Background/rationale
Prostate cancer is a substantive men’s health problem with a high and increasing global incidence, and from this an increasing need for responsive survivorship and psychological care. Problematically, clinical practice guidelines for prostate cancer that address emerging care modalities often do not consider the psychological implications of a diagnosis, and for many men this aspect of care is ad hoc or absent. This issue is further amplified by masculine barriers to help seeking.
Methods
Men-centred care situated within a deep understanding of masculinities has the potential to meaningfully address the quality-of-life challenges facing men with prostate cancer. Five key domains of masculinity have been identified that influence how a man responds to his cancer: Optimistic Action; Sexual Importance/Priority; Family Responsibilities; Emotional Self-Reliance; Strength/Fitness. This along with the Wellbeing Essentials framework provides a template for health professionals to build men-centred care.
Impact on practice
In this approach the health professional partners with the man to enhance personal agency so that he becomes agent in managing his personal experience in a way that encourages mastery of his own well-being. Three perspectives that intersect with masculine models of coping include the stress and coping model, problem-solving therapy, and psychological flexibility. The stress and coping model provides a pragmatic and accessible learning framework for men to engage with. Problem-solving leverages the masculine value of optimistic action. Psychological flexibility responds to the tendency of some men to avoid difficult emotions and not engage with available supports.
Discussion
Improving outcomes for men with cancer requires a paradigm shift. Survivorship care for these men in the job of the care team and models and tools exist to guide this aspect of care. It is time to act.