This study explored the experiences of men living with sexual dysfunction as a consequence of having been treated for prostate cancer. An ethnoculturally diverse sample of 18 men (14 heterosexual, and four homosexual) participated in a series of four to five in-depth interviews. These one-on-one interviews were designed to elicit information pertaining to their beliefs, values and performances regarding masculinity vis-a-vis prostate cancer and its treatment. Interview transcripts were analyzed using the grounded theory method. The core category of 'Preserving Manhood' incorporated five major themes: enhancing the odds; disrupting a core performance; baring an invisible stigma; effortful-mechanical sex; and working around the loss. We conclude that men's performances of sexuality and masculinity were highly interwoven; that loss of sexual functioning constituted a focal disruption for participants; and in some instances, posed a significant threat to their masculine identities.

This qualitative study explored issues of support and coping for couples where the man had been diagnosed with prostate cancer. Thirty-four men with prostate cancer and their spouses were interviewed separately at three points in time: prior to surgery; 8 to 10 weeks post-surgery; and 11 to 13 months post-surgery. The core category for the couples' experience with diagnosis and treatment for prostate cancer was Managing the Impact of Illness. Five major domains emerged, including: dealing with the practicalities; stopping illness from interfering with everyday life; keeping relationships working; managing feelings; and making sense of it all. While it was clearly important for couples to manage illness and to reduce its potential intrusion into everyday life, this strategy had psychological costs as well as benefits. Men struggled to stay in control of their emotions and their lives, typically vacillating between the pulls of fierce self-reliance and fearful neediness. Women were constrained from employing their usual strategies of coping and were distressed by the complicated requirements of being supportive while also honoring their partners' need for self-reliance.

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Findings from this study are situated within a broader developmental framework wherein breast cancer is considered a catastrophic life event that challenges the assimilation and accommodation processes of both partners in the relationship. For couples that are able to overcome the relationship challenges associated with the illness, there is the potential for mutual growth, and a deepening and strengthening of the relationship. Implications for clinical practice are discussed.