Academic journal article Journal of Sociology

The eMale: Prostate Cancer, Masculinity and Online Support as a Challenge to Medical Expertise

Academic journal article Journal of Sociology

The eMale: Prostate Cancer, Masculinity and Online Support as a Challenge to Medical Expertise

Article excerpt

Online communities are developing around particular health problems, with people 'chatting' to others about their health problems, treatment programmes and encounters with medical professionals (Hardey, 1999; Lamberg, 1997b; Rainie and Fox, 2001; Sharf, 1997). Chat rooms and discussion groups are among the most widely visited sites in cyberspace (Lamberg, 1997a). Although little research has been done, some commentators are now arguing that, because of the particular type of communication that takes place in cyberspace, online support groups may provide a form of support that cannot be achieved in face-to-face (FtF) encounters (Lamberg, 1997b; Sharf, 1997; Turner et al., 2001). It has been suggested that, in the absence of FtF cues and prior personal knowledge, users experience commonality and self-awareness without the interference of an environmental reality (Walther, 1996). A sense of anonymity and the ability to plan responses may further make online support groups an attractive alternative to FtF support groups (Turner et al., 2001), particularly because of their potential for enhancing people's ability to feel safe in communication (Hardey, 1999: 831), so they can 'open up' and disclose sensitive information.

Drawing on a qualitative interview-based study of 33 Australian men suffering from prostate cancer and 18 prostate cancer specialists, this article explores experiences of, and attitudes towards, online support groups. It is argued that patients' experiences of online communities are mediated by understandings and experiences of masculinity, and, second, embedded in clinicians' views of Internet-informed patients are paternalistic understandings of the 'patient's role' in treatment and decision-making processes.


Prostate cancer

The lifetime risk of being diagnosed with prostate cancer in Australia is about 1 in 10, with the lifetime probability of dying of prostate cancer approximately 1 in 68 (AIHW, 1999). Despite the high prevalence of prostate cancer, there is little agreement about effective treatment (Garnick, 1993). The causes of prostate cancer are unclear, although studies have shown that both genetic and environmental factors are likely to play a role in its development (Starr, 1998). Every year, around 10,000 Australian men are diagnosed and more than 2500 die of the disease (Frydenberg, 1998: 11). This makes prostate cancer the second highest cause of male cancer deaths after lung cancer. Despite high rates of morbidity and mortality of prostate cancer in Australia, public awareness and support services lag behind those that have developed in relation to comparable diseases such as breast cancer (PCFA, 2003). In a context of uncertainty regarding both cause and treatment, combined with a paucity of community support, online support networks offer a potentially valuable source of information and support.

Men's health and masculinity

In recent times social scientists have moved away from essentialized and dichotomous views of masculinity and femininity towards a view of gender as constructed, constantly evolving, and as a frequently contested social phenomenon (Connell, 1995; Gray et al., 2002; White, 2002). Likewise, in this article gender is not viewed as fixed, but rather, as something that is 'done' or 'accomplished' in everyday life (Connell, 1995: 6). As Butler argues, gender is a 'repeated stylization of the body, a set of repeated acts within a highly rigid regulatory frame that congeal over time to produce the appearance of substance, of a natural sort of being' (Butler, 1990: 33). Despite the ongoing social production and performance of masculinity and femininity, there is, of course, general (albeit hegemonic) agreement about what are considered to be typically feminine or typically masculine characteristics (Connell, 1995; Courtenay, 2000; Gray et al., 2002; White, 2002). For example, Good and Sherrod (2001) characterize masculine as: the strong, silent type (restricted experience and expression of emotions); toughness and violence; self-sufficiency (no needs); being a stud; no sissy stuff (such as emotional sensitivity); being powerful and successful. …

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