Objective
Prostate cancer, the second most common cancer among men, typically onsets in middle or older age. Gay/bisexual men have different social networks and unique social support needs, particularly as it pertains to health care access and prostate side effects. Few studies have investigated the availability and provision of social support for gay and bisexual men with prostate cancer (GBMPCa).
Methods
This study used qualitative data from in-depth, semi-structured, one-on-one telephone interviews with 30 GBMPCa recruited from a national cancer support group network, Malecare. Inductive and deductive coding were used to identify themes about social support provided to GBMPCa during diagnosis and treatment.
Results
GBMPCa reported help from friends, family (parents, siblings), ex-partners, and paid caregivers. Men in relationships reported varying levels of reliance on their partners for support, in part due to relationship dynamics and living arrangements. Single men showed a theme of independence (“I turned down all help”, “my friends don’t want to be bothered”). After diagnosis, many men reported seeking informational and emotional support from prostate cancer support groups; most expressed wanting more support groups specifically for GBMPCa. During or after treatment, men reported receiving a range of instrumental support, largely a function of relationship status and treatment type.
Conclusions
GBMPCa received variable, but generally low, social support during diagnosis and treatment and from a diverse social network, including a prominence of friends and family. Clinicians should be aware of GBMPCa’s distinct patterns of social support needs and providers.
The effect of prostate cancer treatment in gay and bisexual men is an under-researched area. In 2015, we conducted in-depth telephone interviews with 19 gay and bisexual men who had undergone radical prostatectomies. Across the respondents’ five emotional themes emerged: (1) shock at the diagnosis, (2) a reactive, self-reported “depression”, (3) sex-specific situational anxiety, (4) a sense of grief, and, (5) an enduring loss of sexual confidence. Identity challenges included loss of a sense of maleness and manhood, changes in strength of sexual orientation, role-in-sex identity, and immersion into sexual sub-cultures. Relationship challenges identified included disclosing the sexual effects of treatment to partners, loss of partners, and re-negotiation of sexual exclusivity. Most to all of these effects stem from sexual changes. To mitigate these negative effects of radical prostatectomy, and to address health disparities n outcomes observed in gay and bisexual men, all these challenges need to be considered in any tailored rehabilitation program for gay and bisexual men.
As part of a larger study of prostate cancer in gay, bisexual and other men who have sex with men (GBM) in North America, we conducted individual semistructured telephone interviews with 6 GBM who received radiation treatment and 19 who underwent radical prostatectomy. GBM who underwent radiation treatment reported multiple sexual challenges similar to those published for men who underwent radical prostatectomy. Two key differences were identified. GBM who received radiation reported additional bowel and urinary urgency challenges that were not reported by GBM who had radical prostatectomies, which had implications for receptive anal sex. Conversely, GBM who received radiation were less likely to report severe erectile dysfunction, anatomical changes, and total ejaculate loss than GBM with radical prostatectomies. Clinical implications include the importance of addressing these differences in sexual outcomes when discussing treatment options with GBM, possibly as part of a broader discussion of role-in-sex and how to minimize the negative effects of treatment.
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