Prostate Cancer Treatment Decision-Making and Survivorship Considerations among Gay and Bisexual Men: Implications for Sexual Roles and Functioning

Abstract

C H A P T E R S U M M A R Y A man who identifies as a gay or bisexual man (GBM), or as a man who has sex with men (MSM), and who is diagnosed with prostate cancer may experience survivorship and sexual roles and functioning differently from a man who identifies as heterosexual or straight. Whether actual treatment decisions differ between gay or bisexual men and straight or heterosexual men is not known. The effects and consequences of prostate cancer treatment are typically experienced by all men, regardless of sexual orientation, but the concern and bother of treatment side effects in survivorship may have different manifestations. Partnered men of all sexual orientations may have improved survivorship over men not in relationships. Younger men, particularly younger GBM, may have poorer quality of life in cancer survivorship. Healthcare providers are encouraged to create safe and accepting environments for patients to disclose sexual orientation and gender identity and to make the appropriate clinical decisions based on this information with knowledgeable recommendations and strategies during treatment decision making and survivorship. In this chapter we review the published literature about GBM with prostate cancer, decision making when considering treatment options, symptom burden, and sexual roles and functioning in survivorship. Interspersed throughout the chapter are qualitative comments collected by our group from a series of surveys conducted among the LGBT community about their experiences with receiving general healthcare.