Prostate Cancer: The Stress Factor

BY RALPH BLUM

It’s no secret: Men are considerably less likely to seek medical help than women. The reluctance starts with a superficial cut or a bellyache. And when it gets to what’s happening “down there,” given half a chance, we go into “ostrich” mode.

There was an informative article some years ago in Psychiatric Times in which the authors, William F. Piri, MD, and Jeffrey Mello, MSW, focused on some of the factors that keep men from going to a doctor. In seeking care, men may fear being viewed as weak, appearing “unmanly,” feeling that they must live up to society’s image of them as strong and independent by “dealing with it” on their own. So we find ourselves in a bind and resort to denial: When we are questioned about this neglect, we offer excuses such as “I just don’t have the time because of . . .” and give reasons like our work, family obligations, and just plain preferring to “wait and see how things go.”

Moreover, even providing that an annual checkup propels a man into the doctor’s office, Piri and Mello point out that:

…there is no guarantee he will receive prostate cancer screening. The idea of a digital rectal exam typically makes men anxious, provoking concerns about discomfort and the violation of their manhood. Primary care physicians often join their patients in avoiding this sometimes uncomfortable and socially awkward test, which typically lasts less than a minute.

This problem is even more challenging in the African-American community since black men have a prostate cancer mortality rate  twice that of Caucasian men.

          
So what is the answer? Joining a support group is one good way to challenge the manly addiction to independence. However it depends on the group, and not all men find support groups beneficial. In which case counseling or psychotherapy—either individual or group—is a reasonable way to proceed.  

In his last blog, Mark quoted a recent New England Journal of Medicine report stating that in the first three months after a diagnosis of prostate cancer, the rate of heart attack and suicides both increase by about 200%. So instead of ignoring, denying or trying to minimize the psychological effect of prostate cancer, know that all the feelings you have are normal, and that they are common among the more than 200,000 men diagnosed with this disease each year. Getting treatment for your fear, anxiety and depression is as necessary as facing and dealing with the disease itself—and ultimately just as beneficial in recovering your health.