The healthcare experience of prostate cancer patients: exploring the intersection of age and gender

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Louis Braverman

Abstract

Although researchers have conducted extensive studies of the psychoso­cial impacts of prostate cancer and its treatment on men’s bodies, mascu­linity and sexuality, little attention has been devoted to the intersection of gender and age in the healthcare experience of this illness. Based on data collected through direct observation in four French public hospitals, and 65 semi-directive interviews with prostate cancer patients, their relatives and healthcare professionals, this article aims to examine how age and gender shape care pathways. We argue that combining the concept of hegemonic masculinity with an intersectional approach may provide an adequate theoretical framework for analysing the plurality of men’s pros­tate cancer healthcare experience. Four steps of the patient care process are successively analysed to assess how the patient experience of illness may be influenced by power relations that interact with individual charac­teristics: screening, diagnosis, treatment and follow-up care.

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References

Arrington, M. I. (2000). Sexuality, society, and senior citizens: An analysis of sex talk among prostate cancer support group members. Sexuality and Culture 4(4): 45–74.

Arrington, M. I. (2003). “I don’t want to be an artificial man”: Narrative reconstruction of sexuality among prostate cancer survivors. Sexuality and Culture 7(2): 30–58.

Arrington, M. I. (2004). To heal or not to heal?: On prostate cancer, physi¬cian-patient communication, and sexuality. Journal of Loss and Trauma 9(2): 159–66.

Arrington, M. I. (2008). Prostate cancer and the social construction of masculine sexual identity. International Journal of Men’s Health 7(3): 299–306.

Austin, J. L. (1975). How to do Things with Words. 2nd ed. Cambridge: Harvard University Press.

Balmer, C., Griffiths, F. & Dunn, J. (2015). A “new normal”: Exploring the disruption of a poor prognostic cancer diagnosis using interviews and participant-produced photographs. Health 19(5): 451–472.

Bauer, G. R. (2014). Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Social Science & Medicine 110: 10–17.

Bensig, J. (2000). Bridging the gap. The separate worlds of evidence-based medicine and patient-centered medicine. Patient Education and Coun¬seling 39(1): 17–25.

Blank, T. O. (2005). Gay men and prostate cancer: Invisible diversity. Journal of Clinical Oncology 23(12): 2593–2596.

Blank, T. O. & Bellizzi, K. M. (2008). A gerontologic perspective on cancer and aging. Cancer 112(11): 2569–2576.

Bondil, P. & Habold, D. (2015). Développement de l’oncosexualitéet onco¬fertilitéen France: Aspects culturels et psychosociologiques [Develop¬ment of oncosexuality and oncofertility in France: Why now? Cultural and psychosociological aspects]. Psycho-oncologie 9(4): 230–239.

Bourdieu, P. (1998). La domination Masculine [Masculine domination]. Paris: Seuil.

Broom, A. (2004). Prostate cancer and masculinity in Australian society: Acase of stolen Identity? International Journal of Men’s Health 3(2): 73–91.

Broom, A. & Cavenagh, J. (2010). Moralities, masculinities and caring for the dying. Social Science and Medicine 71(5): 869–876.

Broom, A. (2012). Gender and end-of-life care. In E. Kuhlmann & E. nnandale (eds.) The Palgrave Handbook of Gender and Healthcare (pp. 224–238). London: Palgrave Macmillan.

Bullen, K. & Tod, D. (2013). Men and masculinity: Understanding the challenges for urological cancer. Trends in Urology & Men’s Health 4(4): 9–12.

Bury, M. (1982). Chronic illness as a biographical disruption. Sociology of Health and Illness 4(2): 167–182.

Calasanti, T. M. (2003). Theorizing age relations. In S. Biggs, A. Lowenstein & J. Hendricks (eds.) The Need for Theory: Critical Approaches to Social Gerontology (pp. 199–218). Amityville, NY: Baywood.

Calasanti, T., Pietilä, I., Ojala, H. & King, N. (2013). Men, bodily control, and health behaviors: The importance of age. Health Psychology 32(1): 15–23.

Calasanti, T. M. & Slevin, K. F. (eds.) (2006). Age Matters: Re-Aligning Fem¬inist Thinking. New York: Routledge.

Cecil, R., McCaughan, E. & Parahoo, K. (2010). “It’s hard to take because I am a man’s man”: An ethnographic exploration of cancer and mascu¬linity. European Journal of Cancer Care 19(4): 501–509.

Chapple, A. & Ziebland, S. (2002). Prostate cancer: Embodied experience and perceptions of masculinity. Sociology of Health and Illness 24(6): 820–841.

Christensen, A.-D. & Jensen S. Q. (2014). Combining hegemonic masculin¬ity and intersectionality. NORMA 9(1): 60–75.

Collins, P. H. & Bilge, S. (2016). Intersectionality. Cambridge: Polity Press.

Connell, R. W. (2005). Masculinities. Berkeley, CA: University of California Press. 2nd ed. [1995]

Corbin, J. M. & Strauss, A. (1988). Unending Work and Care: Managing Chronic Illness at Home. San Francisco, CA: Jossey-Bass.

Crawford, R. (1980). Healthism, and the medicalization of everyday life. International Journal of Health Services 10(3): 365–388.

Dale, W., Sartor, S., Davis, T. & Bennett, C. L. (1999). Understanding bar¬riers to the elderly detection of prostate cancer among men of lower socioeconomic status. Prostate Journal 1(4):176–184.

Demetriou, D. Z. (2001). Connell’s concept of hegemonic masculinity: A critique. Theory and Society 30(3): 337–361.

Devreux, A. M. (1997). Des appelés, des armes et des femmes: l’appren¬tissage de la domination masculine à l’armée [Girls, guys and guns: Teaching Male Domination in the army]. Nouvelles Questions Féministes 18(3/4): 49–78.

Douglas, M. (1966). Purity and Danger: An Analysis of Concepts of Pollution and Taboo. London: Routledge.

Droz, J. P., Balducci, L., Bolla, M., Emberton, M., Fitzpatrick, J. M., Joniau, S., Kattan, M. W., Monfardini, S., Moul, J. W., Naeim, A., van Poppel, H., Saad, F. & Sternberg, C. N. (2010). Background for the proposal of SIOG guidelines for the management of prostate can¬cer in senior adults. Critical Reviews in Oncology/Hematology 73(1): 68–91.

Droz, J. P., Albrand, G., Gillessen, S., Hughes, S., Mottet, N., Oudard, S., Payne, H., Puts, M., Zulian, G., Balducci, L. & Aapro, M. (2017). Management of prostate cancer in older men: Recommendations of a working group of the International Society of Geriatric Oncology. European Urology 74(4): 521–531.

Dowsett, G. W. (2008). “Losing my chestnut”: One gay man’s wrangle with prostate cancer. Reproductive Health Matters 16(32): 145–150.

Evans, R., Edwards A. G. K., Elwyn, G., Watson, E., Grol, R., Brett, J. & Austoker, J. (2007). ‘It’s a maybe test’: Men’s experiences of prostate specific antigen testing in primary care. The British Journal of General Practice 57(537): 303–310.

Faulkner, A. (2010). Trial, trial, trial again: Reconstructing the gold stan¬dard in the science of prostate cancer detection. In C. Will & T. Moreira (eds.) Medical Proof, Social Experiments: Clinical Trials in Shifting Contexts (pp. 137–152). Farnham: Ashgate.

Furlan, A. B., Kato, R., Vicentini F., Cury J., Antunes A. A. & Srougi M. (2008). Patient’s reactions to digital rectal examination of the prostate. International Brazilian Journal of Urology 35(5): 572–575.

Filiault, S., Drummond, M. & Smith, A. (2008). Gay men and prostate cancer: Voicing the concerns of a hidden population. Journal of Men’s Health 5(4): 327–332.

Flynn, K. E., Reese, J. B., Jeffery, D. D., Abernethy, A. P., Lin, L., Shelby, R. A., Porter, L. S., Dombeck, C. B. & Weinfurt, K. P. (2012). Patient expe¬riences with communication about sex during and after treatment for cancer. Psychooncology 21(6): 594–601.

Gilbert, E., Perz, J. & Ussher, J. (2016). Talking about sex with health pro¬fessionals: The experience of people with cancer and their partner. European Journal of Cancer Care 25(2): 280–293.

Gillespie, C. (2012). The experience of risk as “measured vulnerability”: Health screening and lay uses of numerical risk. Sociology of Health & Illness 34(2): 194–207.

Gkiouleka, A., Huijts, T., Beckfield, J. & Bambra, C. (2018). Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions – A research agenda. Social Science & Medicine 200: 92–98.

Gott, M. & Hinchliff, S. (2011). Sex and ageing: A gendered issue. In S. Arber, K. Davidson & J. Ginn (eds.), Gender and Ageing. Changing Roles and Relationships (pp. 63–78). Philadelphia, PA: Open University Press.

Gray, R., Fitch, M., Phillips, C., Labrecque, M. & Fergus, K. (2000). To tell or not to tell: Patterns of disclosure among men with prostate cancer. Psycho-Oncology 9(4): 273–282.

Gray, R., Fitch, M., Fergus, K., Mykhalovkiy, E. & Church K. (2002). Hegemonic masculinity and the experience of prostate cancer: Narrative approach. Journal of Aging and Identity 7(1): 43–62.

Gray, R., Fergus, K. and Fitch, M. (2005). Two black men with prostate cancer: A narrative approach. British Journal of Health Psychology 10(1): 71–84.

Grosclaude, P., Belot, A., Daubisse Marliac, L. & Remontet, N. (2015). Le cancer de la prostate, évolution de l’incidence et de la mortalité en France entre 1980 et 2011 [Prostate cancer incidence and mortality trends in France from 1980 to 2011]. Progrès en Urologie 25(9): 536–542.

Grummet, J. P., Plass, K. & N’Dow, J. (2017). Prostate cancer management in an ageing population. European Urology 72(4): 532–533.

Gustafsson, P. E., Linander, I. & Mosquera, P. A. (2017). Embodying perva¬sive discrimination: A decomposition of sexual orientation inequalities in health in a population-based cross-sectional study in Northern Swe¬den. International Journal for Equity in Health 16(1): 22–32.

Hankivsky, O. (2012). Women’s health, men’s health, and gender and health: Implication of intersectionality. Social Science & Medicine 74(11): 1712–1720.

Hart, T. L., Coon, D. W., Kovalkowski, M. A., Zhang, K., Hersom J. I., Goltz, H. H., Wittmann, D. A. & Latini, D. M. (2014). Changes in sexual roles and quality of life for gay men after prostate cancer: Challenges for sexual health providers. The Journal of Sexual Medicine (9): 2308–2317.

Hurd Clarke, L. & Lefkowich, M. (2018). “I don’t have any issue with masculinity”: Older Canadian men’s perceptions and experiences of embodied masculinity. Journal of Aging Studies 45: 18–24.

INCa. (2014). La vie deux ans après un diagnostic de cancer. De l’annonce à l’après-cancer [Life two years after a cancer diagnosis. From annoncement to post-cancer], Boulogne-Billancourt: INCa.

INCa. (2017). Les cancers en France, édition 2016 [Cancers in France, 2016 edition], Boulogne-Billancourt: INCa.

Jefferson, T. (2002). Subordinating hegemonic masculinity. Theoretical Criminology 6(1): 63–88.

Jha, G. G., Arnan, V., Soubra, A. & Konety, B. (2014). Challenges of manag¬ing elderly men with prostate cancer. Nature Review Clinical Oncology 11(6): 354–364.

Kampf, A. (2013). “There is a person here” Rethinking ag(ing), gender and prostate cancer. In A. Kampf, B. Marshall & A. Petersen (eds.), Aging Men, Masculinities and Modern Medicine (pp. 52–67). New York: Routledge.

Kelly, D. (2009). Changed men: The embodied impact of prostate cancer. Qualitative Health Research 19(2): 151–163.

Kenerson, D. (2010). Use of the Theory of Planned Behavior to Assess Prostate Cancer Screening Intent among African American Men. PhD dissertation in nursing science. Vanderbilt University. Available on https://pdfs. semanticscholar.org/9d72/0c0b2b4293b248394ace5a8e466c8b3d79ce. pdf (Accessed: October 26, 2019)

Kunkel, E., Bakker, J., Myers, R., Oyesablun, O. & Gomella, L. (2000). Biopsychosocial aspects of prostate cancer. Psychosomatics 41(2): 85–94.

Liamputtong, P. & Suwankhong, D., (2015). Breast cancer diagnosis: Biographical disruption, emotional experiences and strategic man¬agement in Thai women with breast cancer. Sociology of Health & Illnes 37(7): 1086–1101.

McMullin, J. A. & Marshall, V. W. (2001). Ageism, age relations, and gar¬ment industry work in Montreal. The Gerontologist 41(1): 111–122.

Macias, D. J., Sarabia, M. J. & Sklar, D. P, (2000). Male discomfort during digital rectal examination: Does examiner gender make a difference? American Journal of emergency Medicine 18(6): 676–678.

Nagler, H. M., Gerver E. W., Homel, P., Wagner, J. R., Norton, J., Lebo¬vitch, S. & Phillips, J. L. (2005). Digital rectal examination is barrier to populations-based prostate cancer screening. Urology 65(6): 1137–1140.

Loe, M. (2001). Fixing broken masculinity: Viagra as a technology for the production of gender and sexuality. Sexuality and Culture 5(3): 97–125.

Mamo, L. & Fishman, J. R. (2001). Potency in all the right places: Viagra as a technology of the gendered body. Body & Society 7(4): 13–35.

Mongiat-Artus, P., Peyromaure, M., Richaud, P., Droz, J. P., Rainfray, M., Jeandel, C., Rebillard, X., Moreau, J. L., Davin, J. L., Salomon, L., Soulié, M. & les membres du sous- comité prostate du CC-AFU (2009). Recommandations pour la prise en charge du cancer de la prostate chez l’homme âgé: un travail du comité de cancérologie de l’association française d’urologie [Recommendations for the treat¬ment of prostate cancer in the elderly man: A study by the oncology committee of the French association of urology]. Progrès en urologie 19(11): 810–817.

Noone, J. H. & Stephens, C. (2008). Men, masculine identities, and health care utilization. Sociology of Health & Illness 30(5): 711–725.

O’Brien, R., Hart, G. J. & Hunt K. (2007). “Standing out from the herd”: Men renegotiating Masculinity in Relation to their experience of illness. International Journal of Men’s Health 6(3): 178–200.

Oliffe, J. L. (2005). Construction of masculinity following prostatecto¬my-induced impotence. Social Science and Medicine 60(10): 2240–2259.

Oliffe, J. L. (2006). Embodied masculinity and androgen deprivation ther¬apy. Sociology of Health & Illness 28(4): 410–432.

Oliffe, J. L. (2007). Men, masculinities, and prostate cancer: Australian and Canadian patient perspectives of communication with male physi¬cians. Qualitative Health Research 17(2): 149–161.

Oliffe, J. L. (2011). Positioning prostate cancer as the problematic third testicle. In A. Broom and P. Tovey (eds.), Men’s Health and Illness. Body, Identity and Social Context (2nd ed., pp. 33–62). West Sussex: Wiley-Blackwell.

Oliffe, J. L., Gerbrandt, J. S., Bottorff, J. L. & Hislop, T. G. (2010). Health promotion and illness demotion at prostate cancer support groups. Health Promotion Practice 11(4): 562–571.

Parent, M. C., Hammer, J. H., Bradstreet, T. C., Schwartz, E. N. & Jobe, T. (2018). Men’s mental health help-seeking behaviors: An intersectional analysis. American Journal of Men’s Health 12(1): 63–73.

Pietilä, I., Jurva, R., Ojala, H. & Tammela, T. (2018). Seeking certainty through narrative closure: Men’s stories of prostate cancer treatments in a state of liminality. Sociology of Health and Illness 40(4): 639–653.

Potts, A., Gavey, N., Grace, V. M. & Vares, T. (2003). The downside of Viagra: Women’s experiences and concerns. Sociology of Health & Illness 25(7): 697–719.

Potts, A., Grace, V., Gavey, N. & Vares, T. (2004). “Viagra stories”: Chal¬lenging “erectile dysfunction.” Social Science & Medicine 59(3): 489–499.

Quinn, G. P., Sanchez, J. A., Sutton, S. K., Vadaparampil, S. T., Nguyen, G. T., Green B. L., Kanetsky, P. A. & Schabath, M. B. (2015). Cancer and lesbian, gay, bisexual, transgender/transexual, and queer/ques¬tioning (LGBTQ) populations. CA: A Cancer Journal for Clinicians 65(5): 384–400.

Rivas, C., Matheson, L., Nayoan, J., Glaser, A., Gavin, A., Wright, P. & Watson, E. (2016). Ethnicity and the prostate cancer experience: A qual¬itative metasynthesis. Psychooncology 25(10): 1147–1156.

Rozet, F., Hennequin, C., Beauval, J. B., Beuzeboc, P., Cormier, L., Fromont, G., Mongiat-Artus, P., Ouzzane, A., Ploussard, G., Azria, D., Brenot- Rossi, I., Cancerl-Tassin, G., Cussenot, O., Lebret, T., Rebillard, X., Soulié, M., Renard-Penna, R. & Méjean, A. (2016). Recommandations en onco-urologies 2016-2018 du CCAFU Cancer de la prostate [CCAFU French national guidelines 2016-2018 on prostate cancer]. Progès en Urologie 27(1): 95–143.

Sabin, J. A., Riskind, R. G. & Nosek, B. A. (2015). Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. American Journal of Public Health 105(9): 1831–1841.

Sandberg, L. (2016). In lust we trust? Masculinity and sexual desire in later life. Men and Masculinities 19(2): 192–208.

Schaepe, K. S. (2011). Bad news and first impressions: Patient and family caregiver accounts of learning the cancer diagnosis. Social Science and Medicine 73(6): 912–921.

Schulz, A. J. & Mullings, L. (Eds.) (2006). Gender, Race, Class, & Health: Intersectional Approaches. San Francisco, CA: Jossey-Bass.

Stansbury, J. P., Mathewson-Chapman, M. & Grant, K. E. (2003). Gender schema and prostate cancer: Veterans’ cultural model of masculinity. Medical Anthropology 22(2): 175–204.

Tao, Z. Q., Shi, A. M., Wang, K. Z. & Zhang, W. D. (2015). Epidemiol¬ogy of prostate cancer: Current status. European Review for Medical and Pharmacological Sciences 19(5): 805–12.

Tiefer, L. (1996). The medicalization of sexuality: Conceptual, normative, and professional issues. Annual Review of Sex Research 7(1): 252–282.

Terret, C., Albrand, G. & Droz, J. P. (2004). Geriatric assessment in elderly patients with prostate cancer. Clinical Prostate Cancer 2(4): 236–240.

Torbit, L. A., Albiani J. J., Crangle. C. J., Latini, D. M. & Hart, T. L. (2015). Fear of recurrence: The importance of self-efficacy and satisfaction with care in gay men with prostate cancer. Psychooncology 24(6): 691–698.

Tuppin, P., Leboucher, C., Dougé, M., Peyre-Lanquar, G., Gabach, P., Descotes, J. L. & Rebillard, X. (2016). Dépistage individuel du cancer de la prostate chez les hommes de 40 ans et plus, France, 2009-2015. Données du système national d’information inter-régimes de l’assurance maladie [Individual prostate cancer screening in men aged 40 and over, France, 2009-2015. Data from the national health insurance inter-schemes information system]. Bulletin épidémiologique hebdomadaire 39–40: 700–706.

Tronto, J. (1993). Moral Boundaries. A Political Argument for an Ethic of Care. New York: Routledge.

Ussher, J. M., Perz, J., Kellett, A., Chambers, S., Latini, D., Davis, I. D., Rose, D., Dowsett, G. W. & Williams, S. (2016). Health-related quality of life, psychological distress, and sexual changes following prostate cancer: A comparison of gay and bisexual men with heterosexual men. The Journal of Sexual Medicine 13(3): 425–434.

Vassy, K. & Keller, R. (2008). Faut-il contrôler les aspects éthiques de la recherche en sciences sociales et comment?. Mouvements 3–4(55–56): 128–141.

Wall, D. & Kristjanson, L. (2005). Men, culture and hegemonic masculin¬ity: Understanding the experience of prostate cancer. Nursing Inquiry 12(2): 87–97.

Wenger, L. & Oliffe, J. (2014). Men managing cancer: A gender analysis. Sociology of Health and Illness 36(1): 108–122.

Wetherell, M. & Edley, N. (1999). Negotiating hegemonic masculinity: Imaginary positions and psycho-discursive practices. Feminism and Psychology 9(3): 335–356.

Zanchetta Santos, M., Cognet, M., Xenocostas, S., Aoki, D. & Talbot, Y. (2007). Prostate cancer among Canadian men: A transcultural view. International Journal of Men’s Health 6(3): 224–258.