Unrstandg Prostate Cancer Gay, Bisexual, and Other Men Who Have Sex wh Men and Transgenr Women: A Review of the Lerature - PubMed

Contents:

• IN CHIGO, A NEW APPROACH TO GAY AND BISEXUAL MEN WH PROSTATE CANCER
• WHEN GAY MEN GET PROSTATE CANCER
• PROSTATE CANCER GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WH MEN: A REVIEW
• WHEN TO PROSTATE NCER, 'GAY MEN ARE ERASED,' PATIENTS SAY
• UNRSTANDG PROSTATE CANCER GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WH MEN AND TRANSGENR WOMEN: A REVIEW OF THE LERATURE
• CANCER FACTS FOR GAY AND BISEXUAL MEN
• THE SEXUAL FUNCTNG OF GAY AND BISEXUAL MEN FOLLOWG PROSTATE CANCER TREATMENT: RULTS OM THE RTORE STUDY
• THE PROSTATE MATTERS A GAY MAN'S SEX LIFE

IN CHIGO, A NEW APPROACH TO GAY AND BISEXUAL MEN WH PROSTATE CANCER

Curt, 66, diagnosis and surgery were only the begng of a “clil and psychologil and emotnal adventure” — one he felt that many urologists were not equipped to handle, bee he was gay and the majory of doctors and their patients were symptoms are siar for all prostate ncer patients, cludg urary ntence, erectile dysfunctn, dimished libido and loss of ejaculate. But rearchers are fdg that those chang may echo through the liv of gay and bisexual men unexpected, and sometim more difficult, obstacl n be physil and emotnal, and may be reflected patients’ relatnships wh their partners. Amarasekera, who has foced his reer on urologic re for gay and bisexual men and other sexual mori, is the program’s first is an emergg field of study driven part by the creasg number of prostate ncer patients who intify as gay or bisexual.

”The gay and bisexual men their 50s and 60s who are now enterg the prime mographic for prostate ncer also lived through the worst of the AIDS epimic. Amarasekera problem, experts the field say, is that the rearch about gay and bisexual men and prostate ncer is still woefully aquate. V., and young gay men, bee that was the biggt killer, ” said Simon Rosser, a profsor of epimlogy and muny health at the Universy of Mnota, who led a study 2017 of gay and bisexual men wh prostate ncer.

WHEN GAY MEN GET PROSTATE CANCER

“It’s only now that as the AIDS generatn grew olr, and aged to health problems like prostate ncer, that specialists are startg to see gay patients.

Amarasekera studied urologists’ trag and found that many reported receivg ls than five hours of stctn on the treatment of gay and bisexual patients.

He also surveyed gay patients, who overall said their sexual satisfactn was not aquately taken unr nsiratn durg treatment for prostate ncer. “It’s important to llect data on how treatment affects sexual functn differently for gay and bisexual men, who have different sexual repertoir than straight men, ” he said. “If you lack the tools to measure aspects of sexual functn that are specific to gay and bisexual men, you lose an opportuny to track their progrs.

PROSTATE CANCER GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WH MEN: A REVIEW

Amarasekera se at the program’s two clics — one downtown Chigo and the other the historilly gay Northalsted neighborhood — are unprepared to face yet another health crisis. ”The health re system, he said, “margaliz gay men, particularly when to sexual health, and the prostate is so lked to sexual health gay men. It’s jt that many urologists don’t realize that the prostate is “kd of a male ‘G spot, ’” and gay men more often are aware of .

”Jane Ussher, a profsor at the Wtern Sydney Universy School of Medice Atralia, has been studyg the effects of ncer gay men for 20 years. “Partial erectile dysfunctn has a particular impact” on gay patients, she said, and they “report signifintly greater ncern about loss of ejaculate than heterosexual men. Amarasekera “nsired my whole person, and my whole personhood enpassed my beg gay, ” he ia also spired Perry McKay, a Chigo philanthropist whose donatn helped get the Northwtern program off the ground.

“This is an opportuny to munite, tra and te urologists on how to provi better re tailored to the specific needs of gay and bisexual men, ” he Rosser agreed. ”Gene Otto, who is the -host of a support group Palm Sprgs, Calif., for gay and bisexual men wh prostate ncer, se a growg need as well.

WHEN TO PROSTATE NCER, 'GAY MEN ARE ERASED,' PATIENTS SAY

Amarasekera said his experience wh the program “go a long way to addrs the mistst that many gay men feel toward medil stutns. ’”A versn of this article appears prt on, Sectn D, Page 1 of the New York edn wh the headle: Prostate Cancer and New Care for Gay Men. Though the ter landspe has changed sce his diagnosis 2003, Rose's experience is still reprentative of the lack of awarens and rearch surroundg how prostate ncer may affect gay men differently than straight men.

Much of the fundg for rearchg diseas that may affect gay men has been funneled toward HIV; and some of the gay men who may have gotten prostate ncer – which is more mon wh age – died of AIDS and therefore are theoretilly missg om the data, says Simon Rosser, a profsor and director of the HIV/STI Interventn and Preventn Studi at the Universy of Mnota School of Public Health. Sce more gay and bisexual men are htg high-risk ag for prostate ncer the days, he says, "'s gog to bee a bigger issue for gay and bisexual men the next , and no doc on the pla n practice evince-based medice" sce there is no strong evince base.

Not that there's been an easy way to study the populatn; surveillance data ncer rearch isn't typilly nducted by sexual orientatn, adds Rosser, who's recg participants for the first treatment study on gay and bisexual men wh prostate ncer. It don't matter if you're gay or straight, " says Michael Hoyt, an associate psychology profsor at Hunter College New York whose rearch based on a small foc group of gay prostate ncer survivors will soon be published. " Other Battl Some Gay Men Wh Prostate Cancer FaceWhile gay men seem to have about the same rat of prostate ncer as men general – makg the most diagnosed ncer among all men, acrdg to the Centers for Disease Control and Preventn – a review nducted by Rosser and lleagu suggts that gay survivors have poorer sexual functng and lower qualy of life.

UNRSTANDG PROSTATE CANCER GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WH MEN AND TRANSGENR WOMEN: A REVIEW OF THE LERATURE

For one, some gay men Hoyt's foc group reported strs around disclosg their sexual orientatn to their health provirs, while others worked wh clicians who didn't know and didn't ask. But for many gay men, workg wh a provir who knows and honors their sexual orientatn is important part bee more often than straight men, "sex, at some pot has been a cril part of their personal story, " Hoyt one participant his study, for example, who felt that his provirs' failure to acknowledge his sexualy was a blow to who he was as a person – and a patient. "Havg to fight battl and then havg a sexual self that you’ve fought for" should be acknowledged, he told the rearch a practil, medil standpot, too, unrstandg a patient's sexualy is important bee while all prostate ncer survivors have some sexual si effects om treatment, ankly, gay sex is different om straight sex – and treatment optns should be discsed acrdgly.

For example, erectile dysfunctn is a mon si effect of both radiatn and surgery to treat prostrate ncer – and n affect gay men's sex liv differently sce "they need firmer erectns for peratn" than they'd need for vagal terurse, Wtmann says.

" But support om the gay muny is cril for men wh prostate ncer, pecially nsirg some of them have been rejected by their own fay members or geographic muni for their sexual orientatn, Hoyt and others have reported. For Rose, who joed a maly gay nng club a few years after his surgery, havg people his life who listened to and supported him throughout the journey has been key to his well-beg. Koy, MD, MBA, 4 Darryl Mteldorf, MSW, MPA, 5 and William Wt, PhD6AbstractPurpose: Prostate ncer gay, bisexual, and other men who have sex wh men (GBM) is an emergg medil and public health ncern.

CANCER FACTS FOR GAY AND BISEXUAL MEN

Six future directns, to advance the study of the effects of prostate ncer GBM and to improve treatment, are words:: bisexual, ncer, gay, male, prostate, sexual rehabilatnIntroductnImprovg the health of lbian, gay, bisexual, and transgenr (LGBT) dividuals is a Healthy People 2020 goal. 3 Gay, bisexual, and other men who have sex wh men (GBM) who have been diagnosed wh prostate ncer may have differential health-related qualy of life and sexual health out than heterosexual men wh prostate ncer, but existg rmatn is almost always based on small studi, clil se studi, or an anecdote. 4, 5 Until recently, there have been sufficient data on this topic, pecially postncer diagnosis, part bee, “rearch on the relatnal ntext of ncer and sexualy has tend to be heteronormative, assumg that men are long-term, monogamo heterosexual relatnships, th excludg the experienc of sgle and gay men.

The search terms/statements ed were “prostatic neoplasms” or “prostate ncer” or “ncer of the prostate” or “prostatic rcoma” AND “male homosexualy” or “gay men” or “bisexual men” or “men who have sex wh men” or “bisexualy. We exclud studi whose primary foc was on heterosexual men that provid eher no or limed asssment of homosexual men and studi that equably clud other orbidi their analys (cludg other malignanci). 17, 20, 28 Wh 14 of the publitns unrtaken for a special issue one journal, 36 the edors nclu, “If prostate ncer, general, is off most people's radar screen, then gay men wh prostate ncer are a tly visible speci.

Case and media reports intify homophobia as an addnal barrier to digal rectal examatns as part of prostate ncer screeng.

THE SEXUAL FUNCTNG OF GAY AND BISEXUAL MEN FOLLOWG PROSTATE CANCER TREATMENT: RULTS OM THE RTORE STUDY

47 They found s to be more likely to have a history of sexually transmted fectns (STIs) and to report homosexual partners.

49Santillo has intified six gay “liftyle factors” that potentially uld crease the risk of prostate ncer GBM: e of ttosterone supplements and anabolic steroids, e of fasteri (Propecia) for hair loss, HIV stat and antiretroviral (ARV) treatment, a fatty diet, the effects of anal sex on prostate-specific antigen (PSA) ttg, and poor doctor–patient munitn.

THE PROSTATE MATTERS A GAY MAN'S SEX LIFE

In parg 341 heterosexual men wh 111 gay men, Allensworth-Davi reports gay men had worse urary and bowel functng sr, lower mascule self-teem, ls partner affectn, and more treatment regret than heterosexual However, he found no sexual differenc (possibly due to wordg differenc the sexual qutns8) major ncln of this quantative lerature review is that there are aquate studi to be nfint of fdgs, and where differenc are intified, they are based on small nvenience sampl of qutnable power and unknown generalizabily. This nclud that gay men have ltle-to-no unrstandg of the prostate or the sexual challeng associated wh prostate ncer and s treatment.

40 Anecdotal evince shows that GBM wh prostate ncer face unique challeng, cludg the loss of the prostate as a se for sexual pleasure receptive anal sex, 23, 77 loss of ejaculate (which thors emphasize is more central gay sex17, 32, 34), persistent rectal irratn or pa sufficient to prevent receptive anal sex, 5, 30 and erectns too weak for sertive anal sex34 (Anal peratn is timated to require 33% more rigidy than vagal peratn78).