This article examines the relationship between cultural constructions of masculinity and men's experiences of prostate cancer in Australian society. Drawing on the results of a qualitative study involving in-depth interviews with 33 men with prostate cancer, this article focuses on the difficulties posed by prostate cancer for these men's gender identities. Findings illustrate how investigative, diagnostic, and treatment procedures pose significant difficulties for many men, especially in relation to their desires to perform idealised constructions of masculinity. Although a minority viewed the potential challenge posed to their masculinity as insignificant in the wider context of terminality and mortality, the majority considered these factors as fundamental in shaping their experience of disease and influential in making a treatment decision. It is argued that gaining a better understanding of the influence of cultural codes of masculinity on experiences of disease and treatment processes is essential for maximising the quality of care provided to men with prostate cancer.
Keywords: masculinity, prostate cancer, Australian men, gender identities, qualitative study, treatment decisions
In writing about masculinity, social analyses have tended to focus on men's communication and social relationships, with the impact of diagnostic, prognostic, and treatment procedures on experiences of masculinity often left underexamined (Kaplan & Marks, 1995; Kiss & Meryn, 2001; White, 2002). Despite a few recent studies (Gray, Fitch, Phillips, Labrecque & Fergus, 2000; Fergus, Gray & Fitch, 2000; Hines, 1999; Oliffe, 2004), there are still significant gaps in our current knowledge regarding the intersections between medical technologies and procedures and cultural constructions of masculinity, particularly in the case of prostate cancer.
Drawing on the data from 33 in-depth interviews with Australian men with prostate cancer, this paper begins to engage these issues by such questions as:
* How do investigations, diagnostic techniques, treatment programs, and treatment side-effects intersect with gender identities and a desire to perform certain versions of masculinity?
* What influence do such relationships have on men's experiences of disease and decision-making processes?
This paper provides insight into these questions, illustrating that, at least for the men in this study, masculinity prevails as a central concern within the treatment of prostate cancer, often superseding the threat of mortality and thus fundamentally shaping their treatment decisions.
BACKGROUND: PROSTATE CANCER
Approximately one in 10 Australian men are diagnosed with prostate cancer in their lifetime, and approximately one in 68 die of it (AIHW,
1999). Every year, around 10,000 Australian men are diagnosed, and more than 2,500 die of the disease (Frydenberg, 1998), making prostate cancer the second largest cause of male cancer deaths after lung cancer. Despite this, there is little agreement about effective treatment for localised prostate cancer (Garuick, 1993), and the causes of prostate cancer are unclear. Men are living longer, giving the cancer more time to spread beyond the prostate with potentially fatal consequences. Younger men are now developing prostate cancer, and many die of the disease and not with it (Frydenberg, 1998). Earlier onset combined with greater male life expectancy means those cancers have more than adequate time to spread and...