Academic journal article Health and Social Work

Spiritually Based Resources in Adaptation to Long-Term Prostate Cancer Survival: Perspectives of Elderly Wives

Academic journal article Health and Social Work

Spiritually Based Resources in Adaptation to Long-Term Prostate Cancer Survival: Perspectives of Elderly Wives

Article excerpt

Cancer is often referred to as a family disease because the psychosocial consequences of the illness and its treatments affect the quality of life experienced by partners and other family members, as well as that of patients/survivors (Baider, Cooper, & Kaplan De-Nour, 2000). Prostate cancer is a disease that primarily affects elderly men (American Cancer Society, 2004), and treatment side effects including incontinence and impotence (Bertero, 2001) may pose challenges to survivors and their wives, who may also be elderly and coping with their own illness and age-related concerns (Laverly & Clarke, 1999; Morse & Fife, 1998). Spirituality is defined as a reliance on the sacred in the search for meaning, purpose, and significance. Of growing interest is the use of spiritually based resources (SBR) to cope with aging, cancer, and other health-related concerns (Canda & Furman, 1999; Hodge, 2001; Maly, 2000; Pargament, 1997).

SBR are beliefs, values, and practices grounded in a relationship with a sacred source such as God, Higher Power, nature, or however the divine is held (Pargament, 1997). In times of adversity, SBR may inform coping with daily challenges and guide construction of meanings that allow integration of significant events into a perspective on life (Gall, Miguez de Renart, & Boonstra, 2000; Halstead & Fernsler, 1994).This article focuses on SBR. use in a spiritually and racially diverse cohort of elderly wives of long-term prostate cancer survivors. Findings may be relevant to social workers and other health care providers who intervene at the nexus of cancer and aging, as well as those with a broader interest in health-related issues


According to the American Cancer Society (2004), prostate cancer is the most commonly diagnosed carcinoma among men, and it is considered a disease of the elderly population, with more than 70 percent of all diagnoses occurring among those age 65 and older. Long-term survivorship of prostate cancer is a relatively recent phenomenon attributed to treatment advances and increased use of prostate-specific antigen testing, which detects early prostate cancer. Increasing numbers of men are living five years beyond initial diagnosis and are considered long-term survivors. Approximately 83 percent of all cases are diagnosed in the early stages of the disease when treatment outcomes are likely to be more successful, and the relative survival rate for those diagnosed with localized tumors is 100 percent (American Cancer Society).

Although the extension of men's lives is clearly a positive development, long-term survivorship may involve challenges in coping as a result of potentially enduring treatment side effects and their psychosocial sequelae (Gotay, Hollup, & Muraoka, 2002). Current treatments are associated with impotence and urinary incontinence and may cause alterations in the survivor's sense of masculinity, control, and body image. Such changes may negatively influence participation in social activities and capacity for sexual and emotional intimacy (Gotay et al.; Moinpour et al., 1998). Treatment side effects are the strongest predictors of psychological distress, regardless of years since diagnosis, and an estimated 10 percent to 20 percent of survivors are at risk of clinically significant levels of depression and other types of psychological distress (Deimling, Kahana, Bowman, & Schaefer, 2002; Zabora, Brintzenhofe-Szoc, Curbow, Hooker, & Piantadosi, 2001). Distress may cause changes in long-standing and valued patterns of marital interaction that affect both partners (Davison et al., 2002).


During the diagnostic, treatment, posttreatment, and recovery phases, wives of prostate cancer patient/survivors are challenged by threats to their husband's health and quality of life, as well as by changes in emotional and sexual intimacy (Malinski, Heilemann, & McCorkle, 2001; Morse & Fife, 1998). …

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