Prostate Cancer Disclosure and Sexual Orientation: Understanding Outness to Health Carers as a Situational or Consistent Phenomenon

Objective: According to the statistics, one in six men develops prostate cancer. There are several therapeutic options for prostate cancer. Anti-hormone therapy is one of treatment leading to an 80–90% remission. A significant percentage of men who received anti-hormonal treatment complain of decreased libido and erectile dysfunction. Similarly, these men may also suffer from hot flashes, weight gain, growth of [male] breast tissue (gynecomastia), lack of energy and initiative, depression and mental disorders. In this paper, I would like to present a therapeutic case of a man who received sexual counseling at the Israel Cancer Association, and who, upon receiving antihormonal treatment, changed his sexual orientation after having contracted prostate cancer. Design and Method: A series of meetings were conducted, encompassing an interview and sexual counseling. The Klein Sexual Orientation Grid (KSOG) was used in order to evaluate the patient’s sexual orientation. Results: According to the GRID several parameters such as sexual attraction and sexual behavior were significantly different in the comparison between the past and the present. Parameters such as social preference and hetero/gay style did not change. The remaining results will be presented. Conclusions: Following an analysis of this case, it may be concluded that a person’s sexual orientation can change during his lifetime. The hypothesis is that a life-changing event such as cancer, including all the side effects of difficult antihormonal treatments, has the potential to evoke a change in the person’s overall experience and in his sexual experience in particular.

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Impact of sexual orientation on contemporary rates of prostate cancer screening.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.122 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 122-122

Author(s):

Daniel Pucheril ◽

Matthew D. Ingham ◽

Dimitar V. Zlatev ◽

Sebastian Berg ◽

Matthew Mossanen ◽

...

Keyword(s):

Prostate Cancer ◽

Sexual Orientation ◽

Cancer Screening ◽

Sexual Minorities ◽

College Graduates ◽

Prostate Cancer Screening ◽

Insurance Coverage ◽

Multivariable Analysis ◽

Independent Effect ◽

Behavioral Risk

122 Background: Despite increasing societal acceptance of non-heterosexual persons, sexual minorities continue to face discrimination. The effect of non-heterosexual orientation on adoption of cancer preventive services, particularly prostate cancer screening (PSAS), is not clearly known. We hypothesize that male sexual minorities are less likely to receive PSAS compared to heterosexual (HTS) males. Methods: The 2014-16 Behavioral Risk Factor Surveillance System was queried for males 40-69, without a history of prostate cancer, and having answered all sexual orientation (SO) questions. PSAS occurred if a respondent had a PSA test within the last two years for reasons other than “a prostate problem” or “for prostate cancer”. Descriptive statistics were generated for demographic covariates stratified by year and SO [HTS, homosexual (HMS), bisexual (BIS), transgender (TGR), other, and refused]. The Chi-Square test was used to compare the distribution of covariate proportions amongst SO categories within each year. Multivariable regression was used to determine the independent effect of SO and other covariates on receipt of PSAS in this cohort. Results: A weighted 49.2 million individuals (n = 86,893) met inclusion criteria. In 2014 and 2016, 94% and 93% of the cohort identified as HTS. In both years, a higher proportion of HMS (2014: 40.5%, 2016: 47.4) and BIS (2014: 30.3%, 2016: 31.0%) respondents were college graduates compared to HTS males (2014: 28.8%, 2016: 28.9%). In 2014, rates of PSAS were higher amongst HMS (34.9%), BIS (37.1%) and TGR (37.5%) individuals compared to HTS individuals (34.5%). In 2016, rates of PSAS were clinically similar among HTS (30.4%), HMS (30.2%), BIS (30.1%), and TGR (27.8%) individuals. In the multivariable analysis, increasing age (65-69 OR 8.93, 95%CI 7.80-10.22) and education level (College Graduate OR 2.21, 95%CI 1.93-2.54) along with insurance coverage (OR 2.15, 95%CI 1.85-2.51) and a personal physician (OR 2.88, 95%CI 2.59-3.20) were associated with higher odds of PSAS. Aside from HMS orientation (OR 1.30, 95%CI 1.04-1.62), SO was not an independent predictor of PSAS. Conclusions: Based on this nationally representative sample, disparities in regards to PSAS are not apparent for non-HTS males.

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MP40-01 THE IMPACT OF SEXUAL ORIENTATION ON TREATMENT DECISION-MAKING AND PERCEPTIONS OF SEXUAL SIDE-EFFECTS FROM PROSTATE CANCER

The Journal of Urology ◽

10.1097/01.ju.0000556093.77159.95 ◽

2019 ◽

Vol 201 (Supplement 4) ◽

Author(s):

Channa Amarasekera* ◽

Vincent Wong ◽

Kathryn Jackson ◽

Christopher Morrison ◽

Oliver Ko ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Sexual Orientation ◽

Side Effects ◽

Treatment Decision ◽

Treatment Decision Making ◽

Sexual Side Effects ◽

The Impact

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Are prostate cancer treatments correlated to sleep distress?

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.347 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 347-347

Author(s):

Darryl Mitteldorf ◽

Jerrod Nelms

Keyword(s):

Prostate Cancer ◽

Sexual Orientation ◽

Sleep Quality ◽

Emotional Disorders ◽

The United States ◽

Support Network ◽

Poor Sleep ◽

Cancer Treatments ◽

Cancer Support ◽

Prostate Cancer Treatments

347 Background: Sleep distress associated with prostate cancer due to emotional issues like anxiety is well documented. But there have been no investigations focused on sleep distress correlated to specific types of prostate cancer treatments. Methods: During a ten day period in July, 2016, 963 men diagnosed with prostate cancer completed an online survey containing demographic and treatment history questions, the Pittsburg Sleep Quality Index (PSQI) and a current state of health self-assessment. The subjects were randomly chosen from the Malecare prostate cancer support network in the United States and completed the survey. 27% of survey subjects reported being initially diagnosed with Gleason 8 or higher. 42% reported using either androgen deprivation therapy, Zofigo, Xtandi or Xofigo within three months of our survey. Only 5% had been continually on active surveillance. We compiled the PSQI Component score and correlated the scores to a specific prostate cancer treatments, adjudicating for pre-existing conditions such as emotional disorders or apnea. We stratified for race, age, sexual orientation and if the subject had a sleep partner. Results: The PSQI handout says that a total score of 5 or greater indicates sleep distress worthy of consultation with a healthcare provider. Our investigation also considered a “4” to indicate poor sleep quality among participants. Only 398 (41.33%) of our participants scored less than 5 on the PSQI, while only 232 (24.09%) scored less than 4. From these statistics, we showed that over 75% of our study sample suffered sleep distress. However, our analysis failed to disclose significant correlations between specific types of prostate cancer treatments and extent of sleep distress. We did not see correlations regarding subject’s age, race, sleep co-habitation, time from diagnosis to survey and other treatment and demographic stratifications. Conclusions: Sleep distress is well established and broadly experienced by prostate cancer patients. Our study showed there is no advantage to any specific prostate cancer treatment in terms of sleep distress. We also found that severity and instances of sleep distress are distributed without significance across age, race, sexual orientation and time to treatment after diagnosis.

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