Academic journal article International Journal of Men's Health

Testicular Cancer: Passage through the Help-Seeking Process for a Cohort of U.K. Men (Part 1)

Academic journal article International Journal of Men's Health

Testicular Cancer: Passage through the Help-Seeking Process for a Cohort of U.K. Men (Part 1)

Article excerpt

Although there have been many studies in "patient delay" and help-seeking for cancer symptoms, these have tended to be focused on women and breast cancer. Few papers have investigated specifically male cancers and the help-seeking process. We interviewed 10 men who had experienced testicular changes and a diagnosis of testicular cancer. We analysed, using grounded theory methodology, the stories men told about their experience of testicular changes and the process of seeking help. The central unifying theme concerned how men faced and handled uncertainty. The theory suggested several steps whereby they sought to gain an explanation for testicular changes, justify seeking help, and anticipate exposing their fears to professionals. In so doing, men described several barriers founded in their own knowledge, perceptions, and assumptions about testicular cancer. We discuss several taboos surrounding testicular concerns, a range of issues related to masculinity and sexuality, and the role of physicians in the help-seeking process.

Keywords: testicular cancer, help-seeking process, "patient delay," grounded theory methodology, barriers to knowledge, taboo, masculinity, sexuality, physicians

We believe that a greater research focus on the very early stages of testicular cancer is imperative and that, in particular, research is essential to understand how men seek help for testicular changes. The fact that some tumours can be aggressive and fastgrowing requires these men to seek medical help as swiftly as possible. The largest studies of delay behaviour, disease-staging, and survival to date suggest that greater delay may compromise survival (Hernes, Harstad, & Fossa, 1996; Tavolini, Zuliani, Norcen, Dal Moro, Abatangelo, & Oliva, 1999). Men with slower-growing tumours are frequently at risk of delaying, and so compromising their survival. Early presentation to services is important across the spectrum, and it is important to understand the reasons why men delay presenting. Though hitherto a rather medicalised concept, "delay" is increasingly being understood in the light of psychological and social influences such as personality, attitudes to health and the body, gender, and race.

MALE GENDER AND HEALTH CARE UTILISATION

Until recently, studies of factors affecting patient delay and of the experiences of individuals with cancer symptoms in seeking medical help have been focussed on women and breast cancer. However, there have been a few notable exceptions looking at other types of cancer including the specifically male cancers (Chapple, Ziebland, & McPherson, 2004; Gascoigne, Mason, & Roberts, 1999; Sanden & Eriksson, 2000).

The concentration in the literature on healthcare with respect to breast cancer and the lack of research in specifically male cancers seems reflective of a general trend in the past within health research of a neglect of an understanding of men's health. Sabo and Gordon (1995) state that "professional scholars and researchers have been slow to study connections between gender and men's health and illness" (p. 4). One argument put forward by several authors has been that men's health status has been taken as the norm (Courtenay, 2000; Emslie, Hunt, & MacIntyre, 1999; Lyons & Willott, 1999; Watson, 2000). It has been assumed that men's behaviour is natural and inherent and that the focus therefore becomes the overutilisation of services by women rather than the underutilisation of services by men (Courtenay, 2000). Relative underutilisation is unlikely to be a uniform phenomenon for men or to have a singular or simplistic cause. The tendency to view men as "the norm" (and often a white, middle-class one at that) prevents them from being seen as "gendered beings" in their own right (Lyons & Willott, 1999) with all the variety and diversity that this implies.

Just how men come to have a pattern, however varied, of healthcare underutilization has increasingly been the subject of enquiry. …

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