vs. METHOD Female SM/Vs (n = 710) completed an anonymous online survey assessing demographics, mental health, military characteristics, sexual dysfunction, and suicidal ideation. RESULTS One hundred fifty-nine participants (22.39%) reported suicidal ideation during the preceding two weeks. A multivariable ordinal regression adjusted for age, marital status, probable posttraumatic stress disorder (PTSD), probable depression, race/ethnicity, Army service, and deployment history. Lower sexual functioning (adjusted odds ratio [AOR] = 0.98, 95% confidence interval[CI] = 0.95-0.99), probable PTSD (AOR = 2.54, 95% CI = 1.61-4.01), and probable depression (AOR = 5.28, 95% CI = 3.34-8.34) were associated with suicidal ideation. Post-hoc analyses examined the association of suicidal ideation with specific components of sexual functioning: difficulties with sexual arousal (AOR = 0.87, 95% CI = 0.79-0.97) and sexual satisfaction (AOR = 0.85, 95% CI = 0.75-0.96) were associated with suicidal ideation. LIMITATIONS Data were cross-sectional and limited to self-report. DISCUSSION Sexual dysfunction is associated with suicidal ideation, accounting for established mental health, military, and demographic characteristics among female SM/Vs. Efforts to prevent suicidal ideation in female SM/Vs may be enhanced by screening for and treating sexual dysfunction, particularly sexual arousal and satisfaction.
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Affiliation(s)
- Rebecca K Blais
- Department of Psychology, Utah State University, United States.
| | - Lindsey L Monteith
- Denver Veterans Affairs Medical Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), United States; Department of Psychiatry, University of Colorado Anschutz Medical Campus, United States
| | - Jordan Kugler
- Department of Psychology, Utah State University, United States
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45
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Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2017; 6:279-294. [PMID: 29199096 DOI: 10.1016/j.sxmr.2017.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 09/12/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Supportive sexual health care is much-needed adjuvant care to oncologic management for men with prostate cancer (PCa). AIM To inspire the initiation of biopsychosocial sexual health programming where it does not exist and to inform program enhancement in existing sexual rehabilitation clinics (SRCs). METHODS This article reviews the combined 30-year experience of 2 well-established Canadian SRCs for men and their partners after PCa treatments, interwoven with empirical evidence. MAIN OUTCOME MEASURE To comprehensively review the biopsychosocial approach to sexual health assessment of men with PCa and their partners to direct the practicalities of running a successful and sustainable SRC. RESULTS A full description of the biomedical and psychosocial approaches, inclusive of comprehensive sexual function, the penile rehabilitation controversy, and other medical and relationship issues affecting sexual adjustment, is provided to highlight the relevance of proper assessment and follow-through for sexual adaptation and adjustment. 10 recommendations for a successful SRC are discussed, including the principles behind developing a sustainable business plan, staff acquisition and training, budget, integration of treatment and research priorities, respectful and multidisciplinary approaches to care, and suggestions of visit formats, protocols, and questionnaires. We recommend a phased approach of an SRC into usual care with the option to provide accessible and equitable care to patients not within proximal access of treating institutions. CONCLUSION Sexual rehabilitation after treatment for PCa requires a complex treatment process. Providing sustainable sexual rehabilitation programming under the financially strained environment of the Canadian medical system is a challenge; therefore, to provide Canadian patients and their partners with comprehensive cancer care, they deserve a biopsychosocial approach combined with a creative and systematic implementation strategy. Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2018;6:279-294.
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Affiliation(s)
- Stacy Elliott
- Prostate Cancer Supportive Care Program, Prostate Center, Vancouver Hospital, Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada; BC Center for Sexual Medicine, Vancouver Coastal Health Authority, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | - Andrew Matthew
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Department of Surgery (Division of Urology) and Psychiatry, University of Toronto, Toronto, ON, Canada
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46
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Ettridge KA, Bowden JA, Chambers SK, Smith DP, Murphy M, Evans SM, Roder D, Miller CL. "Prostate cancer is far more hidden…": Perceptions of stigma, social isolation and help-seeking among men with prostate cancer. Eur J Cancer Care (Engl) 2017; 27:e12790. [PMID: 29112317 DOI: 10.1111/ecc.12790] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to provide in-depth insight into men's experiences of prostate cancer, specifically: perceived stigma and self-blame, social isolation, unmet need and help-seeking. A qualitative descriptive approach was used. Semi-structured interviews were undertaken with 20 men diagnosed with prostate cancer, and thematic analysis was undertaken. Some participants perceived a stigma associated with prostate cancer and cancer in general, which sometimes acted as a barrier to disclosure. Self-blame and internalisation of cause was not a prominent issue. Participants' descriptions of emotional distress, social isolation and anxiety demonstrated the impact of prostate cancer. Social isolation was most commonly reported as a physical consequence of treatment and/or side effects. Participants felt both support and ongoing care were limited at post-treatment. Most did not seek or receive help for emotional or psychosocial problems from a formal source due to anticipated awkwardness, autonomous coping, not burdening others, unwanted sympathy and retaining privacy. Prostate cancer can cause considerable emotional and social burden for some men, and many are unlikely to seek or receive help. Men, and their support networks, require active encouragement throughout diagnosis, treatment and follow-up to overcome barriers and access additional support, particularly for sexual, emotional and psychosocial issues.
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Affiliation(s)
- K A Ettridge
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - J A Bowden
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Fortitude Valley, Qld, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of South Queensland, Toowoomba, Qld, Australia
| | - D P Smith
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council NSW, Woolloomooloo, NSW, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - M Murphy
- Michael Murphy Research, Melbourne, VIC, Australia
| | - S M Evans
- Monash University, Melbourne, VIC, Australia
| | - D Roder
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,Monash University, Melbourne, VIC, Australia.,School of Health Science, University of South Australia, Adelaide, SA, Australia.,School of Public Health, University of Adelaide and the South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - C L Miller
- School of Public Health, University of Adelaide and the South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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47
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Ussher JM, Perz J, Rose D, Dowsett GW, Chambers S, Williams S, Davis I, Latini D. Threat of Sexual Disqualification: The Consequences of Erectile Dysfunction and Other Sexual Changes for Gay and Bisexual Men With Prostate Cancer. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2043-2057. [PMID: 27102603 PMCID: PMC5547193 DOI: 10.1007/s10508-016-0728-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/21/2015] [Accepted: 02/25/2016] [Indexed: 05/31/2023]
Abstract
Gay and bisexual (GB) men with prostate cancer (PCa) have been described as an "invisible diversity" in PCa research due to their lack of visibility, and absence of identification of their needs. This study examined the meaning and consequences of erectile dysfunction (ED) and other sexual changes in 124 GB men with PCa and 21 male partners, through an on-line survey. A sub-sample of 46 men with PCa and seven partners also took part in a one-to-one interview. ED was reported by 72 % of survey respondents, associated with reports of emotional distress, negative impact on gay identities, and feelings of sexual disqualification. Other sexual concerns included loss of libido, climacturia, loss of sensitivity or pain during anal sex, non-ejaculatory orgasms, and reduced penis size. Many of these changes have particular significance in the context of gay sex and gay identities, and can result in feelings of exclusion from a sexual community central to GB men's lives. However, a number of men were reconciled to sexual changes, did not experience a challenge to identity, and engaged in sexual re-negotiation. The nature of GB relationships, wherein many men are single, engage in casual sex, or have concurrent partners, influenced experiences of distress, identity, and renegotiation. It is concluded that researchers and clinicians need to be aware of the meaning and consequences of sexual changes for GB men when designing studies to examine the impact of PCa on men's sexuality, advising GB men of the sexual consequences of PCa, and providing information and support to ameliorate sexual changes.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Duncan Rose
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Suzanne Chambers
- Menzies Health Institute, Griffith University, Nathan, QLD, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - Scott Williams
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - Ian Davis
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia
| | - David Latini
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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48
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Benoot C, Saelaert M, Hannes K, Bilsen J. The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2059-2083. [PMID: 28039595 DOI: 10.1007/s10508-016-0868-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 09/08/2016] [Accepted: 09/16/2016] [Indexed: 06/06/2023]
Abstract
When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.
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Affiliation(s)
- Charlotte Benoot
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Marlies Saelaert
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Karin Hannes
- Centre for Sociological Research, Catholic University of Leuven, Parkstraat 45, 3000, Louvain, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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49
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Rising CJ, Bol N, Burke-Garcia A, Rains S, Wright KB. Perceived Stress in Online Prostate Cancer Community Participants: Examining Relationships with Stigmatization, Social Support Network Preference, and Social Support Seeking. JOURNAL OF HEALTH COMMUNICATION 2017; 22:469-476. [PMID: 28414570 DOI: 10.1080/10810730.2017.1304471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.
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Affiliation(s)
- Camella J Rising
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Nadine Bol
- b Amsterdam School of Communication Research (ASCoR) , University of Amsterdam , Amsterdam , The Netherlands
| | - Amelia Burke-Garcia
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Stephen Rains
- c Department of Communication , College of Social and Behavioral Sciences, University of Arizona , Tucson , Arizona , USA
| | - Kevin B Wright
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
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50
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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