Roughly one in six men are expected to be diagnosed with prostate cancer throughout their lifetime, making it among the most common cancers acquired. Despite its prevalence, prostate cancer has received relatively little attention in popular culture and certainly has been neglected as an area for psychological intervention in most training programs. As such, many psychologists may be unfamiliar with the psychosocial impact that being diagnosed and living with prostate cancer may have on their patients. Even well-informed practitioners may have little understanding of how gay and bisexual men (and their significant others) are differentially impacted by this disease compared to their straight peers. This edited volume serves as a valuable resource for clinicians and their patients.
The primary audience for this book appears to be quite broad. I anticipated having to wade through technical medical jargon and to have some difficulty grasping some concepts. Instead, I was grateful (if not relieved) to find that the style adopted by the authors is informative and accessible. Biological and medical concepts, while addressed, take second seat to psychosocial experiences of gay and bisexual men (GBM) and to a lesser extent, transgender women with prostate cancer, making this a particularly useful text on this topic for psychologists.
Readers may expect some redundancy among chapters; however, when redundancies are present, they are effective in orienting the reader and providing context for each author’s views and contributions to the overall discussion provided in this book. While various authors’ personal experiences colored how some aspects of GBM’s lives were portrayed (e.g., relationship status, acceptance of casual sexual encounters, importance of sexuality among GBM), the text can certainly be described as an affirming resource for practitioners and GBM alike.
Ussher, Perz and Rosser organize author contributions into three sections: (1) overview of research on GBM experiences of prostate cancer, (2) examine facets of care and support for GBM living with prostate cancer and (3) personalize experiences of prostate cancer through narratives provided by GBM. The attention to flow and organization of content within and across sections was impressive and helped engage the reader.
In the opening section of this text, Kohli et al. effectively identify and summarize the extant research while providing tables that facilitate the readers’ ability to draw their own conclusions. Other authors go on to detail the impact of prostate cancer and discuss the limitations of research and intervention in the subsequent chapters. The reader walks away having gained understanding of basic physical concerns related to prostate cancer as well as an understanding of key concerns GBM may experience as a result of diagnosis and treatment. For example, readers learn that symptoms such as frequent urination, weak urine stream, and, in later stages, bone pain may indicate the presence of prostate cancer while virtually all available treatments may result in erectile difficulties, incontinence, and penile shrinkage. Furthermore, where a medical text may have concluded with discussion of such concerns, the contributors provide analysis of the implications of such concerns.
In the second section, readers are presented with thoughtful interpretation of research results. I appreciated the consistent recognition of the complexity of GBM’s lives throughout this section. Discussions of how heteronormativity has resulted in relatively poorer support and care for GBM men diagnosed with prostate cancer provided a foundation for learning. Authors invited understanding of topics such as the importance of language (e.g., “living with” rather than “survivor of” prostate cancer) in working with GBM, the alienating effect of being treated by physicians who are not willing to discuss anal sex, heteronormative references for penile rigidity needed for penetrative anal versus vaginal intercourse and the importance of inclusion of GBM’s significant others in treatment and care.
Generally, this section of the text was quite informative and may offer validation to GBM who have navigated prostate cancer treatment. As a therapist, I especially appreciated contributions by Quinn et al. on sexual aids, Hart et al. on accessing social support, and Mitteldorf, who provides background and information that can be quickly translated to offering support group services to GBM.
In the final section, GB men share their personal journeys with prostate cancer. The contributions depict a range of coping strategies and ways of making sense of prostate cancer. The humor, intellectualization, and emotional vulnerability in these men’s stories leaves the reader with a very personal understanding of prostate cancer. Indeed, the accounts offered provided a valuable reminder that the research reviewed in the text applies to people. While the book as a whole may be valuable to GBM and those who love them, this section may be particularly useful for men who are struggling to come to terms with a diagnosis and settle on a course of treatment. The practical advice given by these contributors may also be helpful in filling a void for men who are unable or unwilling to seek out support groups.
It is worth noting that several authors wander beyond the focus suggested by the book’s title to include information on the prostate as it relates to transgender women (TGW). At times, inclusion of TGW was thoughtful and informative and led to deeper understanding of, for example, unique issues faced by TGW in participating in screening for and treatment of prostate cancer. Unfortunately, most mention of TGW was somewhat distracting and little more than lamentation on the lack of research on how TGW experience prostate cancer. This limitation, however, did not devalue the significant contribution made through publication of this book.
On whole, the editors and authors put forth a well-balanced resource that will prove useful to clinicians, medical providers, patients, and their loved ones. While few chapters provide direction on clinical intervention, the information contained in the text can certainly be translated to clinical practice. Practicing psychologists may find several uses for this text, including integrating concepts into initial assessments, selecting topics for inclusion in support groups, and bibliotherapy/psychoeducation interventions. Students and academics will appreciate the authors’ critical review, attention to scope of knowledge and identification for areas of future research. I walk away from this text appreciating the authors’ frank discussions and informed contributions to my own understanding of this topic.