Men’s Health and Cancer—The Case of Prostate Cancer

  • Kenneth GannonEmail author


Prostate cancer (PCa) is a disease in which understandings of what it means to be a man and structural inequalities affecting men from different groups intersect and interact in important and complex ways at every stage of the disease “journey” from first noticing a problem, to seeking help and obtaining a diagnosis through treatment to survivorship. PCa needs to be understood with reference to prevailing norms and enactments of masculinity and to the ethnicity and social class of the man with cancer. This chapter will provide basic information about the nature, symptoms and treatment of prostate cancer. It will discuss these in terms of their psychological and psychosocial impact on men and their families, with a particular focus on how concepts of masculinity as well as ethnicity, sexual orientation and gender identity shape these effects.


Prostate cancer: androgen deprivation therapy ADT GnRH agonist Heterosexual Homosexual 


  1. Alibhai, S. M. H., Breunis, H., Timilshina, N., Marzouk, S., Stewart, D., Tannock, I., et al. (2010). Impact of androgen-deprivation therapy on cognitive function in men with nonmetastatic prostate cancer. Journal of Clinical Onclology, 28, 5038–5045.Google Scholar
  2. Allen, J. D., Kennedy, M., Wilson-Glover, A., & Gilligan, T. D. (2007). African-American men’s perceptions about prostate cancer: Implications for designing educational interventions. Social Science and Medicine, 64, 2189–2200.PubMedGoogle Scholar
  3. Asencio, M., Blank, T., Descartes, L., & Crawford, A. (2009). The prospect of prostate cancer: A challenge for gay men’s sexualities as they age. Sexuality Research & Social Policy, 6(4), 38–51.Google Scholar
  4. Bacon, C. G., Giovannucci, E., Testa, M., & Kawachi, I. (2001). The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer. Journal of Urology, 166, 1804–1810.PubMedGoogle Scholar
  5. Badr, H., & Carmack Taylor, C. L. (2009). Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psycho-Oncology, 18, 735–746.PubMedPubMedCentralGoogle Scholar
  6. Baker, R., Sinfield, P., Agarwal, S., Tarrant, C., Steward, W., Mellon, J. K., et al. (2007). Prostate cancer care: Improving measures of the patient experience. Report for the NHS Service Delivery and Organisation R&D (NCCSDO). London: SDO.
  7. Banthia, R., Malcarne, V. L., Varni, J. W., Ko, C. M., Sadler, G. R., & Greenbergs, H. L. (2003). The effects of dyadic strength and coping styles on psychological distress in couples faced with prostate cancer. Journal of Behavioral Medicine, 26(1), 31–52.PubMedGoogle Scholar
  8. Barry, M. J. (2009). Screening for prostate cancer—The controversy that refuses to die. New England Journal of Medicine, 360(13), 1351–1354.PubMedGoogle Scholar
  9. Bennett, G., & Badger, T. A. (2005). Depression in men with prostate cancer. Oncology Nursing Forum, 32, 545–556.PubMedGoogle Scholar
  10. Blank, T. (2005). Gay men and prostate cancer: Invisible diversity. Journal of Clinical Oncology, 12, 2593–2596.Google Scholar
  11. Boehmer, U., & Clark, J. A. (2001). Married couples’ perspectives on prostate cancer diagnosis and treatment decision-making. Psycho-Oncology, 10, 147–155.PubMedGoogle Scholar
  12. Boehmer, U., Cooley, T. P., & Clark, M. A. (2012). Cancer and men who have sex with men: A systematic review. Lancet Oncology, 13(12), e545–e553.PubMedGoogle Scholar
  13. Bolla, M., Collette, L., Van Tienhoven, G., WArde, P., Dubois, J. B., Mirimanoff, R. O. M., et al. (2008). Ten year results of long-term androgen deprivation therapy with goserelin in patients with locally-advanced prostate cancer treated with radiotherapy: A phase III EORTC study. Radiation Oncology, 72(Suppl. 1), S30–S31.Google Scholar
  14. Cant, B., & Taket, A. (2006). Lesbian and gay experiences of primary care in one borough in North London, UK. Diversity in Health and Social Care, 3(4), 271–279.Google Scholar
  15. Cary, K. C., Singla, N., Cowan, J. E., Carroll, P. R., & Cooperberg, M. R. (2014). Impact of androgen deprivation therapy on mental and emotional well being in men with prostate cancer: Analysis from the CaPSURE registry. Journal of Urology, 191, 964–970.PubMedGoogle Scholar
  16. Casey, R. G., Corcoran, N. M., & Goldenberg, S. L. (2012). Quality of life issues in men undergoing androgen deprivation therapy a review. Asian Journal of Andrology, 14(2), 226–231.PubMedPubMedCentralGoogle Scholar
  17. Cetin, K., Li, S., Blaes, A. H., Stryker, S., Liede, A., & Arneson, T. J. (2013). Prevalence of patients with nonmetastatic prostate cancer on androgen deprivation therapy in the United States. Urology, 81(6), 1184–1189.PubMedGoogle Scholar
  18. Chapple, A., & Ziebland, S. (2002). Prostate cancer: Embodied experience and perceptions of masculinity. Sociology of Health & Illness, 24(6), 820–841.Google Scholar
  19. Cherrier, M. M., Aubin, S., & Higano, C. S. (2009). Cognitive and mood changes in men undergoing intermittent combined androgen blockade for non-metastatic prostate cancer. Psycho-Oncology, 18, 237–247.PubMedPubMedCentralGoogle Scholar
  20. Chinegwundoh, F., Enver, M., Lee, A., Nargund, V., Oliver, T., & Ben-Shlomo, Y. (2006). Risk and presenting features of prostate cancer amongst African-Caribbean, South Asian and European men in north-east London. British Journal of Urology International, 98, 1216–1220.Google Scholar
  21. Connolly, R. M., Carducci, M. A., & Antonarakis, E. S. (2012). Use of androgen deprivation therapy in prostate cancer: Indications and prevalence. Asian Journal of Andrology, 14(2), 177–186.PubMedPubMedCentralGoogle Scholar
  22. CRUK Website. Retrieved December 2, 2017, from
  23. CRUK. (2018). Prostate cancer survival statistics. Retrieved December 9, 2018, from
  24. Davison, J. B., Gleave, M. E., Goldenberg, L. S., Degner, L. F., Hoffart, D., & Berkowitz, J. (2002). Assessing information and decision preferences of men with prostate cancer and their partners. Cancer Nursing, 25(1), 42–49.PubMedGoogle Scholar
  25. Dean, L., Meyer, I., Robinson, K., Sell, R., Sember, R., Silenzio, V., et al. (2000). Lesbian, gay, bisexual, and transgender health: Findings and concerns. Journal of the Gay and Lesbian Medical Association, 4, 102–151.Google Scholar
  26. Eton, D. T., & Lepore, S. J. (2002). Prostate cancer and health-related quality of life: A review of the literature. Psycho-Oncology, 11, 307–326.PubMedPubMedCentralGoogle Scholar
  27. Fergus, K., Gray, R., & Fitch, M. (2002). Sexual dysfunction and the preservation of manhood: Experiences of men with prostate cancer. Journal of Health Psychology, 7(3), 303–316.PubMedGoogle Scholar
  28. Filiault, S. M., Drummond, M. J. N., & Smith, J. A. (2008). Gay men and prostate cancer: Voicing the concerns of a hidden population. Journal of Men’s Health, 5(4), 327–332.Google Scholar
  29. Frey, A. U., Sonksen, J., & Fode, M. (2014). Neglected side effects after radical prostatectomy: A systematic review. Journal of Sexual Medicine, 11(2), 374–385.PubMedGoogle Scholar
  30. Gannon, K., Glover, L., O’Neill, M., & Emberton, M. (2005). Lower urinary tract symptoms in men: Self-perceptions and the concept of bother. BJU International, 96, 823–827.PubMedGoogle Scholar
  31. Gannon, K., Guerro-Blanco, M., & Abel, P. D. (2010). Reconstructing masculinity following radical prostatectomy for prostate cancer. The Aging Male, 13(4), 258–264.PubMedGoogle Scholar
  32. Gore, J. L., Krupski, T., Kwan, L., Maliski, S., & Litwin, M. S. (2005). Partnership status influences quality of life in low-income, uninsured men with prostate cancer. Cancer, 104(1), 191–198.PubMedGoogle Scholar
  33. Green, H. J., Pakenham, K. I., Headley, B. C., Yaxley, J., Nicol, D. L., Mactaggart, P. N., et al. (2002). Altered cognitive function in men treated for prostate cancer with luteinizing hormone-releasing hormone analogues and cyproterone acetate: A randomized controlled trial. BJU International, 90, 427–432.PubMedGoogle Scholar
  34. Grey, R. E., et al. (2002). Prostate cancer and erectile dysfunction: Men’s experiences. International Journal of Men’s Health, 1(1), 15–29.Google Scholar
  35. Hale, S., Groga, S., & Willott, S. (2010). Male GPs’ views on men seeking medical help: A qualitative study. British Journal of Health Psychology, 15, 697–713.PubMedGoogle Scholar
  36. Harden, J., Sanda, M. G., Wei, J. T., Yarandi, H. N., Hembroff, L., & Hardy, J. (2013). Survivorship after prostate cancer treatment: Spouses’ quality of life at 36 months. Oncology Nursing Forum, 40(6), 567–573.PubMedPubMedCentralGoogle Scholar
  37. Harrison, S. E., Watson, E. K., Ward, A. M., Khan, N. F., Turner, D., Adams, E., et al. (2012). Cancer survivors’ experiences of discharge from hospital follow-up. European Journal of Cancer Care, 21(3), 390–397.PubMedGoogle Scholar
  38. Heaphy, B., Yip, A., & Thompson, D. (2003). Lesbian, gay and bisexual lives over 50. Nottingham: York House.Google Scholar
  39. Herr, H. W. (1997). Quality of life in prostate cancer patients. CA: A Cancer Journal for Clinicians, 47(4), 207–217.Google Scholar
  40. Heslin, K. C., Gore, J. L., King, W. D., & Fox, S. A. (2008). Sexual orientation and testing for prostate and colorectal cancers among men in California. Medical Care, 46(12), 1240–1248.PubMedPubMedCentralGoogle Scholar
  41. Holzbeierlein, J. M., Castle, E., & Thrasher, J. B. (2004). Complications of androgen deprivation therapy: Prevention and treatment. Oncology, 18, 303–309.PubMedGoogle Scholar
  42. Hudson, S. V., Miller, S. M., Hemler, J., Ferrante, J. M., Lyle, J., Oeffinger, K. C., et al. (2012). Adult cancer survivors discuss follow-up in primary care: ‘Not what I want, but maybe what I need’. Annals of Family Medicine, 10(5), 418–427.PubMedPubMedCentralGoogle Scholar
  43. Huggins, C., & Hodges, C. V. (1941). Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Research, 1(4), 293–297.Google Scholar
  44. Jacobs, J. R., Banthia, R., Robins Sadler, G., Varni, J. W., et al. (2002). Problems associated with prostate cancer: Differences of opinion among health care providers, patients, and spouses. Journal of Cancer Education, 17, 33–36.PubMedGoogle Scholar
  45. Joly, F., Alibhai, S. M., Galica, J., Park, A., Yi, Q. L., Wagner, L., et al. (2006). Impact of androgen deprivation therapy on physical and cognitive function, as well as quality of life of patients with nonmetastatic prostate cancer. Journal of Urology, 176(6 pt 1), 2443–2447.PubMedGoogle Scholar
  46. Jowett, A., & Peel, E. (2009). Chronic illness in non-heterosexual contexts: An online survey of experiences. Feminism and Psychology, 19(4), 454–474.Google Scholar
  47. Klitzman, R., & Greenberg, J. (2002). Patterns of communication between gay and lesbian patients and their health care providers. Journal of Homosexuality, 42, 65–75.PubMedGoogle Scholar
  48. Krongrad, A., Lai, H., Burke, M. A., Goodkin, K., & Lai, S. (1996). Marriage and mortality in prostate cancer. The Journal of Urology, 156(5), 1696–1700.PubMedGoogle Scholar
  49. Lavery, H. J., & Cooperberg, M. R. (2017). Clinically localized prostate cancer in 2017: A review of comparative effectiveness. Urologic Oncology, 35(2), 40–41.PubMedGoogle Scholar
  50. Lee, M., Jim, H. S., Fishman, M., et al. (2015). Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: A controlled comparison. Psycho-Oncology, 24, 472–477.PubMedGoogle Scholar
  51. Macefield, R. C., Metcalfe, C., Lane, J. A., Donovan, J. L., Avery, K. N. L., Blazeby, J. M., et al. (2010). Impact of prostate cancer testing: an evaluation of the emotional consequences of a negative biopsy result. British Journal of Cancer, 102, 1335–1340.PubMedPubMedCentralGoogle Scholar
  52. Malcarne, V. L., Banthia, R., Varni, J. W., Robins Sadler, G., Greenbergs, H. L., & Ko, C. M. (2002). Problem-solving skills and emotional distress in spouses of men with prostate cancer. Journal of Cancer Education, 17, 150–154.PubMedGoogle Scholar
  53. Messing, E. M., Manola, J., Sarosdy, M., Wilding, G., Crawford, E. D., & Trump, D. (1999). Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. New England Journal of Medicine, 341, 1781–1788.PubMedGoogle Scholar
  54. Nead, K. T., Gaskin, G., Chester, C., Swisher-McClure, S., Leeper, N. J., & Shah, N. H. (2017). Association between androgen deprivation therapy and risk of dementia. JAMA Oncology, 3(1), 49–55.PubMedGoogle Scholar
  55. Neville, S., & Henrickson, M. (2006). Perceptions of lesbian, gay and bisexual people of primary healthcare services. Journal of Advanced Nursing, 55(4), 407–415.PubMedGoogle Scholar
  56. Ng, E., Woo, H. H., Turner, S., Leong, E., Jackson, M., & Spry, N. (2012). The influence of testosterone suppression and recovery on sexual function in men with prostate cancer: Observations from a prospective study in men undergoing intermittent androgen suppression. Journal of Urology, 187, 2162–2166.PubMedGoogle Scholar
  57. Norcross, W., Ramirez, C., & Palinkas, L. A. (1996). The influence of women on the health-care seeking behaviour of men. Journal of Family Practice, 43(5), 475–480.PubMedGoogle Scholar
  58. Oliffe, J. (2006). Embodied masculinity and androgen deprivation therapy. Sociology of Health & Illness, 28, 410–432.Google Scholar
  59. Riechers, E. A. (2004). Including partners into the diagnosis of prostate cancer: A review of the literature to provide a model of care. Urologic Nursing, 24(1), 22–38.PubMedGoogle Scholar
  60. Salminen, E. K., Portin, R. I., Koskinen, A., Helenius, H., & Nurmi, M. (2003). Androgen deprivation and cognition in prostate cancer. British Journal of Cancer, 89, 971–976.PubMedPubMedCentralGoogle Scholar
  61. Salminen, E. K., Portin, R. I., Koskinen, A., Helenius, H., & Nurmi, M. (2004). Associations between serum testosterone fall and cognitive function in prostate cancer patients. Clinical Cancer Research, 10, 7575–7582.PubMedGoogle Scholar
  62. Salminen, E. K., Portin, R. I., Koskinen, A., Helenius, H., & Nurmi, M. (2005). Estradiol and cognition during androgen deprivation in men with prostate carcinoma. Cancer, 103, 1381–1387.PubMedGoogle Scholar
  63. Sanda, M. G., Dunn, R. L., Michalski, J., et al. (2008). Quality of life and satisfaction with outcome among prostate cancer survivors. New England Journal of Medicine, 358, 1250–1261.Google Scholar
  64. Seymour-Smith, S., Brown, D., Cosma, G., Shopland, N., Battersby, S., & Burton, A. (2016). “Our people has got to come to terms with that”: Changing perceptions of the digital rectal examination as a barrier to prostate cancer diagnosis in African-Caribbean men. Psycho-Oncology, 25, 1183–1190.PubMedGoogle Scholar
  65. Seymour-Smith, S., Wetherell, M., & Phoenix, A. (2002). My wife ordered me to come: A discursive analysis of doctors’ and nurses’ accounts of men’s use of general practitioners. Journal of Health Psychology, 7(3), 253–276.Google Scholar
  66. Sinfield, P., et al. (2009). Men’s and carers’ experiences of care for prostate cancer: A narrative literature review. Health Expectations, 12, 301–312.PubMedPubMedCentralGoogle Scholar
  67. Soloway, C. T., Soloway, M. S., Kim, S. S., & Kava, B. R. (2005). Sexual, psychological and dyadic qualities of the prostate cancer ‘couple’. BJU International, 95(6), 780–785.PubMedGoogle Scholar
  68. Stanford, J. L., Feng, Z., Hamilton, A. S., Gilliland, F. D., Stephenson, R. A., Eley, J. W., et al. (2000). Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: The prostate cancer outcomes study. Journal of the American Medical Association, 283, 354–360.PubMedGoogle Scholar
  69. Stansbury, J. P., Mathewson-Chapman, M., & Grant, K. E. (2005). Gender schema and prostate cancer: Veterans’ cultural model of masculinity. Medical Anthropology, 22, 175–204.Google Scholar
  70. Steer, A. N., Aherne, N. J., Gorzynska, K., Hoffman, M., Last, A., Hill, J., et al. (2013). Decision regret in men undergoing dose-escalated radiation therapy for prostate cancer. International Journal of Radiation Oncology, 86(4), 716–720.Google Scholar
  71. Thompson, R. (2014). Hear me now one year on. BME Cancer Communities. Retrieved May 31, 2018, from
  72. Weinrich, S. P., Boyd, M. D., Bradford, D., et al. (1998). Recruitment of African Americans into prostate cancer screening. Cancer Practice, 6(1), 23–30.PubMedGoogle Scholar
  73. Wiechno, P. J., Sadowska, M., Kalinowksi, T., Michalski, W., & Demkow, T. (2013). Does pharmacological castration as adjuvant therapy for prostate cancer after radiotherapy affect anxiety and depression levels, cognitive functions and quality of life? Psycho-Oncology, 22, 346–351.PubMedGoogle Scholar
  74. Williams, K. C., Hicks, E. M., Chang, N., Connor, S. E., & Maliski, S. L. (2014). Purposeful normalization when caring for husbands recovering from prostate cancer. Qualitative Health Research, 24(3), 306–316.PubMedGoogle Scholar
  75. Winterich, J. A., Grzywacz, J. G., Quandt, S. A., Clark, P. E., Miller, D. P., Acuña, J., et al. (2009). Men’s knowledge and beliefs about prostate cancer: Education, race, and screening status. Ethnicity and Disease, 19(2), 199–203.PubMedGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.University of East LondonLondonUK

Personalised recommendations