Men Don’t Even Ask for Directions, Let Alone Help – With Our Colons! How Masculinity Plays Into Some of the Most Common Medical Issues for Men

Did you know March is National Colorectal Cancer Awareness Month! In honor of this, we at the Center for Men’s Excellence want to bring attention to a very common form of cancer that affects so many men! Prostate cancer is the most commonly diagnosed type of cancer in men and is the second leading cancer-related cause of death in men.

What is Prostate Cancer?

Cancer is a disease that starts in our cells. Normal cells will multiply and eventually die when damaged or worn out. In cancer, the cells do not do this. Instead, the cells will keep growing and forming new abnormal cells which produce a tumor. A tumor can be cancerous (malignant) or non-cancerous (benign).

Cancer can grow anywhere in the body, including the prostate. The prostate is a walnut-sized gland that makes fluid to cover semen, and together with the seminal vesicles, this mixture forms the ejaculate that passes through the urethra and out of the penis. Prostate cancer grows slowly for many men, but for others it can grow rapidly and spread quickly.

Who is at risk?

All men are at risk of prostate cancer! Research has shown men’s risk of prostate cancer increases with age, and most prostate cancer is found in men between the ages of 65-74. Research has also shown that African American men are more likely to develop the disease at a rate that is approximately 60% higher compared to Caucasian men. Genetic factors (i.e., family history or ancestry) have been found to contribute to an increased risk for prostate cancer.

Benefits of Early Detection

When found early, more than 98% of men are alive five years later. Finding prostate cancer early means a better chance of prolonging your life. There are two early detection tests used for screening for prostate cancer:

  1. Digital Rectal Exam (DRE)—a doctor or nurse inserts a gloved, lubricated finger into the rectum to feel for any bumps or any abnormalities on the prostate
  2. Prostate Specific Antigen (PSA)—is a test that examines the level of PSA in the blood. Higher levels of PSA are common in men with prostate cancer.

Treatment options

  • Surgery, also known as a prostatectomy, is the removal of the prostate.
  • Radiation Therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing
  • Chemotherapy uses anticancer drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing
  • Hormone therapy is also called androgen deprivation therapy (ADT). It is suspected that male sex hormones can cause prostate cancer to grow (cite). Therefore, ADT is a cancer treatment that removes hormones or blocks their action to stop cancer cells from growing.

Coping after prostate cancer treatment

There is a significant amount of research demonstrating a link between prostate cancer treatment and erectile dysfunction. Approximately 80% of men cope with erectile dysfunction as a side effect of prostate cancer treatment. Erectile dysfunction is an inability to achieve or maintain an erect penis which can get in the way of your overall satisfaction with sex. Erectile dysfunction is a very sensitive topic for many men to discuss, but remember, YOU ARE NOT ALONE! Thanks to Masters and Johnson (1970), many sexologists and therapists are trained in sex therapy around the world and are ready to help.

How does masculinity contribute to men’s experience of prostate cancer treatment?

There is a significant amount of research on how men are less likely to seek help, to go to the doctor or to even seek therapeutic services. Studies have shown that men are 3.5x more likely to commit suicide and are more likely (e.g., 80% higher) to die from cancer or heart disease (50% higher) compared to women. You, like many men, may hold beliefs that can lead to a lack of treatment when it comes to your physical or mental health. For example, many men may avoid check-ups even if they are in pain as they may believe or have thoughts such as, “oh it will go away,” or “we’ll let things get worse before we go to the doctors.” Other men may hold the belief that “you only go to the doctors if you are sick or you feel bad” therefore they may be less likely, in general, to believe in check-ups. We must take this into consideration along with the fact that prostate cancer is considered a silent process until it is very advanced. Therefore, for men with early prostate cancer, their prostate cancer usually causes no symptoms and without getting regular check-ups, a delayed diagnosis increases a man’s risk of their prostate cancer spreading. One additional point we need to discuss is the screening process itself! The digital rectal exam (DRE) may be viewed as a threat to one’s manhood which may be a reason to avoid screening due to the feelings of being violated and the thought “I’m not going to let the doctor do that to me.” Male shame and disinclination to seek help is a direct factor impacting health disparities for men. Therefore, it is important for you to consider how your beliefs, your identity or your sense of yourself plays a role in the treatment of your prostate cancer or erectile dysfunction.

Research suggests men’s identity or sense of themselves as being a man is crucial in men’s experience of erectile dysfunction and prostate cancer treatment in two ways: (1) it frames how men interpret what is happening to them, and (2) men’s sense of themselves and their sense of self suffers harm. Researchers found that men often report that their masculinity was lost (i.e., no longer a man) or diminished (i.e., not a whole man) regarding erectile dysfunction after prostate cancer treatment. Researchers also found men’s lost or diminished masculinity to be a source of anxiety, depression and/or embarrassment, which lead many men to feel disempowered, to question their self-worth, and/or to fear that they would be stigmatized.

It’s time to check in with yourself! Do you notice having any of these common beliefs? Are you having thoughts that you will not be, or are no longer a man, or not a whole man, as a result of your prostate cancer or prostate cancer treatment? Are you experiencing any feelings of anxiety, depression or embarrassment regarding your prostate cancer diagnosis, treatment or side effects?

Remember you are not alone! Many men find prostate cancer to bring many changes and challenges. Understanding your prostate cancer and how you manage it can help you increase your confidence in changes you make to improve and maintain your health.

Resources

 

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References

Burnett, A. L., Edwards, N. C., Barrett, T. M., Nitschelm, K. D., & Bhattacharyya, S. K. (2020). Addressing Health-Care System Inequities in the Management of Erectile Dysfunction: A Call to Action. American journal of men’s health14(5), 1557988320965078.

Bianco Jr, F. J., McHone, B. R., Wagner, K., King, A., Burgess, J., Patierno, S., & Jarrett, T. W. (2009). Prevalence of erectile dysfunction in men screened for prostate cancer. Urology, 74(1), 89-93.

Chambers, S. K., Chung, E., Wittert, G., & Hyde, M. K. (2017). Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment. Translational andrology and urology, 6(1), 60.

Cuevas, A. G., Trudel-Fitzgerald, C., Cofie, L., Zaitsu, M., Allen, J., & Williams, D. R. (2019). Placing prostate cancer disparities within a psychosocial context: challenges and opportunities for future research. Cancer Causes & Control30(5), 443-456.

Linschoten, M., Weiner, L., & Avery-Clark, C. (2016). Sensate focus: A critical literature review. Sexual and Relationship Therapy31(2), 230-247.

Rose, V. L. (n.d.). Cancer Facts and Figures. American Family Physician, 59(6). 1697.

Weiner, L., & Avery-Clark, C. (2017). Sensate focus in sex therapy: The illustrated manual. Taylor & Francis.

Wittmann, D., Foley, S., & Balon, R. (2009). Effective sexual response after treatment for prostate cancer: The role of grief and mourning. Society for Sex Therapy and Research 2009: 34th Annual Meeting, April 2-5, 2009, Arlington, VA [Abstracts], 80-81.

The culture of masculinity and its negative impacts on men [Video file]. (2019, September 8). Retrieved February 17, 2021, from https://www.pbs.org/video/the-culture-of-masculinity-and-its-negative-impact-on-men-1567960454/

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

https://gis.cdc.gov/Cancer/USCS/DataViz.html

*Credit for featured image is provided by iStock by Getty Images

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