Canadian Health Network

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If you are male and over the age of 65 you are at risk of developing prostate cancer (men in their fifties are also at risk). One in eight men will develop prostate cancer in his lifetime, most over the age of 70.

Prostate cancer has one of the highest cancer survival rates, according to the Canadian Cancer Society.

An estimated 20,100 Canadian men will be diagnosed in 2004 alone. These men live with prostate cancer, and are dealing with both the physical and the emotional and psychological side effects associated with it.

			One couple's experience…
			Although the characters in this story are not real, they represent one of the psychological side effects that men and their partners may experience after a prostate cancer diagnosis. The sterilizing white of the walls glared into their eyes where the sun beamed in from the warm August day outside. The nurse swished past them and gently pulled the blinds down. The room transformed from a searing alabaster to a creamy warm glow. "Honey?" "Hmmm?" Flip. Flip. The magazine passed the time. "You know I love you, right?" Pause. "I know. I love you too." "So, why do we have to do this?" "We just have to. You know that. I need to do this." Flip. Flip. Flip. This was not how it was meant to be - he knew that. They shouldn't be sitting here in this office, waiting to talk to someone about their sex life, or rather lack thereof. Funny how a year can change things. He looked at her now and took her hand in his. He said, "A year ago I would have said 'Forget it.' But today is different. You deserve more than this. I deserve more than this. We have tried everything. This prosthesis is the only option we have. Of course I know you love me and if I didn't love you, love us, I wouldn't be here. But I do care. Just living isn't enough. Now we need to start living it right - " "The doctor will see you now," the nurse called, now standing by the desk. His breath caught. His hand tightened around his wife's without realizing it…until he felt her squeeze back. She pulled him out of his daze as he looked at her. "Time to live life right again," he thought as he and his wife disappeared behind the shelves of file folders of men that had been there before them.

Dr. Ross Gray, Co-director of the Psychosocial and Behavioural Research Unit at Toronto Sunnybrook Regional Cancer Centre in Toronto, has focused much of his work since the mid-1990's on men's health and men's cancers, specifically psychosocial and supportive care research related to cancer.

Dr. Gray says that, "…ill men are in a psychological bind. They may feel vulnerable, and experience more intense emotions than they are accustomed to feeling." A sense of loss of masculinity, through side effects of treatment - impotence and incontinence - have been found to be the leading psychosocial/emotional concerns of men with prostate cancer. Dr. Gray and his colleagues found that most men, however, prefer to avoid discussing these issues at all , some even reporting that they have had no such emotional side effects.

Research shows that when men do decide to disclose information about their condition they generally turn to their partners. When men seek support beyond their partners, they generally turn to a prostate cancer support group, initially to gather information, then returning to find out more. Interviews reveal that men who choose to participate in these groups find it helpful being able to talk with each other about their experiences and clearly benefit from sharing them.

Support groups are an excellent place to get information and learn from others, and they can make a person feel less alone. For a full listing of prostate cancer support groups in Canada, visit the Canadian Prostate Cancer Network web site.

Men with prostate cancer:
Can try to accept how they feel and use the support surrounding them to help get them through difficult times.

Partners:
Can understand that men deal with emotional and psychological effects differently and support them along their path. As Dr. Gray states, "There is no formula for this. It can include giving men space and time to come to terms with a diagnosis, gathering information, minimizing the importance of sex versus survival, keeping things as normal as possible, supporting men's desire to not be too public about the disease and treatment, and emphasizing continued attraction."

Friends, family and coworkers of men with prostate cancer:
Can be empathetic and understanding of the situation.

Health professionals:
Can ensure that adequate diagnoses are made and that services are available for all aspects of prostate cancer, from dealing with the day-to-day issues to handling psychological and emotional effects. Health professionals need to consider how best to address self-esteem and interpersonal challenges in a sensitive manner.