Health issu for gay men and other men who have sex wh men - Mayo Clic

Contents:

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

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

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.

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

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.

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.

WHEN GAY MEN GET PROSTATE CANCER

15The third study was an onle survey study of 92 gay men treated wh prostate ncer, livg the Uned Stat and Canada.

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). 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.

CANCER FACTS FOR GAY AND BISEXUAL MEN

17 Goldstone30 scrib munitn wh one's doctor, as cril, but not his experience as a surgeon that gay men may be embarrassed to ask about sexual functn. 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.

CANCER RISKS FOR GAY AND BISEXUAL MEN

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. Dowsett35 scrib his experience this way: “All the brochur I was given by helpful nurse unsellors never mentned gay men wh prostate ncer. No mentn is ma of gay men who might also be HIV-posive, or where a gay male uple might both have the disease.

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. ”25How prostate ncer treatment affects the inty of GBM as gay or bisexual do not appear to have been studied, directly. 19 Both the chang may fluence the inty of GBM as gay/bisexual and, more broadly, as sexual begs.