Defining Young in the Context of Prostate Cancer

Abstract

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer.

A prospective study of psychological distress after prostate cancer surgery

“…The relationship between younger age and a poorer psychological outcome has been previously reported, and likely relates to masculine constructions of what it means to be a young man, that are inconsistent with a diagnosis of prostate cancer. 19 For example, the psychological threat of prostate cancer in younger men, who have a financially dependent family, a developing career, and a self-image strongly connected to perceptions of strength and vitality, may loom large. For aging men who are affected by other common and often cooccurring chronic diseases, such as cardiovascular disease, diabetes, or osteoarthritis, the burden of prostate cancer additional to these may be overwhelming.…”

“…20 This new study confirms these findings in a well-characterised surgical population closely tracked more than 24 months and further supports the need for life course to be considered in men's risk profiles for poorer survivorship outcomes. $40 001 to $60 000 70 (27) $60 001 to $80 000 48 (19) $80 001 + 40 (15) Unwilling to answer/Don't know 12 (5) Comorbid condition, n (%) Myocardial infarction 21 (7) Heart failure 13 ( Prospective longitudinal studies are now emerging to describe how this distress evolves over time. More than 1.1 million men are diagnosed with prostate cancer each year worldwide, and most of them will be long-term survivors.…”

Clinical outcomes in a contemporary series of “young” patients with castration-resistant prostate cancer who were 60 years and younger

“…Finally, another question is the age at which a patient with PC can be considered "young," which has still not been clearly defined [30]. We chose a cut-off age of 60 years because PC is mainly diagnosed in patients older than 65 years, all our patients developed castration resistance before this age, and the median age of the patients enrolled in recent pivotal studies of mCRPC ranges from 68 to 71 years [8,[10][11][12][13][14][15]; however, others may consider this purely arbitrary.…”

Underserved groups and barriers to cancer care

“…As with lung cancer, the diagnosis and treatment of prostate cancer pose unique challenges both to the experience of cancer, physical functioning and service use, and this may be directed by age or life stage (Chambers et al . , ). Socially constructed ideals about masculinity may impact men's experience of disease or treatment and their levels of distress and may inhibit help seeking for sexual problems after treatment (Oliffe & Thorne ; Chambers et al .…”

“…Socially constructed ideals about masculinity may impact men's experience of disease or treatment and their levels of distress and may inhibit help seeking for sexual problems after treatment (Oliffe & Thorne ; Chambers et al . , ). In this issue, Appleton et al .…”