Prostate Cancer among Canadian Men: A Transcultural Representation
Zanchetta, Margareth Santos, Cognet, Marguerite, Xenocostas, Spyridoula, Aoki, David, Talbot, Yves, International Journal of Men's Health
Health services should consider the masculine representation of disease that underlies men's health behaviors. This study presents a transcultural view of Prostate Cancer (PC) among Canadian men of European descent. Nine men who were enrolled in a PC support group in Southeastern Ontario comprised the sample. Data were collected through interviews, genograms and ecomaps. The contrasting-ideas method guided analysis and interpretation of the findings. Healthcare providers must assist men to understand that an immediate investment of time is imperative to adequately decode and understand medical information, consider available therapies, and reflect on the potential outcome of their decisions.
Keywords: prostate cancer, masculinity, transcultural representation
Beliefs about the origins and natural course of cancer vary among cultures and influence individuals' attitudes about prevention, screening, and management programs (Dein, 2004; DiMatteo, 2003; Lodge, 2001). In the context of modern medical care, individuals who live with cancer are expected to participate in medical decisions, give informed consent, and modify habits of life to transcend their limitations (Anonymous, 2004a). Prevention and illness management are assumed to be among these tasks and responsibilities. Such an active attitude is expected of all Canadians (Carlier & Cognet, 2005). Healthcare policies are based on a contractual model of health prevention (Dozon, 2001) where the consumer plays the role of sentinel in his or her own health and learning (Kelly, 1999). However, an "untiring warrior" attitude is not universal among individuals with cancer, because the experience of cancer may be complicated by confusion, stereotypes, and stigma. Public discourse about positive thinking and success, and persistent war-metaphor medical language (Penson, Schapira, Daniels, Chabner, & Lynch, 2004) may justify either hope for a cancer cure or pessimism about the future (Anonymous, 2004a).
Among men who have survived cancers specific to males, reconstructed identity involves a new concept of a healthy life, and new roles and relationships that transcend all the limitations of cancer (Evans, Butler, Etowa, Crawley, Rayson, & Bell, 2005; Little, Paul, Jordens, & Sayers, 2002). More information is needed about what men who have undergone treatment for prostate cancer (PC) think about PC as a result of their experience of the disease given their ethnocultural heritage (Lees & Papadopoulos, 2000).
In a previous study with 15 French-speaking, Canadian men (self-identified as Canadian born or immigrant from France, Italy or Algeria), Zanchetta (2002) described distinct representations of PC. The cultural value the men attributed to virility strongly biased their representations of PC. These interpretations opened the door to reflection about possible shared interpretations of PC among men from other ethnocultural backgrounds. In this study, expressions of affiliation with ethnocultural groups by the participants were accepted as a form of self-identification (Bradby, 2003; Cuche, 1996). (1) We conceptualized elements of representation of PC that could be repeatedly identified among various ethnocultural groups, indicating that these traits are multicultural.
Research on men's health frequently overlooks the sociocultural and psychological effects of illness (Papadopoulos & Lees, 2004), in particular how men in different cultures develop representations of diseases based on their social milieus and popular education. We do not know whether men from different cultures share a core representation of PC. However, we assume that such a core representation would redefine men's identities, their ways of handling health challenges and their ways of using health services. A transcultural representation of PC may be linked to the male social roles determined by power, authority, domination, strength, and virility (Gray, Fitch, Fergus, Mykhalovskiy, & Church, 2002; Kiss & Meryn, 2001). …