Prostate Cancer Gay, Bisexual, and Other Men Who Have Sex wh Men: A Review - PMC

Contents:

• CANCER FACTS FOR GAY AND BISEXUAL MEN
• WHEN GAY MEN GET PROSTATE CANCER
• WHEN TO PROSTATE NCER, 'GAY MEN ARE ERASED,' PATIENTS SAY
• IN CHIGO, A NEW APPROACH TO GAY AND BISEXUAL MEN WH PROSTATE CANCER
• PROSTATE CANCER GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WH MEN: A REVIEW
• CANCER RISKS FOR GAY AND BISEXUAL MEN
• 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

Fear of discrimatn: Some gay and bisexual men don’t tell their health re provirs about their sexual orientatn, bee they worry about discrimatn affectg the qualy of health re they receive. "I thk I found maybe one article, and wasn't real helpful, " says Rose, whose urologist didn't know he is gay. 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.

WHEN GAY MEN GET PROSTATE CANCER

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. 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. " Beyond the BedroomOutsi of the bedroom, gay men's diagnos n also mean isolatn om the gay muny, rearchers have found.

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

" 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 example, some ci have support groups for gay ncer survivors and anizatns like the Natnal LGBT Cancer Network n help. 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.

"It's not the end of the world, " he would tell men – gay or straight – who have been newly diagnosed wh prostate ncer. But the unique challeng facg gay and bisexual men wh prostate ncer have largely gone who have sex wh men (MSM) are ls likely to get regular prostate ncer screengs, and those who are diagnosed are ls likely to have faial and social support, acrdg to rearch ced by the Natnal Instut of Health. And if their health re provir is not culturally petent, gay and bisexual men are much ls likely to unrstand how treatment will impact their qualy of life.

”As a rult, Margoli add, many lbian, gay, bisexual and transgenr patients go back the closet when they beg ncer treatment. “I’ve been a gay activist — and been out — so long that I took for granted I uld talk openly to my doctors, ” he told NBC News. Brass’ said his sexual functn was relatively good, but stead he stggled wh ntence for weeks — g as many as ne “pads” a day and stayg wh yards of a bathroom at all you’re gay and you go to a urologist who hasn’t alt wh gay men, they’ll tell you, 'Brg your wife wh you.

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

'"He joed a prostate ncer support group specifilly for gay and bisexual men at Mount Sai Hospal Manhattan, one of several anized by the natnal advocy anizatn wh other queer men “allowed to be very open about our feelgs — and our sexualy — and to be empathetic wh each other, ” Brass said. “If you’re gay and you go to a urologist who hasn’t alt wh gay men, they’ll tell you, ‘Brg your wife wh you, ’" he said. "A NEGLECTED AREA"It’s impossible to know how many gay men have been diagnosed prostate ncer, bee qutns about sexualy are rarely clud rearch studi.

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

“The medil muny say, ‘We don’t want to ask olr heterosexual men qutns that might upset them, ’" Simon Rosser, an LGBTQ health specialist and -thor of "Gay and Bisexual Men Livg Wh Prostate Cancer, " told NBC Rosser, PhD, MPH, is a profsor at the Universy of Mnota School of Public Health. Universy of MnotaA profsor at the Universy of Mnota School of Public Health, Rosser has received a $3 ln grant om the Natnal Cancer Instute to put together the first prehensive rehabilatn program specifilly for gay and bisexual men wh prostate ncer.

”Rosser said the silence and shame surroundg the topic allows ugly myths to flourish — like that gay sex somehow “ed” their ncer. And we have studi that show out are different for gay men: We have worse mental health, we have greater urary problems, but our sexual out are reliably better. Gettg the disease, ironilly, is somethg of a luxury for a gay men of Brass’ age: Too many had their liv cut short by the AIDS epimic long before they’d typilly be diagnosed (the average age for a prostate ncer diagnosis is 66) the advent of lifavg antiretroviral dgs the mid-1990s, though, gay men are fally reachg their goln years.

”It stole a generatn, but the AIDS epimic also tght gay men how to fight disease, how to ask qutns and how to mand better treatment.

CANCER RISKS FOR GAY AND BISEXUAL MEN

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.

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

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. “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.