Article 2: A Gay Mans Guide to Prostate Cancer more information about this landmark book for our community
Article 3: What Gay Men (and Those Near and Dear to Them) Need to Know About Prostate Cancer: by Gerald Perlman, PhD and Jack Drescher, MD
Among gay men and for most LGBT cancer patients, the subject of prostate cancer is complicated by the intersecting stigmata of both cancer and homosexuality. Most people do not want to talk about prostate cancer and most straight people do not want to talk about homosexuality. It is therefore not surprising that the overwhelming majority of personal and professional publications about prostate cancer are written by, for and about heterosexual men and their female partners. If prostate cancer, in general, is off most people’s radar screen, then gay men with prostate cancer are a truly invisible species.
An invisible LGBT clinical population is a troublesome fact, given that clinical experience has shown that most men—gay or straight—are traumatized upon being told they have prostate cancer. Even before the shock of diagnosis abates, every man is confronted with the task of finding the right doctor(s), choosing the right treatment(s), and inevitably dealing with the unwelcome side effects caused by those treatments.
These facts require that the man with prostate cancer be patient, informed, persistent, and courageous. It also requires, in the opinion of both the lay and professional contributors to this volume, that he be able to find emotional and psychological support from his partner, his friends, and his doctors.
Based on work begun by Darryl Mitteldorf, LCSW through the nonprofit, Malecare, in 1997, the THE OFFICIAL JOURNAL OF THE ASSOCIATION OF GAY AND LESBIAN PSYCHIATRISTS has issued a Special Double Issue called, A Gay Man's Guide to Prostate Cancer. Aimed not only at the mental health professionals who read the JGLP and who may treat gay men with prostate cancer, it is for the patients themselves. It is also intended to be helpful to the partners, family members, support systems and physicians of men with prostate cancer.
The first section addresses prostate cancer from the perspective of health and mental health professionals. The second section consists of papers written from a personal point of view: articles by gay men of diverse ages, races, and ethnicities describing their own experiences with prostate cancer.
Vincent Santillo and Frank Lowe, MD, begin the professional section of papers with “Gay Men and Prostate Cancer.” They discuss the basics of prostate cancer with an overview of the causes, diagnosis, screening guidelines and treatments for prostate cancer. They highlight issues of particular concern to gay men, including the potential effect of testosterone supplements, HIV status, anal sex and its impact on PSA testing, and the potential change in sexual response during anal sex resulting from the removal of the prostate. They explore issues of doctor-patient communication as they specifically relate to the gay prostate cancer patient.
Among health professionals, the diagnosis and treatment of prostate cancer often raises more questions than it answers. Consequently, Santillo and Lowe describe a different treatment bias than does David Cornell in “A Gay Urologist’s Changing Views on Prostate Cancer.” Dr. Cornell traces the history of prostate cancer diagnosis and treatment through the 1980s and 90s to the present. He describes some of the unique concerns that gay men have when consulting with a urologist and making treatment decisions. He also writes about the need for and his development of a gay prostate cancer website. Dr. Cornell argues for the aggressive treatment of prostate cancer taking into account the need to be aware of lifestyle issues.
In “The Ups and Downs of Gay Sex After Prostate Cancer Treatment,” Steven Goldstone, MD, addresses practical questions regarding gay sex after a man has been treated for prostate cancer. He also addresses some of the concerns of the partners of gay man with prostate cancer. Dr. Goldstone offers the reader a practical and matter of fact primer of what may happen during and what to do after prostate cancer treatment.
In “Psychotherapy with Gay Prostate Cancer Patients, Darryl Mitteldorf, LCSW, uses examples from his own practice to highlight psychological issues that surface in individual psychotherapy with gay men diagnosed and treated for prostate cancer. Many of his patients report symptoms of both depression and anxiety. Mitteldorf sees the goal of psychotherapy as reducing the psychological symptoms that result from internalizing the diagnosis and undergoing physical treatment. He warns that as gay men navigate the heterosexually biased world of prostate cancer treatment, they must also confront potential problems of stigmatization, including scarring, ejaculation and erectile dysfunction, and HIV/AIDS envy.
The last professional paper is Gerald Perlman, PhD’s “Prostate Cancer, The Group, and Me.” However, it is both a professional and personal paper. Dr. Perlman writes of his own journey as a gay man dealing with his own prostate cancer that led to his becoming a facilitator of a Malecare support group for other gay men with the same disease. He describes the dynamics and concerns of gay men with prostate cancer within the context of a Malecare self-help group.
The second section of personal accounts begins with Roberto Martinez, MPH’s “Prostate Cancer and Sex.” Martinez, a self-described “sexually active Latino gay man,” tells of how the surgical removal of his prostate gland affected his thoughts, feelings, attitudes and activities about sexuality in general. He also speaks more specifically about how the physical changes he experienced engendered emotional changes in his own struggles with sex and masturbation.
Lidell Jackson’s “Surviving Yet Another Challenge,” also talks about prostate cancer’s challenge to his sexuality. Jackson, a self-proclaimed sex-positive gay man, compares the challenge of prostate cancer to the struggle he went through when he sero-converted. As a man of color, Jackson feels particularly strong about alerting his Black brothers to their increased risk of developing prostate cancer.
Jerry Harris, PhD had his radical prostatectomy many years prior to the other contributors. In, “Living with Prostate Cancer: One Gay Man’s Experience,” he tells of his difficulties with the medical community and of his struggle with sexual dysfunction following his surgery.
In “Identity and Prostate Cancer: Comments on a Messy Life,” the pseudonymous “Mark Miller” laments what he calls “the devastation” to his sense of self and body image following a radical prostatectomy. He remarks on his own fears of being unacceptable and unappealing in a gay community that he views as being consumed with youth and beauty. In contrast, prominent psychiatrist and psychoanalyst Bert Schaffner, MD, describes how dealing with “Prostate Cancer at age 84.” did not alter his sexual identity. Dr. Schaffner writes that he feels as gay as ever, and in a way feels freer to be more related and affectionate.
In “Together with Prostate Cancer,” Robert Parkin, MD and his partner Howard Girven present their particular experience as an older gay couple confronting prostate cancer. Theirs is a unique tale of their respective experiences seeking treatment for their prostate cancers during overlapping times at Loma Linda University Medical Center. They discuss what it was like being gay in that setting and how their sex life has evolved following treatment.
The impact on couples is taken up further by Greg Higgins, CSW in: “A Gay Man and His Partner Face Prostate Cancer Together.” Higgins writes about his experience with the medical profession and the importance of being proactive about one’s treatment as well as the need to look for support. He devotes a good portion of his paper to the effect his cancer has had on his relationship of 10 years to a man more than 20 years his junior.
Those who think prostate cancer is just an older man’s disease will be startled to read Vincent Santillo’s “Prostate Cancer Diagnosis and Treatment of a 33 Year Old Gay Man.” Santillo takes the reader on a personally revealing journey of his struggle with prostate cancer, how it changed him and how it affected his relationship of 12 years.
We hope this issue will serve as a reference guide and resource for gay men, their partners and family members who are coping with prostate cancer and LGBT cancer .