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Lampe NM, Barbee H, Tran NM, Bastow S, McKay T. Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach. Int J Aging Hum Dev 2024; 98:39-55. [PMID: 37122150 PMCID: PMC10598237 DOI: 10.1177/00914150231171838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults experience significant health disparities. Examining these disparities has become an international research priority, but gaps remain. In this review article, we summarize major contributions of and ongoing gaps in health disparities research among LGBTQ+ older adults, while focusing on four major content areas: (a) social determinants of health disparities, (b) mental, cognitive, and physical health disparities, (c) reproductive and sexual health disparities, and (d) seeking LGBTQ+-affirming and age-friendly care. Using a structural competency approach, we develop a four-part agenda for this research area that enhances our understanding of how macro-level systems, institutions, and structures drive health disparities among aging LGBTQ+ communities. We also outline future research on structural competency in LGBTQ+ older adult health, while providing recommendations for researchers and clinicians. These recommendations illuminate potential best practices for bettering the health and quality of life of LGBTQ+ older populations.
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Affiliation(s)
- Nik M. Lampe
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
| | - Harry Barbee
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, USA
| | - Nathaniel M. Tran
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Skyler Bastow
- Department of Sociology, Florida State University, Tallahassee, FL, USA
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Tara McKay
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
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Daniels J, Stephenson R, Langer S, Northouse L, Odouli R, Amarasekera C, Vandeneeden S, Langston M. "Ultimately, You Realize You're on Your Own": The Impact of Prostate Cancer on Gay and Bisexual Men Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105756. [PMID: 37239485 DOI: 10.3390/ijerph20105756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/07/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown to disrupt established GB partnership dynamics. Communication barriers often develop within GB relationships affected by PCa, further exacerbating couple tensions, isolating partners, and lowering quality of life for both patients and partners. In order to elaborate on these phenomena following a PCa diagnosis, we conducted focus group discussions with GB men in relationships. Men were recruited nationally through PCa support groups, and after completing consent procedures, they were invited to one of two focus group discussions conducted through video conference. Topics discussed included the diagnosis and medical decision making pertaining to PCa; healthcare provider experiences; the emotional, physical, and sexual impact of PCa diagnosis and treatment; sources of support and appraisal of resources; and partner involvement and communication. There were twelve GB men who participated in focus group discussions that were audio-recorded and transcribed, and analyzed using a thematic approach. GB couple experiences with PCa during and after treatment choice and recovery identified common patient-provider communication barriers. In particular, GB men reported difficulties in disclosing their sexuality and relationship to their providers, limiting conversations about treatment choice and partner engagement in care. Both patients and partners experienced times of being alone after treatment, either by choice or to give space to their partner. However, partners often did not explicitly discuss their preferences for being alone or together, which resulted in partners' disengagement in their relationship and the prostate cancer healthcare process. This disengagement could blunt the notable PCa survival benefits of partnership for GB men.
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Affiliation(s)
- Joseph Daniels
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
| | - Rob Stephenson
- University of Michigan School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
| | - Shelby Langer
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
| | - Laurel Northouse
- University of Michigan School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
| | - Roxana Odouli
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA 94612, USA
| | - Channa Amarasekera
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Stephen Vandeneeden
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA 94612, USA
| | - Marvin Langston
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, CA 94305, USA
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Jackson SS, Patel S, Parker K. Cancer disparities among sexual and gender minority populations. J Natl Med Assoc 2023; 115:S32-S37. [PMID: 37202001 PMCID: PMC10204147 DOI: 10.1016/j.jnma.2023.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/01/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Sarah S Jackson
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shyam Patel
- Sexual & Gender Minority Research Office, National Institutes of Health, Bethesda, MD, USA
| | - Karen Parker
- Sexual & Gender Minority Research Office, National Institutes of Health, Bethesda, MD, USA.
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Wittmann D, Mehta A, McCaughan E, Faraday M, Duby A, Matthew A, Incrocci L, Burnett A, Nelson CJ, Elliott S, Koontz BF, Bober SL, McLeod D, Capogrosso P, Yap T, Higano C, Loeb S, Capellari E, Glodé M, Goltz H, Howell D, Kirby M, Bennett N, Trost L, Odiyo Ouma P, Wang R, Salter C, Skolarus TA, McPhail J, McPhail S, Brandon J, Northouse LL, Paich K, Pollack CE, Shifferd J, Erickson K, Mulhall JP. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022; 19:1655-1669. [PMID: 36192299 DOI: 10.1016/j.jsxm.2022.08.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/18/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships. AIM We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients' and partners' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship. METHODS The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR). OUTCOMES Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel. RESULTS The guidelines account for patients' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship. CLINICAL IMPLICATIONS The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer. STRENGTHS & LIMITATIONS The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries. CONCLUSION The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research. Wittmann D, Mehta A, McCaughan E, et al. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022;19:1655-1669.
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Affiliation(s)
- Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.
| | - Akanksha Mehta
- Department of Urology, Emory University, Atlanta, GA, USA
| | - Eilis McCaughan
- In Memoriam, Ulster University School of Nursing, County Londonderry, Colraine, UK
| | | | - Ashley Duby
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Matthew
- Adult Psychiatry and Health System, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Arthur Burnett
- Department of Urology, Johns Hopkins University, Baltimore, MD, USA
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stacy Elliott
- Departments of Psychiatry and Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | | | - Sharon L Bober
- Department of Psychiatry, Dana Farber Cancer Institute and Harvard University, Boston, MA, USA
| | - Deborah McLeod
- School of Nursing, NS Health Authority and Dalhousie University, Halifax, NS, Canada
| | - Paolo Capogrosso
- Department of Urology, Ciircolo & Fondazione Macchi Hospital, University of Insubria, Varese, Lombardy, Italy
| | - Tet Yap
- Department of Urology, Guys & St Thomas' Hospital, City of London, London, UK
| | - Celestia Higano
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Stacy Loeb
- Department of Urology at NYU Grossman School of Medicine, New York, NY, USA
| | - Emily Capellari
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Michael Glodé
- Department of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA
| | - Heather Goltz
- School of Social Work, University of Houston-Downtown, Houston, TX, USA
| | - Doug Howell
- Patient with Lived Experience, Keaau, HI, USA
| | - Michael Kirby
- Faculty of the Health and Human Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Nelson Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Landon Trost
- Department of Urology, Brigham Young University, Provo, UT, USA; Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | - Run Wang
- Department of Surgery-Urology, University of Texas McGovern Medical School, Houston, TX, USA; Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Carolyn Salter
- Department of Urology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Ted A Skolarus
- Department of Urology, University of Michigan, Ann Arbor, MI, USA; VA Health Services Research & Development, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - John McPhail
- Patient and Partner with Lived Experience, Okemos, MI, USA
| | - Susan McPhail
- Patient and Partner with Lived Experience, Okemos, MI, USA
| | - Jan Brandon
- Partner with Lived Experience, Nashville, TN, USA
| | | | - Kellie Paich
- Clinical Quality and Survivorship, Movember Foundation, Culver City, CA, USA
| | - Craig E Pollack
- Department of Health Policy Management, Johns Hopkins University, Baltimore, MD, USA
| | - Jen Shifferd
- Department of Physical Therapy and Rehabilitation Medicine, Michigan Medicine Therapy Services, Ann Arbor, MI, USA
| | - Kim Erickson
- Department of Physical Therapy and Rehabilitation Medicine, Michigan Medicine Therapy Services, Ann Arbor, MI, USA
| | - John P Mulhall
- Department of Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Wheldon CW, Polter EJ, Simon Rosser BR, Kapoor A, Talley KMC, Haggart R, Kohli N, Konety BR, Mitteldorf D, Ross MW, West W, Wright M. Pain and Loss of Pleasure in Receptive Anal Sex for Gay and Bisexual Men following Prostate Cancer Treatment: Results from the Restore-1 Study. JOURNAL OF SEX RESEARCH 2022; 59:826-833. [PMID: 34219559 PMCID: PMC8720903 DOI: 10.1080/00224499.2021.1939846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Prostate cancer treatments disrupt receptive anal intercourse (RAI) for gay and bisexual men (GBM). Sexual dysfunction following prostate cancer treatment may include severe pain in the anorectum during RAI (i.e., anodyspareunia). The purpose of this study was to explore the impact of prostate cancer and its treatments on RAI among GBM. Data were from a cross-sectional online survey of 100 GBM prostate cancer survivors who reported pleasurable RAI prior to treatment. Approximately 47% of the sample reported recent RAI, which was more common among GBM in long-term relationships. RAI was also associated with engagement in other sexual behaviors (e.g., oral and insertive anal sex). Anodyspareunia was reported by 23% of the men who had attempted recent RAI. Anodyspareunia was negatively associated with mental health, performing oral sex on a partner, and bowel function. The overwhelming majority received no information from their healthcare providers about loss of RAI function prior to prostate cancer treatment. Culturally responsive cancer survivorship care may need to address the loss of RAI function for GBM prostate cancer survivors.
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Affiliation(s)
- Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA USA
| | - Elizabeth J. Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aditya Kapoor
- Department of Radiology, Trinity Teleradiology Services, Vancouver, BC, Canada
| | - Kristine M. C. Talley
- Adult and Gerontological Health, University of Minnesota School of Nursing School, Minneapolis, Minnesota, USA
| | - Ryan Haggart
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Michael W. Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Wells-Prado DR, Ross MW, Rosser BRS, Polter EJ, Capistrant BD, Haggart R, Kohli N, Konety BR, Mitteldorf D, Talley KMC, West W, Wheldon CW. Prostate cancer disclosure and sexual orientation: Understanding outness to healthcare providers as a situational or consistent phenomenon. PATIENT EDUCATION AND COUNSELING 2022; 105:2033-2037. [PMID: 34865891 PMCID: PMC9126994 DOI: 10.1016/j.pec.2021.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/03/2021] [Accepted: 11/19/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE In this study, we investigated if outness is more a situational or a consistent characteristic in gay, bisexual, and other men who have sex with men (GBM) treated for prostate cancer and how the disclosure of sexual orientation impacts provider discussions of sexual side effects. METHODS Data came from Restore, an online cross-sectional survey of 193 GBM prostate cancer survivors living in North America and were analyzed using various statistical models. RESULTS Disclosure of sexual orientation and of living with prostate cancer were not significantly correlated. Participants who were out regarding sexual orientation were more likely to report that their surgeons and urologists discussed the sexual side effects of treatment. CONCLUSION Outness appears to be a situational phenomenon. GBM prostate cancer survivors who were out regarding sexual orientation received more discussion surrounding sexual side effects of prostate cancer treatment from their providers. PRACTICE IMPLICATIONS It is important for healthcare providers to inquire about patient's sexual orientation to provide holistic care to these patients to address health disparities within this group.
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Affiliation(s)
- Daniel R Wells-Prado
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA.
| | - Michael W Ross
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA.
| | - B R Simon Rosser
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St., Minneapolis, MN 55454, USA.
| | - Elizabeth J Polter
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St., Minneapolis, MN 55454, USA.
| | - Bea D Capistrant
- School of Social Work, Smith College, Lilly Hall 23 West St., Northampton, MA 01063, USA.
| | - Ryan Haggart
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA; Department of Urology, University of Minnesota, 909 Fulton Street SE, Minneapolis, MN 55414, USA.
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA.
| | - Badrinath R Konety
- Department of Urology, Rush Medical College, 600S Paulina St Suite 524, Chicago, IL 60612, USA.
| | - Darryl Mitteldorf
- Malecare Cancer Support, 63 Avenue A, apt 13i, New York, NY 10009, USA.
| | - Kristine M C Talley
- School of Nursing, University of Minnesota, 308 SE Harvard St, Minneapolis, MN 55455, USA.
| | - William West
- Department of Writing Studies, University of Minnesota, 315 Pillsbury Dr SE, Minneapolis, MN 55455, USA.
| | - Christopher W Wheldon
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
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Mitchell E, Ziegler E. Sexual Dysfunction in Gay and Bisexual Prostate Cancer Survivors: A Concept Analysis. JOURNAL OF HOMOSEXUALITY 2022; 69:1119-1139. [PMID: 33818298 DOI: 10.1080/00918369.2021.1905384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual dysfunction is a common side effect of prostate cancer (PCa) treatment, yet it remains poorly defined in the literature. Current definitions are based on heteronormative assumptions which do not consider the unique experiences of gay and bisexual (GBM) PCa survivors. The purpose of this paper is to use Walker and Avant's method to conduct a concept analysis of sexual dysfunction among GBM in the context of PCa survivorship. The review included 46 articles published between 2002-2019. The following attributes were identified: (1) erectile dysfunction, (2) ejaculatory change (anhedonia/anejaculation), (3) urinary incontinence/climacturia, and (4) anodyspareunia. For GBM PCa survivors, sexual dysfunction involves reduced or abnormal functioning of four core elements of a sexual encounter, which inhibit GBM from engaging in and being satisfied with sexual activity.
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Affiliation(s)
- Evan Mitchell
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Erin Ziegler
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Wheldon CW, Polter E, Rosser BRS, Bates AJ, Haggart R, Wright M, Mitteldorf D, Ross MW, Konety BR, Kohli N, Talley KMC, West W, Tatum AK. Prevalence and Risk Factors for Sexually Transmitted Infections in Gay and Bisexual Prostate Cancer Survivors: Results From the Restore-2 Study. Front Oncol 2022; 12:832508. [PMID: 35600390 PMCID: PMC9117614 DOI: 10.3389/fonc.2022.832508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Equitable cancer survivorship care for gay and bisexual male (GBM) prostate cancer survivors should be responsive to their sexual health needs. Rates of sexually transmitted infections (STIs) are higher among GBM compared to heterosexual men across the lifespan. In addition, evidence suggests that GBM will use a variety of strategies to cope with sexual dysfunction that may increase risk for STIs. The purpose of this study was to determine the prevalence of STIs following prostate cancer treatment among GBM and identify risk factors. Methods In 2019, 401 GBM previously treated for prostate cancer were recruited into the Restore-2 Study. They completed a baseline online questionnaire with items assessing STIs diagnosed since being treated for prostate cancer. Any STI diagnoses was regressed on demographic, clinical, and relationship related variables using binary logistic regression. Results Forty-five participants (11.4%) were diagnosed with an STI during or following their prostate cancer treatment. The mostly commonly diagnosed STI was syphilis (4.3%), followed by gonorrhoea (2.8%), and chlamydia (2.5%). Four participants were infected with HIV following their prostate cancer treatment. Independent risk factors for STI diagnosis included time since prostate cancer diagnosis (aOR = 1.18; 95% CI: 1.10-1.26), nonmonogamous sexual relationship (aOR = 11.23; 95% CI: 2.11-59.73), better sexual function (aOR = 1.02; 95% CI: 1.01-1.04), penile injection treatment (aOR = 3.28; 95% CI: 1.48-7.29), and multiple sex partners (aOR = 5.57; 95% CI: 1.64-18.96). Conclusions GBM prostate cancer survivors are at risk for STIs. Culturally responsive STI prevention should be incorporated into cancer survivorship plans, particularly as men are treated for and regain sexual function over time.
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Affiliation(s)
- Christopher W. Wheldon
- Cancer Health Equity, Education and Research Lab, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
- *Correspondence: Christopher W. Wheldon,
| | - Elizabeth Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Alex J. Bates
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ryan Haggart
- Department of Urology, University of Minnesota, Minneapolis, MN, United States
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - Michael W. Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Kristine M. C. Talley
- Adult and Geriatric Health, University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
| | - Alexander K. Tatum
- Department of Counseling Psychology, Social Psychology, and Counseling, College of Health, Ball State University, Muncie, IN, United States
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Bates AJ, Rosser BRS, Polter EJ, Wheldon CW, Talley KMC, Haggart R, Wright M, Mitteldorf D, West W, Ross MW, Konety BR, Kohli N. Racial/Ethnic Differences in Health-Related Quality of Life Among Gay and Bisexual Prostate Cancer Survivors. Front Oncol 2022; 12:833197. [PMID: 35494011 PMCID: PMC9043609 DOI: 10.3389/fonc.2022.833197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Prostate cancer treatment has established effects on the health-related quality of life (HRQOL) of patients. While racial/ethnic differences in HRQOL have been explored in heterosexual patients, this is the first study to examine racial/ethnic differences in a cohort of sexual minority prostate cancer survivors. Methods We used data from the Restore-1 study, an online cross-sectional survey of sexual and gender minority (SGM) prostate cancer survivors in North America, to explore the association between race/ethnicity and HRQOL. General mental and physical HRQOL was assessed using the Short-Form Health Survey version 2 (SF-12). The frequency and distress of prostate cancer specific symptoms was assessed using the Expanded Prostate Cancer Composite (EPIC) scale. Multivariable linear regression was used to estimate mean differences in HRQOL between sexual minority men of color and their white, non-Hispanic counterparts after adjustment for pertinent demographic and medical characteristics. Results Among 190 participants, 23 (12%) self-identified as non-white and/or Hispanic. In unadjusted analysis, sexual minority men of color compared to their white counterparts reported worse HRQOL scores in the EPIC hormonal summary (73.8 vs. 81.8) and hormonal function (70.9 vs 80.5) domains. Clinically important differences between men of color and their white counterparts were seen in the EPIC bowel function (mean difference (MD): -4.5, 95% CI: -9.9, 0.8), hormonal summary (MD: -8.0, 95% CI: -15.6, -0.4), hormonal function (MD: -9.6, 95% CI: -17.6, -1.6), and hormonal bother (MD: -6.7, 95% CI: -14.4, 1.1) domains. After adjustment for covariates, clinically important differences persisted between men of color and white, non-Hispanic men on the hormonal summary (74.4 vs. 81.7), hormonal function (71.3 vs. 80.3), and hormonal bother (77.0 vs. 82.7) domains. Conclusions This exploratory study provides the first evidence that sexual minority men of color may have worse HRQOL outcomes compared to white, non-Hispanic sexual minority men following prostate cancer treatment.
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Affiliation(s)
- Alex J Bates
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Kristine M C Talley
- Adult and Geriatric Health, University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - Ryan Haggart
- Department of Urology, University of Minnesota, Minneapolis, MN, United States
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
| | - Michael W Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
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10
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EDITORIAL COMMENT. Urology 2022; 163:124-125. [DOI: 10.1016/j.urology.2021.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022]
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11
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Development of a Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-With-Men With Prostate Cancer. Sex Med 2022; 10:100480. [PMID: 35149341 PMCID: PMC9023244 DOI: 10.1016/j.esxm.2021.100480] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 12/24/2022] Open
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12
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Polter EJ, Kohli N, Rosser BS, Talley KM, Wheldon CW, Hoefer CJ, Wright M, Haggart R, Mitteldorf D, Kilian G, Konety BR, Ross MW, West W. Creation and Psychometric Validation of the Sexual Minorities and Prostate Cancer Scale (SMACS) in Sexual Minority Patients-The Restore-2 Study. J Sex Med 2022; 19:529-540. [PMID: 35131199 PMCID: PMC8893317 DOI: 10.1016/j.jsxm.2021.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Existing measures of sexual functioning in prostate cancer survivors focus primarily on erectile function and do not adequately measure the experiences of sexual minority men. AIM To develop and psychometrically evaluate a new scale to measure sexual functioning among sexual minority men with prostate cancer. METHODS Sexual minority prostate cancer patients (n = 401) completed an online battery of urinary and sexual functioning tests in 2019, including a new 37-item instrument about their sexual functioning post-treatment for prostate cancer. OUTCOMES We used confirmatory factor analysis to determine the construct validity of a new scale including five subscales: a four-factor model for all participants (n = 401) evaluated Sexual Satisfaction, Sexual Confidence, Frequency of Sexual Problems, and Urinary Incontinence in Sex. A single-factor model completed only by participants who had attempted or desired receptive anal sex (n = 255) was evaluated in the fifth subscale: Problematic Receptive Anal Sex. To evaluate criterion validity, we calculated the intercorrelations between each Sexual Minorities and Prostate Cancer Scale (SMACS) subscale and four related scales: the Expanded Prostate Cancer Index Composite-50 (EPIC), the Functional Assessment of Cancer Therapy-Prostate, the Brief Symptom Inventory-18, and the International Consultation on incontinence questionnaire. Cronbach's alphas were calculated to measure internal consistency (ie, reliability). RESULTS Cronbach's alpha values ranged from 0.64 to 0.89. Loadings (0.479-0.926) and model fit indices were strong (Root Mean Square Error of Approximation: 0.085, Standardized root mean squared residual: 0.063, comparative fit index: 0.927, Tucker-Lewis Index: 0.907). For criterion validity, Sexual Satisfaction, Sexual Confidence, and Frequency of Sexual Problems were moderately correlated with EPIC function and bother scores (r = 0.50-0.72) and Urinary incontinence in sex correlated moderately with EPIC Urinary Function and International Consultation on incontinence questionnaire scores (0.45-0.56). CLINICAL IMPLICATIONS The SMACS can be used by clinicians and researchers to comprehensively measure sexual functioning in sexual minority men, in conjunction with existing scales. STRENGTHS AND LIMITATIONS This new scale is validated in a large, geographically diverse cohort of sexual minority cancer survivors and fills an important gap in existing measures of sexual functioning. Limitations include a lack of a validation sample. CONCLUSION The SMACS is a valid and reliable new scale that measures sexual minority men's experience of urinary incontinence in sex, problematic receptive anal sex, and sexual distress. Polter EJ, Kohli N, Rosser BRS, et al. Creation and Psychometric Validation of the Sexual Minorities and Prostate Cancer Scale (SMACS) in Sexual Minority Patients-The Restore-2 Study. J Sex Med 2022;19:529-540.
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Affiliation(s)
- Elizabeth J. Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - B.R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristine M.C. Talley
- Adult and Gerontological Health Cooperative, University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Chris J. Hoefer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ryan Haggart
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Gudrun Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Michael W. Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
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13
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van der Kamp J, Betten AW, Krabbenborg L. In their own words: A narrative analysis of illness memoirs written by men with prostate cancer. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:236-252. [PMID: 34855224 PMCID: PMC9300072 DOI: 10.1111/1467-9566.13412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 06/03/2023]
Abstract
By drawing on a narrative analysis of 11 autobiographical illness memoirs, this article investigates the complexities of what it means to live with prostate cancer over a period of time. Acknowledging how cancer disrupts everyday life, we focus on the day-to-day experiences and struggles that take place inside and outside the hospital. By building on illustrative quotes from the memoirs, we discuss different facets of cancer as a lived experience. Our findings show that men reconstruct their identity in the memoirs in response to the disruptive nature of cancer by including various identities from previous times. They describe a relationship with their cancer that is fluid and fitful and often depends on place, time and circumstances. We also found that the 'not knowing' of prostate cancer creates uncertainty, which can take different forms, transcends time and is shaped through medical technologies, continual testing and disagreeing doctors. Prostate cancer is often seen as easily treatable, but our findings call for a different way of looking at its impact. We argue that memoirs, written by men themselves, make it palpable what it means to live with cancer. As such, illness memoirs offer a way to advance our sociological understanding of cancer-as-a-lived experience.
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Affiliation(s)
- Jill van der Kamp
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
| | - Afke Wieke Betten
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
| | - Lotte Krabbenborg
- Institute for Science in SocietyRadboud UniversityNijmegenThe Netherlands
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14
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Drysdale K, Cama E, Botfield J, Bear B, Cerio R, Newman CE. Targeting cancer prevention and screening interventions to LGBTQ communities: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1233-1248. [PMID: 33316150 DOI: 10.1111/hsc.13257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Although some people within LGBTQ communities are at risk of developing some cancers at higher rates than non-LGBTQ people, there is limited evidence of the outcomes of targeted cancer prevention and screening interventions for these communities. This scoping review examined key findings regarding the feasibility, acceptability and efficacy of evaluated intervention studies conducted in high income settings and published in peer reviewed literature (2014-2020) by combining evidence of both cancer risk-reducing behavioural interventions and screening and preventative practice interventions. While there is limited evidence of stronger outcomes from targeted interventions with cohorts of gender and sexuality diverse communities, compared with the use of mainstream or untailored interventions, there is stronger evidence that targeted interventions are more acceptable to these communities and may be more feasible in some contexts. Thus, there is benefit in understanding what targeting entails in these interventions, and to understand what influences acceptability, to inform the design and delivery of such interventions.
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Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Jessica Botfield
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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15
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West W, Torres MB, Mitteldorf D, Capistrant BD, Konety BR, Polter E, Rosser BRS. The Challenge of Coming Out to Providers by Gay and Bisexual Men With Prostate Cancer: Qualitative Results from the Restore Study. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:426-438. [PMID: 36035335 PMCID: PMC9417115 DOI: 10.1080/19317611.2021.1924335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 06/01/2023]
Abstract
This study investigates the experience of communicating sexual orientation by gay, bisexual and men who have sex with men (GBM) to physicians involved in their prostate cancer care. Methodology consisted of qualitative analysis conducted on 30 in-depth interviews of GBM recruited from a national online cancer support site. Results revealed four key strategies around sexual disclosure. These ranged from explicitly outing themselves to selective or non-disclosure. Disclosures had unpredictable multiple outcomes ranging from increased trust in the patient-physician relationship to seeking alternate treatment. We concluded competent care is achieved when physicians know their patient's sexual orientation, and are trained in them.
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Affiliation(s)
- William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | | | - Badrinath R. Konety
- Department of Urology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elizabeth Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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16
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Ralph S. Developing UK Guidance on How Long Men Should Abstain from Receiving Anal Sex before, During and after Interventions for Prostate Cancer. Clin Oncol (R Coll Radiol) 2021; 33:807-810. [PMID: 34362626 DOI: 10.1016/j.clon.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Affiliation(s)
- S Ralph
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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17
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Boehmer U, Ozonoff A, Winter M, Berklein F, Potter J, Hartshorn KL, Ward KC, Ceballos RM, Clark MA. Health-related quality of life among colorectal cancer survivors of diverse sexual orientations. Cancer 2021; 127:3847-3855. [PMID: 34237147 DOI: 10.1002/cncr.33762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of this study was to examine the health-related quality of life of sexual minority survivors in comparison with heterosexual survivors. METHODS Four hundred eighty eligible survivors participated in a telephone survey that measured survivors' outcomes, which consisted of physical and mental quality of life and self-rated fair or poor health. These survivors were diagnosed with stage I, II, or III colorectal cancer an average of 3 years before the survey and were recruited from 4 cancer registries. Using forward selection with generalized linear models or logistic regression models, the authors considered 4 domains-personal factors, environmental factors, health condition characteristics, and body function and structure-as correlates for each survivorship outcome. RESULTS The authors found that unadjusted physical quality of life and self-rated fair/poor health were similar for all survivors. Sexual minority survivors had poorer unadjusted mental quality of life in comparison with heterosexual survivors. After adjustments for covariates, this difference was no longer statistically significant. Three domains (personal factors, health condition characteristics, and body function and structure) explained colorectal cancer survivors' fair/poor health and 46% of the variance in physical quality of life, whereas 56% of the variance in mental quality of life was explained by personal factors, body function and structure, and environmental factors. CONCLUSIONS This study has identified modifiable factors that can be used to improve cancer survivors' quality of life and are, therefore, relevant to ongoing efforts to improve the survivorship experience.
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Affiliation(s)
- Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Al Ozonoff
- Harvard Medical School, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts
| | - Michael Winter
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Flora Berklein
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Jennifer Potter
- Harvard Medical School, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Fenway Institute, Boston, Massachusetts
| | - Kevan L Hartshorn
- Section of Hematology Oncology, Boston University School of Medicine, Boston, Massachusetts
| | - Kevin C Ward
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Rachel M Ceballos
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Melissa A Clark
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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18
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Kinnaird W, Kirby MG, Mitra A, Davda R, Jenkins V, Payne H. The management of sexual dysfunction resulting from radiotherapy and androgen deprivation therapy to treat prostate cancer: A comparison of uro-oncology practice according to disease stage. Int J Clin Pract 2021; 75:e13873. [PMID: 33260255 DOI: 10.1111/ijcp.13873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/15/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To establish current uro-oncology practice in the management of sexual dysfunction (SD) following radiotherapy (RT) and/or androgen deprivation therapy (ADT) to treat prostate cancer. To identify differences in approach to the management of SD according to disease stage. SUBJECTS AND METHODS A 14-question mixed methods survey was designed to assess the current UK practice. Closed- and open-ended questions were used to quantify results while allowing participants to expand on answers. The survey was distributed to members of the British Uro-Oncology Group at the 2019 annual meeting. RESULTS Surveys were completed by 63 uro-oncologists attending the annual meeting of the British Uro-Oncology Group (response rate 66%). The major issue highlighted was a difference in approach to managing SD according to disease stage. More than half of the participants (56%) said 'advanced stage of disease' was a barrier to discussing SD. Clinicians were less likely to discuss SD, take baseline assessments, refer to a specialist clinic or offer rehabilitation when dealing with patients with advanced disease. Only a minority said that the management of SD was primarily their responsibility (11%). Nearly all clinicians (92%) had access to SD clinics; however, the majority of clinicians did not routinely refer patients. CONCLUSIONS This study shows that men with advanced prostate cancer need better support in managing SD. Patients receiving long-term ADT are less likely to be offered any kind of help or intervention. Specific guidance on managing SD in this cohort may result in improvements in sexual function, emotional well-being, quality of life, mental health and confidence.
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Affiliation(s)
- William Kinnaird
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Anita Mitra
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Reena Davda
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Valerie Jenkins
- Sussex Health Outcomes Research and Education in Cancer, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Heather Payne
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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19
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Nasser NJ, Klein J, Agbarya A. Markers of Toxicity and Response to Radiation Therapy in Patients With Prostate Cancer. Adv Radiat Oncol 2021; 6:100603. [PMID: 33490732 PMCID: PMC7811126 DOI: 10.1016/j.adro.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 02/07/2023] Open
Abstract
The main treatment modalities for localized prostate cancer are surgery and radiation. Surgery removes the whole prostate gland, whereas with radiation therapy the irradiated prostate remains within the patient's body. Biomarkers specific to the prostate gland should become undetectable after surgery, but this is not the case when radiation therapy is used, as residual prostate cells may still be metabolically active. Here, we review the role of tumor markers of toxicity and response to radiation therapy in patients with prostate cancer, including prostate specific antigen, human kallikrein 2, osteopontin, prostate cancer associated 3, citrulline, and others.
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Affiliation(s)
- Nicola J. Nasser
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan Klein
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Abed Agbarya
- Institute of Oncology, Bnai Zion Medical Center, Haifa, Israel
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20
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Honaryar MK, Tarasenko Y, Almonte M, Smelov V. Epidemiology of Cancers in Men Who Have Sex with Men (MSM): A Protocol for Umbrella Review of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4954. [PMID: 32660003 PMCID: PMC7400300 DOI: 10.3390/ijerph17144954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022]
Abstract
While earlier studies on men having sex with men (MSM) tended to examine infection-related cancers, an increasing number of studies have been focusing on effects of sexual orientation on other cancers and social and cultural causes for cancer disparities. As a type of tertiary research, this umbrella review (UR) aims to synthesize findings from existing review studies on the effects of sexual orientation on cancer. Relevant peer-reviewed systematic reviews (SRs) will be identified without date or language restrictions using MEDLINE, Cochrane Database of Systematic Reviews, and the International Prospective Register for Systematic Reviews, among others. The research team members will prepare the data extraction forms. Two reviewers will independently assess extracted SRs using the Assessment of Methodological Quality of Systematic Reviews. A third reviewer will weigh in to resolve discrepancies. The reviewers will be blinded to publisher, journal, and authors, making their judgements on the title, year, and abstract. The Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist will guide data synthesis. By collating evidence from multiple reviews into one accessible and usable document, our first UR on global epidemiology of malignancies among MSM would serve as an evidence-based decision-making tool for the public health community.
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Affiliation(s)
- Manoj Kumar Honaryar
- Prevention and Implementation Group (PRI), International Agency for Research on Cancer (IARC), World Health Organization (WHO), 150 Cours Albert Thomas, 69372 Lyon, France; (M.K.H.); (M.A.)
- Service des Urgences, Hôpital Lariboisiere, Assistance Publique Hôpitaux de Paris (Aphp), 2 Rue Ambroise Paré, 75010 Paris, France
| | - Yelena Tarasenko
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Dr, Statesboro, GA 30458, USA;
| | - Maribel Almonte
- Prevention and Implementation Group (PRI), International Agency for Research on Cancer (IARC), World Health Organization (WHO), 150 Cours Albert Thomas, 69372 Lyon, France; (M.K.H.); (M.A.)
| | - Vitaly Smelov
- Prevention and Implementation Group (PRI), International Agency for Research on Cancer (IARC), World Health Organization (WHO), 150 Cours Albert Thomas, 69372 Lyon, France; (M.K.H.); (M.A.)
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark
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21
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Rosser BRS, Kohli N, Polter EJ, Lesher L, Capistrant BD, Konety BR, Mitteldorf D, West W, Dewitt J, Kilian G. The Sexual Functioning of Gay and Bisexual Men Following Prostate Cancer Treatment: Results from the Restore Study. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1589-1600. [PMID: 31016492 PMCID: PMC8559526 DOI: 10.1007/s10508-018-1360-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 05/19/2023]
Abstract
Prostate cancer is the second most common cancer in gay, bisexual, and other men who have sex with men (GBM). Few studies have assessed the effects of treatment on GBM's sexual behavior. For an online survey, 193 gay and bisexual men with prostate cancer were recruited from the North American's largest online cancer support group. Sexual functioning was measured using the Expanded Prostate Cancer Index Composite (EPIC) and a tailored Gay Sexual Functioning Inventory (GSFI). GBM have worse EPIC urinary and hormonal function and worse hormonal bother, but better sexual function and bother scores than published norms. In the GSFI, two-thirds of participants described their sexual functioning, post-treatment, as fair to poor. Only 22% reported erections sufficient for insertive anal sex. For receptive anal sex, one-third met criteria for anodyspareunia. Over half reported urination problems during sex or at orgasm. Erectile difficulties were common, severe, and a reason cited for not using condoms. Three men HIV seroconverted post-prostate cancer treatment. Differences in function and bother scores were observed by type of treatment, age, race/ethnicity, sexual orientation, but not relationship status. Sexual functioning significantly predicted long-term mental and physical health. GBM scored significantly worse on mental health and better on physical health than published norms. Sexual recovery after prostate cancer treatment is problematic for most GBM. Research to develop more effective sexual recovery, tailored to the needs of GBM treated for prostate cancer, is needed. Six implications for clinicians treating GBM with prostate cancer are identified.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA.
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | - Lindsey Lesher
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | | | | | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
| | - James Dewitt
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | - Gunna Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
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22
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McInnis MK, Pukall CF. Sex After Prostate Cancer in Gay and Bisexual Men: A Review of the Literature. Sex Med Rev 2020; 8:466-472. [DOI: 10.1016/j.sxmr.2020.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
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23
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Amarasekera C, Wong V, Jackson K, Yura E, Patel M, Manjunath A, Kundu S. A Pilot Study Assessing Aspects of Sexual Function Predicted to Be Important After Treatment for Prostate Cancer in Gay Men: An Underserved Domain Highlighted. LGBT Health 2020; 7:271-276. [PMID: 32584648 DOI: 10.1089/lgbt.2018.0245] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Existing questionnaires assessing sexual function after prostate cancer (PCa) were developed in predominantly heterosexual male cohorts and may measure function incompletely in gay men. We sought to determine if there are sexual function domains relevant to gay men that are not captured by the Expanded Prostate Cancer Index Composite (EPIC) sexual function assessment. Methods: Fifty-three gay men with PCa responded to an online survey regarding the applicability of the sexual function domain in the validated EPIC questionnaire. They were then queried about whether the prostate is a source of sexual pleasure and the importance of measuring sexual satisfaction as it relates to receptive anal intercourse. Results: A majority of gay men with PCa found the EPIC sexual function tool to be applicable when measuring erectile function (76.5%). Of the men queried, 64.2% felt that the prostate is a source of sexual pleasure and 52.8% felt it important to measure sexual satisfaction associated with receptive anal intercourse. A larger proportion of gay men who engaged in receptive anal intercourse, compared with those who did not engage in receptive anal intercourse, felt that the prostate is a source of sexual pleasure (100% vs. 57.1%), and thought it important to measure sexual satisfaction as it relates to receptive anal intercourse after PCa treatment (90.0% vs. 45.2%). Conclusions: Our findings highlight the need to create a validated questionnaire to measure sexual satisfaction from receptive anal intercourse to help care for men engaging in receptive anal intercourse after PCa treatment.
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Affiliation(s)
- Channa Amarasekera
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Vincent Wong
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Kathryn Jackson
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Emily Yura
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Mehul Patel
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Adarsh Manjunath
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Shilajit Kundu
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Abstract
Prostate cancer is the second most common cause of cancer-related death in men in the USA, but the effect of prostate cancer diagnosis and treatment on men in a sexual minority group, including men who have sex with men and transgender women, is poorly understood. Efforts to study this population are complicated, as cancer registries do not routinely collect information on sexual orientation. As a result, epidemiological data regarding this population have come from small studies that have included disparate rates of prostate cancer screening, diagnosis and treatment. Qualitative studies indicate that prostate cancer is experienced differently by sexual minorities, with distinct health-care needs that arise owing to differences in sexual practices, social support systems and relationships with the medical community. Notably, sexual minorities have been reported to experience poorer health-related quality of life outcomes than heterosexual men, and tend to have less robust social support systems, experience increased psychological distress caused by sexual dysfunction (areas of which are unmeasured after treatment), experience isolation within the health-care system and express increased levels of dissatisfaction with treatment. The incidence of prostate cancer actually seems to be decreased in men from sexual minorities living with HIV, despite there being no differences in screening and treatment, with poor cancer-specific mortality. Although the literature on patients with prostate cancer in men from sexual minority groups has historically been sparse, peer-reviewed research in this area has grown considerably during the past decade and has become an important field of study.
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25
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Higa DH, Crepaz N, McDonald CM, Adegbite-Johnson A, DeLuca JB, Kamitani E, Sipe TA. HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988-2017. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:1-S7. [PMID: 32073309 DOI: 10.1521/aeap.2020.32.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988-2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Affiliation(s)
- Darrel H Higa
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Nicole Crepaz
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Christina M McDonald
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | | | - Julia B DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Emiko Kamitani
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
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Rosser BRS, Hunt SL, Capistrant BD, Kohli N, Konety BR, Mitteldorf D, Ross MW, Talley KM, West W. Understanding Prostate Cancer in Gay, Bisexual, and Other Men Who Have Sex with Men and Transgender Women: A Review of the Literature. CURRENT SEXUAL HEALTH REPORTS 2019; 11:430-441. [PMID: 31929765 PMCID: PMC6953377 DOI: 10.1007/s11930-019-00234-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW a)Prostate cancer in sexual and gender minorities is an emerging medical and public health concern. The purpose of this review is to summarize the state of the science on prostate cancer in gay, bisexual, and other men who have sex with men (GBM) and transgender women (TGW). We undertook a literature review of all publications on this topic through February 2017. With 88 unique papers (83) on prostate cancer in GBM and 5 case reports of prostate cancer in TGW), a small but robust literature has emerged. RECENT FINDINGS b)The first half of this review critiques the literature to date, identifying gaps in approaches to study. The second half summarizes the key findings in eleven areas. In light of this admittedly limited literature, GBM appear to be screened for prostate cancer less than other men, but they are diagnosed with prostate cancer at about the same rate. SUMMARY c)Compared to other men, GBM have poorer urinary, bowel, and overall quality-of-life outcomes but better sexual outcomes after treatment; all these findings need more research. Prostate cancer in TGW remains rare and under researched, as the literature is limited to single-case clinical reports.
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Affiliation(s)
- B. R. Simon Rosser
- Division of Epidemiology & Community Health, School of
Public Health, University of Minnesota
| | - Shanda L. Hunt
- Education and Research Services, University of
Minnesota
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of
Minnesota, Minneapolis, MN
| | | | | | - Michael W. Ross
- Department of Family Medicine & Community Health,
Medical School, University of Minnesota, Minneapolis, MN
| | | | - William West
- Department of Writing Studies, University of
Minnesota
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Ussher JM, Perz J, Rose D, Kellett A, Dowsett G. Sexual Rehabilitation After Prostate Cancer Through Assistive Aids: A Comparison of Gay/Bisexual and Heterosexual Men. JOURNAL OF SEX RESEARCH 2019; 56:854-869. [PMID: 29913078 DOI: 10.1080/00224499.2018.1476444] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of assistive aids in sexual rehabilitation after prostate cancer (PCa) was examined in 124 gay, bisexual, and other men who have sex with men (GBM) and 225 heterosexual men. GBM were significantly more likely to use assistive aids (79% versus 56%), to try multiple assistive aids (M = 1.65 versus M = 0.83) including medication, penile injection, penile implant, vacuum pump, and nonmedical sex aids, and to seek information about sexual rehabilitation on the Internet, through counseling, or in a support group. There were no differences between the groups in satisfaction with the use of assistive aids. However, use of aids was a significant negative predictor of sexual functioning for GBM and a significant positive predictor for heterosexual men. Interview accounts described satisfaction with assistive aids in terms of maintaining erectile functioning and relationships. The majority of men in the study also described hindrances, both physical and social, resulting in discontinuation of assistive aids, including perceived artificiality, loss of sexual spontaneity, side effects, failure to achieve erectile response, cost, and lack of access to information and support. It is concluded that the specific needs and concerns of GBM and heterosexual men regarding sexual rehabilitation after PCa need to be addressed by clinicians.
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Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, Western Sydney University
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University
| | - Duncan Rose
- Translational Health Research Institute, Western Sydney University
| | - Andrew Kellett
- Translational Health Research Institute, Western Sydney University
| | - Gary Dowsett
- Australian Research Centre in Sex, Health, and Society, La Trobe University
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Gordon JR, Baik SH, Schwartz KTG, Wells KJ. Comparing the Mental Health of Sexual Minority and Heterosexual Cancer Survivors: A Systematic Review. LGBT Health 2019; 6:271-288. [PMID: 31314662 DOI: 10.1089/lgbt.2018.0204] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose: Sexual minority (SM) individuals are more likely to experience mental health concerns than heterosexual individuals. However, little is known to date about the psychological needs of SM cancer survivors. The objective of this systematic review was to identify whether SM cancer survivors experience disparate psychological outcomes compared with heterosexual cancer survivors. Methods: PubMed/MEDLINE, PsycINFO, CINAHL, Web of Science, and ProQuest databases were searched systematically to identify studies that compared mental health outcomes between SM and heterosexual survivors. A standardized data extraction form was used to extract data from eligible articles. The Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies was used to assess study quality. Results: Twelve studies met the inclusion criteria and assessed distress, depression, anxiety, perceived stress, and mental and emotional quality of life (QOL). Most studies enrolled survivors diagnosed either with female breast cancer or with prostate cancer. Most studies reporting on mental health among women found no differences between SM and heterosexual survivors. Studies conducted among men found that SM survivors experienced higher distress, depression, and anxiety, and lower emotional/mental QOL than heterosexual survivors. Conclusion: The findings of the present synthesis suggest that mental health disparities may exist among SM men diagnosed with cancer, particularly prostate cancer. More research is required to identify mental health disparities among SM survivors diagnosed with other cancers, as well as predisposing and protective factors. In addition, mental health screening and interventions are needed for SM men after cancer diagnosis.
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Affiliation(s)
- Janna R Gordon
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Sharon H Baik
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Karen T G Schwartz
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Kristen J Wells
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
- Department of Psychology, San Diego State University, San Diego, California
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Langston ME, Fuzzell L, Lewis-Thames MW, Khan S, Moore JX. Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States. LGBT Health 2019; 6:192-201. [PMID: 31107153 DOI: 10.1089/lgbt.2018.0112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: A lack of national data makes it difficult to estimate, but LGB adults appear to have a higher risk of cancer. Although limited research exists to explain the disparity, we aimed to explore potential differences in access to and utilization of health information and in cancer-related beliefs and behaviors. Methods: We used data from the Health Information National Trends Survey 5, Cycle 1 conducted from January 25 through May 5, 2017. Using survey-weighted logistic regression, we explored potential differences in health information-seeking behavior, trusted sources of health care information, engagement with the health care system, awareness of cancer risk factors, cancer fatalism, cancer-related health behaviors, and historical cancer screening between 117 LGB and 2857 heterosexual respondents. Results: LGB respondents were more likely to report looking for information about health or medical topics than heterosexual respondents (adjusted odds ratio [aOR]: 3.12; confidence interval [95% CI]: 1.07-9.06), but less likely to seek health information first from a doctor (aOR: 0.17; 95% CI: 0.06-0.50) after adjusting for age, race, and sex. LGB persons were less likely to report that they trust receiving health or medical information from friends and family and more likely to be worried about getting cancer (aOR: 2.30; 95% CI: 1.04-5.05). Conclusions: Our findings indicate a growing need for the production of tailored cancer prevention and control materials for members of sexual minority groups. More work is needed to understand barriers that LGB populations face in accessing this health information and building informative social support networks.
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Affiliation(s)
- Marvin E Langston
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Lindsay Fuzzell
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Marquita W Lewis-Thames
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Justin X Moore
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Alexis O, Worsley AJ. The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies. Am J Mens Health 2018; 12:2076-2088. [PMID: 30112965 PMCID: PMC6199434 DOI: 10.1177/1557988318793785] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 12/02/2022] Open
Abstract
Studies suggest that gay and bisexual men are affected by the psychological aspects of prostate cancer treatment differently than that of heterosexual men; however the data have not yet been synthesized. The focus of this meta-synthesis is to explore gay and bisexual men's experiences of prostate cancer posttreatment. Empirical research published in peer reviewed journals between January 1990 and January 2018 were identified in six databases: CINAHL, Cochrane, Medline, PsycINFO, PubMed, and Web of Science. Titles and abstracts were checked by two reviewers. The six studies that met the inclusion criteria were selected and reviewed for quality and the extracted data were then synthesized. The main themes that emerged were sexual impact, physical and psychological difficulties, challenges to intimacy, and support mechanisms. Gay and bisexual men can have specific sexual roles and developing prostate cancer and undergoing treatment may compromise their ability to perform their sexual role. The needs of heterosexual men were perceived to be accommodated more often than that of gay and bisexual men because of engrained heteronormativity in the health-care system. The review suggests that more support groups specifically for gay and bisexual men should be established, while urologists should cater to the sexual and masculine implications of treatment, and not frame problems for gay and bisexual men in heterosexual terms. By failing to address the salient needs and concerns of gay and bisexual men, health-care professionals are reinforcing invisibility and marginalization of gay and bisexual men with prostate cancer.
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Affiliation(s)
- Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Swindon Campus, UK
| | - Aaron James Worsley
- Faculty of Health and Life Sciences, Oxford Brookes University, Swindon Campus, UK
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Gonzales G, Zinone R. Cancer diagnoses among lesbian, gay, and bisexual adults: results from the 2013-2016 National Health Interview Survey. Cancer Causes Control 2018; 29:845-854. [PMID: 30043193 DOI: 10.1007/s10552-018-1060-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/17/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE The objective of this study was to compare cancer diagnoses by age, gender, and sexual orientation. METHODS This study used data on 129,431 heterosexual adults and 3,357 lesbian, gay, and bisexual (LGB) adults in the 2013-2016 National Health Interview Survey. Logistic regression models compared the prevalence of cancer diagnoses by sexual orientation while controlling for demographics, socioeconomic status, and health profiles. Then, using coefficients from fully adjusted models, we estimated average marginal effects to compare the probability of a cancer diagnosis by sexual orientation across five age categories. RESULTS After controlling for demographic and socioeconomic characteristics, gay men (odds ratio [OR] 1.54; 95% confidence interval [CI] 1.10-2.18) were more likely to have been diagnosed with cancer compared to heterosexual men, and bisexual women (OR 1.70; 95% CI 1.16-2.48) were more likely to have been diagnosed with cancer compared to heterosexual women. Gay men aged 65 years and older were 6.0% points (p < 0.05) more likely to be diagnosed with cancer compared to heterosexual men of the same age. Bisexual women aged 65 years and older were 7.6% points (p < 0.05) more likely to be diagnosed with cancer compared to women of the same age. CONCLUSIONS Some sexual minorities may be at greater risk for cancer (or having a personal history of cancer) compared to heterosexuals. More research on cancer detection, treatment, and survivorship in sexual minorities is critically needed. Health care providers and public health practitioners should be aware of the unique health care needs in LGB adults, including their elevated cancer risks.
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Affiliation(s)
- Gilbert Gonzales
- Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Suite 1200, Nashville, TN, 37203, USA.
| | - Ryan Zinone
- Vanderbilt University School of Medicine, Nashville, TN, 37203, USA
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Capistrant BD, Lesher L, Kohli N, Merengwa EN, Konety B, Mitteldorf D, West WG, Rosser BRS. Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer. Oncol Nurs Forum 2018; 45:439-455. [PMID: 29947351 PMCID: PMC7201404 DOI: 10.1188/18.onf.439-455] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To describe social support patterns of gay and bisexual men with prostate cancer (GBMPCa) and how social support is associated with prostate cancer outcomes. SAMPLE & SETTING A cross-sectional online survey with 186 GBMPCa recruited from a national cancer support group network. METHODS & VARIABLES Descriptive statistics of social support and linear regression of social support on general and prostate cancer-specific quality of life (QOL). Social support and health-related QOL were assessed generally and specific to prostate cancer. RESULTS Participants primarily relied on partners or husbands, gay and bisexual friends, chosen family, and men from support groups for support. The most common types of support received were informational and emotional social support. Low general social support was significantly associated with worse prostate cancer symptom bother and general mental QOL. Wanting more social support was significantly associated with worse prostate cancer-specific and general QOL. IMPLICATIONS FOR NURSING Clinicians should be aware of the different social support networks and needs of GBMPCa and refer them to relevant support groups to improve QOL.
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Rosser BRS, Kohli N, Lesher L, Capistrant BD, DeWitt J, Kilian G, Konety BR, Merengwa E, Mitteldorf D, West W. What Gay and Bisexual Men Treated for Prostate Cancer Want in a Sexual Rehabilitation Program: Results of theRestoreNeeds Assessment. UROLOGY PRACTICE 2018; 5:192-197. [DOI: 10.1016/j.urpr.2017.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Lindsey Lesher
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin D. Capistrant
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James DeWitt
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Gunna Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota
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Editorial Commentary. UROLOGY PRACTICE 2018. [DOI: 10.1016/j.urpr.2017.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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35
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Rosser BRS, Konety BR, Mitteldorf D, Kohli N, Lesher L, West W, Capistrant BD, DeWitt J, Merengwa E, Kilian G. What Gay and Bisexual Men Treated for Prostate Cancer are Offered and Attempt as Sexual Rehabilitation for Prostate Cancer: Results from theRestoreStudy. UROLOGY PRACTICE 2018; 5:187-191. [DOI: 10.1016/j.urpr.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Lindsey Lesher
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin D. Capistrant
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James DeWitt
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Gunna Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Brookman-May SD, Campi R, Henríquez JDS, Klatte T, Langenhuijsen JF, Brausi M, Linares-Espinós E, Volpe A, Marszalek M, Akdogan B, Roll C, Stief CG, Rodriguez-Faba O, Minervini A. Latest Evidence on the Impact of Smoking, Sports, and Sexual Activity as Modifiable Lifestyle Risk Factors for Prostate Cancer Incidence, Recurrence, and Progression: A Systematic Review of the Literature by the European Association of Urology Section of Oncological Urology (ESOU). Eur Urol Focus 2018; 5:756-787. [PMID: 29576530 DOI: 10.1016/j.euf.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 12/19/2022]
Abstract
CONTEXT Smoking, sexual activity, and physical activity (PA) are discussed as modifiable lifestyle factors associated with prostate cancer (PCa) development and progression. OBJECTIVE To evaluate the available evidence concerning the association of smoking, sexual activity, and sports and exercise on PCa risk, treatment outcome, progression, and cancer-specific mortality. EVIDENCE ACQUISITION A systematic review of studies published between 2007 and 2017 using MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement criteria was conducted. EVIDENCE SYNTHESIS While data concerning the impact of smoking on PCa development remain conflicting, there is robust evidence that smoking is associated with aggressive tumor features and worse cancer-related outcome, which seems to be maintained for 10 yr after smoking cessation. Less convincing and limited evidence exists for the association of sexual activity with PCa risk. The findings related to PA and PCa support the inference that exercise might be a useful factor in the prevention of PCa and tumor progression, while it is not finally proved under which specific conditions PA might be protective against disease development. CONCLUSIONS Smoking is associated with aggressive tumor features and worse cancer-related prognosis; as this negative impact seems to be maintained for 10yr after smoking cessation, urologists should advise men to quit smoking latest at PCa diagnosis to improve their prognosis. As several studies indicate a positive impact of exercise on tumor development, progression, and treatment outcome, it is certainly reasonable to advocate an active lifestyle. Least convincing evidence is available for the interaction of sexual activity and PCa, and well-conducted and longitudinal studies are clearly necessary to evaluate whether the suggested associations between PCa risk and sexual behavior are real or spurious. PATIENT SUMMARY In this systematic review, we looked at the impact of smoking, sexual activity, and sports and exercise on prostate cancer risk and outcome after treatment. While the evidence for sexual activity is not overall clear, we found that smoking might lead to more aggressive cancers and result in worse treatment outcome. Physical activity might prevent prostate cancer and improve cancer-related outcomes as well. Hence, it is certainly reasonable to advocate an active lifestyle and advise men to quit smoking.
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Affiliation(s)
| | - Riccardo Campi
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Jose D S Henríquez
- Unidad de Uro-Oncología, Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tobias Klatte
- Department of Urology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Maurizio Brausi
- Department of Urology, B. Ramazzini Hospital, Carpi-Modena, Italy
| | | | - Alessandro Volpe
- Department of Urology, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Martin Marszalek
- Department of Urology and Andrology, Donauspital, Vienna, Austria
| | - Bulent Akdogan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Christina Roll
- Department of Trauma and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians University (LMU) Munich, Munich, Germany
| | - Oscar Rodriguez-Faba
- Unidad de Uro-Oncología, Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
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Thomas C, Wootten AC, Robinson P, Law PCF, McKenzie DP. The impact of sexual orientation on body image, self-esteem, urinary and sexual functions in the experience of prostate cancer. Eur J Cancer Care (Engl) 2018; 27:e12827. [PMID: 29461652 DOI: 10.1111/ecc.12827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 11/27/2022]
Abstract
Prostate cancer (PCa) poses a large health burden globally. Research indicates that men experience a range of psychological challenges associated with PCa including changes to identity, self-esteem and body image. The ways in which sexual orientation plays a role in the experience of PCa, and the subsequent impact on quality of life (QoL), body image and self-esteem have only recently been addressed. By addressing treatment modality, where participant numbers were sufficient, we also sought to explore whether gay (homosexual) men diagnosed with PCa (PCaDx) and with a primary treatment modality of surgery would report differences in body image and self-esteem compared with straight (heterosexual) men with PCaDx with a primary treatment modality of surgery, compared with gay and straight men without PCaDx. The results of our study identified overall differences with respect to PCaDx (related to urinary function, sexual function and health evaluation), and sexual orientation (related to self-esteem), rather than interactions between sexual orientation and PCaDx. Gay men with PCaDx exhibited higher levels of urinary functioning than straight men with PCaDx, the difference being reversed for gay and straight men without PCaDx; but this result narrowly failed to achieve statistical significance, suggesting a need for further research, with larger samples.
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Affiliation(s)
- C Thomas
- Epworth Prostate Centre, Epworth HealthCare, Richmond, Victoria, Australia
| | - A C Wootten
- Smiling Mind, Melbourne, Victoria, Australia
| | - P Robinson
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - P C F Law
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D P McKenzie
- Epworth Research Institute, Epworth HealthCare, Richmond, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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McConkey RW, Holborn C. Exploring the lived experience of gay men with prostate cancer: A phenomenological study. Eur J Oncol Nurs 2018; 33:62-69. [PMID: 29551179 DOI: 10.1016/j.ejon.2018.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/12/2018] [Accepted: 01/30/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE Gay men with prostate cancer are an 'invisible species' in the research literature despite concerns that the impact of treatment may be more profound and in some ways unique compared to heterosexual men. The aim of this research is to explore the lived experience of gay men with prostate cancer. METHOD In-depth interviews were recorded and transcribed verbatim from a purposive sample of eight gay men treated for prostate cancer in Ireland. A qualitative methodological approach employing Giorgi's descriptive phenomenological method was used to collect and analyse data. FINDINGS Three key aspects emerged representing the essence of the participants lived experience; The experience of diagnosis, treatment decision making, and the impact of treatment, with sub-themes of shock of diagnosis, the generalist nature of information, sexual side effects and incontinence, and masculinity and gay identity. Secondly, the experience of the healthcare service with sub-themes of sexual orientation disclosure and communication with the healthcare team; and thirdly, sources of support and means of coping which included significant others, family & friends, cancer support groups, and gay resources and support services. CONCLUSION Gay men with prostate cancer have unmet information and supportive care needs throughout their prostate cancer journey, especially related to the impact of sexual dysfunction and associated rehabilitation, negatively impacting their quality of life. Issues associated with heteronormativity, minority stress, and stigma may influence how gay men interact with the health service, or how they perceive the delivery of care. Healthcare education providers should update prostate cancer education programmes accordingly.
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Affiliation(s)
- Robert W McConkey
- Urology Outpatient Department, Galway University Hospital, Galway, Ireland.
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Abstract
OBJECTIVE To describe lesbian, gay, bisexual, and transgender (LGBT) individuals' barriers to accessing and receiving quality cancer care. DATA SOURCES Published data on cancer care and studies of LGBT individuals. CONCLUSION There is a clustering of barriers among LGBT individuals, which suggests multiple inequities exist in LGBT individuals' cancer care, although data on disparities along the cancer control continuum are not consistently available. IMPLICATIONS FOR NURSING PRACTICE Nurses can make a difference in LGBT individuals' cancer care by obtaining training on LGBT health and their cancer-related needs and by providing a welcoming and respectful relationship with LGBT patients.
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Kelly D, Sakellariou D, Fry S, Vougioukalou S. Heteronormativity and prostate cancer: A discursive paper. J Clin Nurs 2017; 27:461-467. [PMID: 28382781 DOI: 10.1111/jocn.13844] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To discuss the risks that heteronormative assumptions play in prostate cancer care and how these may be addressed. BACKGROUND There is international evidence to support the case that LGBT patients with cancer are less likely to report poor health or self-disclose sexual orientation. Gender-specific cancers, such as prostate cancer, require particular interventions in terms of supportive care. These may include advice about side-effect management (such as incontinence or erectile dysfunction), treatment choices and social and emotional issues. In this paper, we discuss and analyse the heteronormative assumptions and culture that exist around this cancer. We argue that this situation may act as a barrier to effective supportive care for all Lesbian women, Gay, Transgender and Bisexual patients, in this case men who have sex with men. [Correction added on 21 September 2017, after first online publication: The first sentence of the Background section has been revised for clarity in this current version.] DESIGN: Theoretical exploration of heteronormativity considered against the clinical context of prostate cancer. METHODS Identification and inclusion of relevant international evidence combined with clinical discussion. RESULTS This paper posits a number of questions around heteronormativity in relation to prostate cancer information provision, supportive care and male sexuality. While assumptions regarding sexual orientation should be avoided in clinical encounters, this may be difficult when heteronormative assumptions dominate. Existing research supports the assertion that patient experience, including the needs of LGBT patients, should be central to service developments. CONCLUSION Assumptions about sexual orientation should be avoided and recorded accurately and sensitively, and relational models of care should be promoted at the start of cancer treatment in an appropriate manner. These may assist in reducing the risks of embarrassment or offence to nonheterosexual patients, or to professionals who may adopt heteronormative assumptions. RELEVANCE TO CLINICAL PRACTICE Having an awareness of the risks of making heteronormative assumptions in clinical practice will be useful for all health professionals engaged in prostate cancer care. This awareness can prevent embarrassment or upset for patients and ensure a more equitable provision of service, including men with prostate cancer who do not identify as heterosexual.
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Affiliation(s)
- Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Sarah Fry
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Ussher JM, Rose D, Perz J. Mastery, Isolation, or Acceptance: Gay and Bisexual Men's Construction of Aging in the Context of Sexual Embodiment After Prostate Cancer. JOURNAL OF SEX RESEARCH 2017; 54:802-812. [PMID: 27712111 DOI: 10.1080/00224499.2016.1211600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Age is the predominant risk factor for developing prostate cancer, leading to its description as an "older man's disease." Changed sexual embodiment is a concern for men who develop prostate cancer, often compounding experiences of age-related sexual decline. Although research has examined heterosexual men's experiences of aging in the context of sexual embodiment after prostate cancer, gay and bisexual men have received little attention. This qualitative study used a material-discursive analysis, drawing on positioning theory and intersectionality, to explore constructions of aging following prostate cancer in 46 gay or bisexual men. Thematic decomposition of one-to-one interviews identified three subject positions: "mastering youth," involving maintaining an active sex life through biomedical interventions, accessing commercial sex venues, or having sex with younger men; "the lonely old recluse," involving self-positioning as prematurely aged and withdrawal from a gay sexual scene; and "accepting embodied aging," involving the incorporation of changed sexual function into intimate relationships and finding pleasure through nonsexual activities. These subject positions are conceptualized as the product of intersecting masculine and gay identities, interpreted in relation to broader cultural discourses of "new aging" and "sexual health," in which sexual activity is conceptualized as a lifelong goal.
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Affiliation(s)
- Jane M Ussher
- a Centre for Health Research, School of Medicine , Western Sydney University
| | - Duncan Rose
- a Centre for Health Research, School of Medicine , Western Sydney University
| | - Janette Perz
- a Centre for Health Research, School of Medicine , Western Sydney University
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Dutta A, Uno H, Holman A, Lorenz DR, Gabuzda D. Racial differences in prostate cancer risk in young HIV-positive and HIV-negative men: a prospective cohort study. Cancer Causes Control 2017; 28:767-777. [PMID: 28451806 PMCID: PMC5557016 DOI: 10.1007/s10552-017-0896-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 04/18/2017] [Indexed: 01/07/2023]
Abstract
PURPOSE African American men have the highest incidence of prostate cancer among ethnic groups, and racial disparity is highest in younger men. Prostate cancer prevalence is rising in HIV-infected men due to improved survival on antiretroviral therapies, yet little is known about racial differences in prostate cancer risk by HIV-infection status and age. METHODS This is a prospective cohort study of prostate cancer risk in 2,800 HIV-infected and -uninfected men who have sex with men (MSM) aged 40-70 years (22% African American) who were enrolled in the multicenter AIDS cohort study from 1996 to 2010. Poisson regression models were used to examine associations between race and HIV-infection status and prostate cancer risk among men aged 40-70, 40-55, and 56-70 years. RESULTS Among men aged 40-70 years, incidence rates (IR) per 100,000 person-years were 169 among all men and 276 among African American HIV-infected men. Prostate cancer risk was similar by HIV-infection status (IRR 1.0, 95% CI 0.55-1.82), but nearly threefold higher in African Americans compared to non-African Americans in adjusted models (IRRs 2.66 and 3.22, 95% CIs 1.36-5.18 and 1.27-8.16 for all or HIV-infected men, respectively). Racial disparity in prostate cancer risk was greatest in African American men aged 40-55 years (adjusted IRR 3.31, 95% CI 1.19-9.22). Prostate cancer risk showed associations with family history of prostate cancer (p = 0.001), but not heavy smoking, androgen supplement use, or HIV-related factors. CONCLUSIONS Among MSM, African American HIV-positive and HIV-negative men aged 40-55 years have threefold increased risk of young-onset prostate cancer compared to non-African American men, highlighting the need to make informed decisions about screening in this population.
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Affiliation(s)
- Anupriya Dutta
- Department of Cancer Immunology and Virology, Dana Farber Cancer Institute, Center for Life Science 1010, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Hajime Uno
- Department of Population Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alex Holman
- Department of Cancer Immunology and Virology, Dana Farber Cancer Institute, Center for Life Science 1010, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - David R Lorenz
- Department of Cancer Immunology and Virology, Dana Farber Cancer Institute, Center for Life Science 1010, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Dana Gabuzda
- Department of Cancer Immunology and Virology, Dana Farber Cancer Institute, Center for Life Science 1010, 450 Brookline Avenue, Boston, MA, 02215, USA.
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43
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Hoyt MA, Frost DM, Cohn E, Millar BM, Diefenbach MA, Revenson TA. Gay men's experiences with prostate cancer: Implications for future research. J Health Psychol 2017; 25:298-310. [PMID: 28810471 DOI: 10.1177/1359105317711491] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Gay men's experiences with prostate cancer and its impact on health-related quality of life are poorly understood. This qualitative study explored gay men's experience with prostate cancer with a focus on the emotional, physical, and sexual impact of cancer; support needs; and healthcare interactions. Three semi-structured focus groups of gay men with prostate cancer were conducted. A conventional content analytic approach was used to identify six primary content areas that described poignant aspects of the men's experience with prostate cancer: minority stress, intimacy and sexuality concerns, impact on life outlook, healthcare experiences, social support and the gay community, and intersectional identities.
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Affiliation(s)
- Michael A Hoyt
- Hunter College and the Graduate Center, The City University of New York, USA
| | | | | | - Brett M Millar
- Hunter College and the Graduate Center, The City University of New York, USA
| | | | - Tracey A Revenson
- Hunter College and the Graduate Center, The City University of New York, USA
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44
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Pinks D, Davis C, Pinks C. Experiences of partners of prostate cancer survivors: A qualitative study. J Psychosoc Oncol 2017; 36:49-63. [PMID: 28506193 DOI: 10.1080/07347332.2017.1329769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate cancer, Australia's leading cancer, has treatment side effects that reduce the quality of life for both survivors and partners. Limited partner research exists. This study aimed to address this gap in the literature by gathering data directly from partners to obtain a deeper understanding of their experiences of prostate cancer survivorship that helps inform healthcare service providers. A qualitative approach was taken to explore participant views (N = 16) through three focus groups and two in-depth interviews. Five themes emerged relating to caregiver burden, knowledge deficit, isolation, changes of sexual relations, and unmet needs. Possible implications for practice may include the need for specific partner-related information and interventions to assist couples to cope with the emotional distress caused by treatment side effects.
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Affiliation(s)
- Darren Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
| | - Cindy Davis
- b Faculty of Arts, Business, and Law , University of the Sunshine Coast , Sippy Downs , Australia
| | - Clair Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
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Baughman A, Clark MA, Boehmer U. Experiences and Concerns of Lesbian, Gay, or Bisexual Survivors of Colorectal Cancer. Oncol Nurs Forum 2017; 44:350-357. [PMID: 28635972 PMCID: PMC5920528 DOI: 10.1188/17.onf.350-357] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify the experiences and needs of lesbian, gay, or bisexual (LGB) survivors of colorectal cancer (CRC) and to expand the current understanding of LGB survivorship by obtaining in-depth knowledge of survivorship among individuals with a cancer other than breast or prostate.
. RESEARCH APPROACH Qualitative, semistructured individual interviews via telephone.
. SETTING Participants were recruited using social media, flyers, word of mouth, and contact with LGB and cancer organizations during a four-month period.
. PARTICIPANTS Eight LGB individuals with a diagnosis of stage III CRC from 2009-2014.
. METHODOLOGIC APPROACH All interviews were audio recorded and then transcribed verbatim. Thematic analysis performed by more than one analyst was used for the interview transcripts.
. FINDINGS Participants described experiences with social support and isolation, cancer care from an LGB perspective, and substantial economic impacts of their cancer diagnosis. In addition, they reported struggles with health insurance coverage, employment, and housing during and after their treatment for CRC.
. CONCLUSIONS In addition to issues regarding sexual identity disclosure and social support, economic impacts of CRC exist; these are likely critical to healthy survivorship in LGB men and women.
. INTERPRETATION Attention should be paid to the economic impact of CRC on LGB individuals, along with issues of social support and sexual identity disclosure. Oncology nurses could play an important role in determining the economic and social needs of patients with CRC, accepting the often nontraditional support networks of LGB individuals, and facilitating disclosure of an LGB identity.
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Affiliation(s)
- Allyson Baughman
- Department of Community Health Sciences at Boston University School of Public Health
| | - Melissa A Clark
- At the time of the study MA Clark was with Brown University. She is now at University of Massachusetts Medical School
| | - Ulrike Boehmer
- Department of Community Health Sciences at Boston University School of Public Health
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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Capistrant BD, Torres B, Merengwa E, West WG, Mitteldorf D, Rosser BRS. Caregiving and social support for gay and bisexual men with prostate cancer. Psychooncology 2016; 25:1329-1336. [PMID: 27530377 PMCID: PMC5524199 DOI: 10.1002/pon.4249] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 06/11/2016] [Accepted: 08/12/2016] [Indexed: 12/15/2022]
Abstract
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, semistructured, one-on-one telephone interviews with 30 GBMPCa recruited from a national cancer support group network, Malecare. Inductive and deductive codes were used to identify themes about social support provided to GBMPCa during diagnosis and treatment. RESULTS GBMPCa reported help from friends, family (parents and 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.
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Affiliation(s)
- Benjamin D Capistrant
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St. Peter, MN, USA
| | | | - William G West
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Rosser BRS, Capistrant B, Torres B, Konety B, Merengwa E, Mitteldorf D, West W. The Effects of Radical Prostatectomy on Gay and Bisexual Men's Mental Health, Sexual Identity and Relationships: Qualitative Results from the Restore Study. SEXUAL AND RELATIONSHIP THERAPY 2016; 31:446-461. [PMID: 27942251 DOI: 10.1080/14681994.2016.1228871] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
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.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, 1300 S. 2 St. #300, University of Minnesota, Minneapolis, MN, USA
| | - Benjamin Capistrant
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St. Peter, MN, USA
| | - Badrinath Konety
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
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Rosser BRS, Capistrant B, Torres MB, Konety B, Merengwa E, Mitteldorf D, West W. The effects of radical prostatectomy on gay and bisexual men's sexual functioning and behavior: qualitative results from the restore study. SEXUAL AND RELATIONSHIP THERAPY 2016; 31:432-445. [PMID: 30111985 DOI: 10.1080/14681994.2016.1217985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
To advance research on the sexual effects of prostate cancer in sexual minorities, we conducted telephone interviews with 19 gay and bisexual men (GBM) who had undergone radical prostatectomies. Challenges to sexual functioning included anatomical penile changes, loss of ejaculate, climacturia, and erectile dysfunction. All sexual behavior with other men, not just insertive anal sex, was affected, across all stages of the sexual response cycle. Rather than narrowly focusing on erectile functioning, rehabilitation for GBM needs to be comprehensive in addressing anatomical changes, sexual behavior comprehensively, and functioning across the sexual response cycle. Seven recommendations for practitioner education are identified.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Benjamin Capistrant
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Maria Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St. Peter, MN, USA
| | - Badrinath Konety
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
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Rosser BRS, Capistrant B. Online Versus Telephone Methods to Recruit and Interview Older Gay and Bisexual Men Treated for Prostate Cancer: Findings from the Restore Study. JMIR Cancer 2016; 2:e9. [PMID: 28410183 PMCID: PMC5369633 DOI: 10.2196/cancer.5578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 11/13/2022] Open
Abstract
Background Recently, researchers have faced the challenge of conflicting recommendations for online versus traditional methods to recruit and interview older, sexual minority men. Older populations represent the cohort least likely to be online, necessitating the use of traditional research methods, such as telephone or in-person interviews. By contrast, gay and bisexual men represent a population of early adopters of new technology, both in general and for medical research. In a study of older gay and bisexual men with prostate cancer, we asked whether respondents preferred online versus offline methods for data collection. Given the paucity of research on how to recruit older gay and bisexual men in general, and older gay and bisexual men with prostate cancer in particular, we conducted an observational study to identify participant preferences when participating in research studies. Objective To test online versus offline recruitment demographic data collection, and interview preferences of older gay and bisexual men with prostate cancer. Methods Email blasts were sent from a website providing support services for gay and bisexual men with prostate cancer, supplemented with an email invitation from the web-host. All invitations provided information via the study website address and a toll-free telephone number. Study tasks included respondents being screened, giving informed consent, completing a short survey collecting demographic data, and a 60-75 minute telephone or Internet chat interview. All materials stressed that enrollees could participate in each task using either online methods or by telephone, whichever they preferred. Results A total of 74 men were screened into the study, and 30 were interviewed. The average age of the participants was 63 years (standard deviation 6.9, range 48-75 years), with most residing in 14 American states, and one temporarily located overseas. For screening, consent, and the collection of demographic data, 97% (29/30) of the participants completed these tasks using online methods. For the interview, 97% (29/30) chose to be interviewed by telephone, rather than Internet chat. Conclusions Older gay and bisexual men, when given choices, appear to prefer a mixed methods approach to qualitative investigations. For most aspects of the study, the older men chose online methods; the exception was the interview, in which case almost all preferred telephone. We speculate that a combination of the deeply personal nature of the topic (sexual effects of prostate cancer treatment), unfamiliarity with online chat, and possibly the subject burden involved in extensive typing contributed to the preference of telephone versus online chat. Recruitment of older men into this study showed good geographic diversity. We recommend that other qualitative researchers consider a mixed methods approach when recruiting older populations online.
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Affiliation(s)
- B R Simon Rosser
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, MN, United States
| | - Benjamin Capistrant
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, MN, United States
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