What's Guidg Prostate Cancer Care for Gay Men? | MedPage Today

gay prostate problems

After beg visible the prostate ncer muny for 20 years, gay and bisexual men are fally beg seen." name="scriptn

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

Once laser-foced on HIV/AIDS, the gay muny is now addrsg one of the perils of gettg olr. * gay prostate problems *

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. 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. '"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.

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

Rat of prostate ncer are largely the same among gays and others, but sexual functng issu and qualy of life brg different ncerns. * gay prostate problems *

“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.

WHEN GAY MEN GET PROSTATE CANCER

Unrstand health ncerns for gay men and other men who have sex wh men, and learn how to promote good health. * gay prostate problems *

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. 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.

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.

THE PROSTATE MATTERS A GAY MAN'S SEX LIFE

* gay prostate problems *

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.

GAY MEN'S EXPERIENC OF SEXUAL CHANG AFTER PROSTATE NCER TREATMENT-A QUALATIVE STUDY SWEN

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. 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). 4, 33 Distst of the medil muny5 and reluctance to disclose sexualy to provirs19, 77 are mon barriers, wh 21% of 2560 olr LGBT (aged 50–95) reportg they are not “out” to health provirs and 13% reportg homophobic re.

82 One explanatn is that “Many gay men have had bad experienc wh the healthre system and is difficult for them to be open wh their urologist about the fact that they are gay.

Olr gay men wh prostate ncer may have greater difficulty disclosg their sexualy to healthre provirs and/or volvg partners than younger GBM who me out, post-Stonewall.

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

25 In ntrast, urologists were intified as particularly unhelpful: “The nservative hetero-normative and sometim homophobic nature of those volved the medil procs of prostate ncer rulted distrs, dissatisfactn and negative psychologil impact for participants. ”25 As one participant noted, “… we need to have urologists clued up to al wh gay men, we need unrstandg that our needs and issu are not the same as (those of) a heterosexual man. Inty challeng In a qualative study of 14 heterosexual men and 4 homosexual men, prostate ncer and erectile dysfunctn were intified as major threats to mascule inty.

WHAT'S GUIDG PROSTATE CANCER CARE FOR GAY MEN?

107We found three se reports documentg effects of prostate ncer on GBM upl: one where the patient was treated wh radil prostatectomy, 31 one where both were diagnosed at about the same time and treated wh proton therapy, 19 and an exploratory study of sexual functng three gay upl, where one was treated for prostate ncer.

AcknowledgmentsThis article was veloped as part of the Rtore study, a Natnal Cancer Instute-fund grant award tled, “Unrstandg the Effects of Prostate Cancer on Gay and Bisexual Men” (Grant No. The impact of the AIDS epimic rcg the hort of olr gay men the Uned Stat by an timated 25% and the number of olr men who are not sexually active would lead this to be an overtimate; however, the broad range timat of GBM and gay male relatnships, together wh signifint unrreportg bias to socially sensive and potentially stigmatizg ems, potentially unteract this Allensworth-Davi D. 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.

THE EFFECTS OF RADIL PROSTATECTOMY ON GAY AND BISEXUAL MEN'S MENTAL HEALTH, SEXUAL INTY AND RELATNSHIPS: QUALATIVE RULTS OM THE RTORE STUDY

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.

*BEAR-MAGAZINE.COM* GAY PROSTATE PROBLEMS

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2x"],"width":100,"aspectRat":1,"type":"square1x1"}"/><source media="(m-width: 768px)" width="100" height="100" srcSet="width_100%2C$height_100/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c, width_200%2C$height_200/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c 2x" data-pb-im-nfig="{"urls":["width_100%2C$height_100/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c"," width_200%2C$height_200/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c 2x"],"width":100,"aspectRat":1,"type":"square1x1"}"/><img alt="Jill Margo" class="_1srKI" data-ttid="Image-image" src="width_140%2C$height_140/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c" srcSet="width_100%2C$height_100/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c, width_200%2C$height_200/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c 2x" siz="(max-width: 767px) 100px" data-id="cf1a9a9c6b649667188b9fcbfbd58af2cf1c" data-pb-im-nfig="{"urls":["width_100%2C$height_100/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c"," width_200%2C$height_200/t_crop_fill%2Cq_to:bt%2Cfl_any_format/cf1a9a9c6b649667188b9fcbfbd58af2cf1c 2x"],"width":100,"aspectRat":1,"type":"square1x1"}" width="100" height="100"/></picture></figure><div class="_3ohH5"><span class="qIIE_ _3BRJF"><span class="_1GUY1" data-ttid="AuthorNam"><strong><a class="sLxGg" data-ttid="AuthorURL" href="/by/jill-margo-j7gd4">Jill Margo</a></strong></span></span><span class="zwqgD">Health edor</span></div></div><sectn class="_2dzEx"><div class="_2cdD4" data-ttid="ArticleTimtamp"><span>Updated </span><time data-ttid="ArticleTimtamp-time"><span>Mar 1, 2016 – 6.28pm<!-- -->,<!-- --> <span class="_2UK0V" data-ttid="ArticleTimtamp-updated">first published at <!-- -->9.00am</span></span></time></div><div class="_31gDS" data-ttid="ArticleTools"><div class="_26BHG"><button 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class="tl7wu"><p>After beg visible the prostate ncer muny for 20 years, gay and bisexual men are fally beg seen.</p><p>Late 2015, a set of four booklets was produced Atralia specifilly for gay and bisexual men.</p><p>This is thought to be a world first and the iative was fund by the feral ernment via a Cancer Atralia grant.</p><figure class="gzJMC unfed NvmVw" data-pb-type="im"><picture><source media="(m-width: 1180px)" width="620" height="349" srcSet="zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_620%2Cq_88%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e, zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_1240%2Cq_52%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e 2x" data-pb-im-nfig="{"aspectRat":1.777778,"type":"landspe16x9","width":620,"urls":["zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_620%2Cq_88%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e"," 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srcSet="zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_382%2Cq_88%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e, zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_764%2Cq_52%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e 2x" siz="(max-width: 767px) 382px" data-id="c1624ae2b7575d711eb2db15d43960944bf2664e" data-pb-im-nfig="{"aspectRat":1.777778,"type":"landspe16x9","width":382,"urls":["zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_382%2Cq_88%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e"," zoom_1%2C$multiply_1%2C$rat_1.777778%2C$width_1784%2C$x_216%2C$y_8/t_crop_ctom/c_sle%2Cw_764%2Cq_52%2Cf_to/c1624ae2b7575d711eb2db15d43960944bf2664e 2x"]}" width="382" height="215"/></picture><figptn class="LuHig"><p>Where the imagery and language of rmatn about prostate ncer has tradnally been heterosexual, the new rourc e the language of the gay muny and don't hold back.<!-- --> <ce class="_23SOU">Anna Bryhanova</ce></p></figptn></figure><p>The booklets take a ank look at the role of the prostate gay sex.</p><p>Anthony Lowe, chief executive of the Prostate Cancer Foundatn of Atralia, which produced the booklets, says they are beg ed as a base for rourc Bra and Canada.</p></div></div><asi class="_3JfHJ"></asi><div class="ZAfSI"><div class="adWrapper _3XglG Hqxcp" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos2-mobile"></div><div class="" id="adspot-728x90-pos2-tablet"></div><div class="" id="adspot-970x250_728x90-pos2-sktop"></div><small class="_3azTn">Advertisement</small></div></div><div class="_2J452"><div class="_33oUB"><div class="tl7wu" id="endOfArticle"><p>Gay men are more likely to enunter this ncer than heterosexual men, not bee they are at a higher risk but bee they and their partners uld both velop .</p><p>While they share many of the same challeng as their heterosexual peers, there are signifint differenc, Dr Gary Morrison, a Sydney-based health nsultant, says.</p><h2>Allayed fears </h2><p>Four years ago he was diagnosed wh prostate ncer and says had the rourc been available then they would have allayed many of his fears and eased his journey.</p><p>The diagnosis threw him and while the rmatn pack his surgeon gave him was prehensive and eful, the choic were overwhelmg.</p><p>Morrison says the new rourc follow through and provi the implitns of each choice for gay and bisexual men.</p><div class="ZAfSI"><div class="adWrapper _3XglG _35ekj Hqxcp _3_nxH" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos3-mobile"></div><div class="" id="adspot-728x90-pos3-tablet"></div><small class="_3azTn">Advertisement</small></div></div><p>They regnise that the social environment for gay men is different, that their sexual practic are more versatile and that prostate ncer might have a broar effect.</p><p>"Sexually, they are more 'out there' and are probably more sexually active than straight men. This ncer has the potential to change their whole life as gay men," Morrison says.</p><p>It n change their self-image and their sense of masculy, to the extent that pursug a sexual life n be more plited and challengg.</p><p>Where the imagery and language of rmatn about prostate ncer has tradnally been heterosexual, Morrison says the new rourc e the language of the gay muny and don't hold back.</p><h2>Calm and rmative</h2><p>They are lm and rmative and although the gay muny is diverse, everyone om bankers to bikers n unrstand them.</p><div class="ZAfSI"><div class="adWrapper _3XglG _35ekj Hqxcp _3_nxH" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos4-mobile"></div><div class="" id="adspot-728x90-pos4-tablet"></div><small class="_3azTn">Advertisement</small></div></div><p>Dpe good tentns, discrimatn and homophobia still exist the health system and when to prostate ncer assumptns are often ma.</p><p>An olr unmarried man is assumed to be sexually active, jt as 's assumed that after treatment a wife will llect the man and take re of him at home.</p><p>To talk about gay sexualy such an environment n be dntg and the booklets suggt men seek health profsnals they feel fortable wh.</p><p>One booklet quot a man sayg that others "jt don't get what means to be a gay man and the importance of the prostate a gay man's sex life".</p><p>Radil surgery to remove a ncero prostate has the most obv effects.</p><h2>Important role </h2><div class="ZAfSI"><div class="adWrapper _3XglG _35ekj Hqxcp _3_nxH" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos5-mobile"></div><div class="" id="adspot-728x90-pos5-tablet"></div><small class="_3azTn">Advertisement</small></div></div><p>Whout a prostate there is no ejaculatn and no semen exchange, which has an important role the sexual play between men who have sex wh men.</p><p>Whout a prostate, the receptive partner anal sex don't get the benef of havg his prostate massaged, a procs that gments asm.</p><p>Whout a prostate, the active partner might not have an erectn rigid enough for perative anal sex. While men might rever some erectile functn after surgery, vagal peratn is generally easier.</p><p>Surgery n e problems wh urary ntence, which n rce a man's sense of beg sexually sirable. It n also lead to the leakg of ure on asm.</p><p>For some men asm be paful, although this generally don't last.</p><p>Apart om creatg a sr, surgery n rce length and width of the penis, further affectg body image.</p><div class="ZAfSI"><div class="adWrapper _3XglG _35ekj Hqxcp _3_nxH" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos6-mobile"></div><div class="" id="adspot-728x90-pos6-tablet"></div><small class="_3azTn">Advertisement</small></div></div><p>Radiatn has a range of issu too, such as a slow cle potency, rctn ejaculate and bowel plitns.</p><h2>Mak pa worse</h2><p>Followg radiatn, the receptive partner might fd anal sex mak the pa worse and damag the lite lg of the an and rectum.</p><p>The booklets ver the entire prostate ncer experience, om qutns of ttg to tryg to start a new relatnship when treatment is over.</p><p>The nature of relatnships and emotnal support stctur gay muni is often different to heterosexual muni and gay men often talk about a greater sense of isolatn. There is value, the booklets say, participatg gay support groups, which n provi a sense of unrstandg, belongg and muny.</p><p>If a man has a partner, prervg timacy is important and the booklets suggt he be up ont. Not disclosg his issu n e tratn and misunrstandg, leavg them to send gus each other.</p><div class="ZAfSI"><div class="adWrapper _3XglG _35ekj Hqxcp _3_nxH" data-ttid="ad-wrapper"><div class="" id="adspot-320x360_320x50_300x250_300x50-pos7-mobile"></div><div class="" id="adspot-728x90-pos7-tablet"></div><small class="_3azTn">Advertisement</small></div></div><p>"One unfortable moment may be nothg pared to what you n ga by takg the risk to open the nversatn."</p><p>Intimacy n be improved by talkg bee 's about beg physilly and emotnally close, about beg alone together, showg affectn, offerg and receivg fort and reassurance.</p><p>When to future partners, many men are ncerned whether they will still be attractive. Will other men still want to have sex wh them or will they be dismissed? </p><p>The booklets say while a man might want to disclose ls to a sual sexual partner, he shouldn't assume the reactn will always be negative.</p><p>The rourc are available om the PCFA onle, on USB stick and booklets.</p></div><div class="_3E2eQ"><div class="_2wCJp"><div class="_1fSQD"><span class="_13Ymr" data-ttid="AuthorCard"><span><strong><a class="_35mP2" data-ttid="AuthorURL" href="/by/jill-margo-j7gd4">Jill Margo</a></strong> is the health edor, based the Sydney office. Jill has won multiple priz, cludg two Walkley Awards and is an adjunct associate profsor at School of Clil Medice, Faculty of Medice and Health, UNSW Sydney, Atralia.</span><span class="_1OfwR AJ5Ph" data-ttid="Author-Social"><span> <!-- -->Connect wh <!-- -->Jill<!-- --> on <a class="_3q9R7" href="//" rel="noopener noreferrer" target="_blank">Twter</a>.</span><span> <!-- -->Email <!-- -->Jill<!-- --> at <a class="_3AEsg" href=""></a></span></span></span></div></div><div class="_3nTt0" data-ttid="ArticleFooter"><div class="_30U_H"><div class="_26BHG"><button aria-scribedby="articleFooterLogTooltip" class="JSEcE uxhXB" data-click-outsi-ignore="te" data-ttid="SaveArticle-button" type="button"><span class="DcglW"><svg class="_1SIxy" focable="false" height="1em" aria-hidn="te" width="1em"><e xlk:href="#in-bookmark"></e></svg></span><span class="">Save</span></button><div class="_2jGyo _3Xjsv" id="articleFooterLogTooltip" role="tooltip"><div class="KNEjM" data-ttid="SaveArticle-tooltip"><button class="__V_M" type="button">Log </button> or <a class="_3NFfI" data-ttid="SaveArticle-subscribeLk" href=">Subscribe</a> to save article</div></div></div><div class="_332VY" data-ttid="ArticleSocialShare"><button class="_1whEj E-qQO" data-ttid="ArticleSocialShare-buttonShare" type="button"><span class="_1cmVb"><svg class="_1SIxy" focable="false" height="1em" aria-hidn="te" width="1em"><e xlk:href="#in-share"></e></svg></span><span class="">Share</span></button></div></div><div class="_28OFW"><div class="nEW5f"><a class="_2SABC" href=" rel="noopener noreferrer" target="_blank"><span>License article</span></a></div></div></div><div class="_3QtdZ" data-ttid="ArticleTags"><div class="_27M2O _2-Rvi" data-ttid="NewsfeedArticleDriver" role="alert"><hear class="_1slp0"><h2 class="_2iSlc">Introducg your <span class="_3jl0N">Newsfeed</span></h2><button class="_1aHhd" data-ttid="NewsfeedArticleDriver-close" type="button"><svg class="_1SIxy" aria-labelledby="newsfeed article driverclose-tle" focable="false" height="1em" aria-label="Close" role="img" width="1em"><tle id="newsfeed article driverclose-tle">Close .

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