Ross E. Gray

Relationship vulnerabilities during breast cancer: patient and partner perspectives

Objective: Close interpersonal relationships play a crucial role in a womans adjustment to breast cancer. To date, the literature has focused primarily on characteristics or behaviors of the well spouse that influence a womans adaptation to the illness. The present qualitative investigation extended this literature by adopting an interactional perspective based on the underlying assumption that relationship partners coping and distress is mutually influential. The focus of the analysis was patient and partner perceptions of relationship strife or tension over the course of the illness based on the notion that such interactions may be as or more harmful to relationships than supportive exchanges are helpful.

Restoration of Satisfying Sex for a Castrated Cancer Patient with Complete Impotence: A Case Study

We present a first-hand account of a fully impotent, testosterone-suppressed prostate cancer patient who has satisfying, multiorgasmic sex using a strap-on dildo. We use his narrative to examine dildos as an alternative to erectile dysfunction treatments for men, such as this patient, who find selective inhibitors of PDE-5 ineffective and surgical intervention unacceptable. We explore what conditions allowed this man to progress from suspicious distrust of the dildo to full acceptance. In terms of making a dildo acceptable to other patients, we contrast offering it to them as a penile prosthesis in a formal medical setting versus treating it as a toy in fantasy sex play. Last, we present a neurobiological hypothesis involving sensory integration to help explain why sex with the strap-on dildo can be satisfying to a male.

‘Nothing fit me’: nationwide consultations with young women with breast cancer

Objectiveu2002 There exists little research about the experience of breast cancer for young women in Canada. To address this gap, the Canadian Breast Cancer Network (CBCN) and the Ontario Breast Cancer Community Research Initiative undertook a research project to explore the information and support experiences, needs and recommendations of geographically diverse Canadian young women with breast cancer.

Perspectives on colorectal cancer screening: a focus group study.

Objectiveu2002 To assess attitudes and acceptability of Ontario consumers and doctors towards colorectal screening with faecal occult blood testing (FOBT) and colonoscopy.

Masculinities and College Men's Depression: Recursive Relationships

Abstract Depression is a significant problem among college men. This qualitative study examines the interplay between masculinities and depression among Canadian-based college men who self-identified or were formally diagnosed with depression. The resulting three themes – mind matters, stalled intimacy and lethargic discontent – reveal the recursive relationships between masculinities and depression whereby depression quashed men’s aspirations for embodying masculine ideals, with depression potentially triggered by self-doubt and concerns about harbouring a faulty masculinity. Key findings include participants’ juxtaposing their private negative self-talk with attempts to pass as self-assured in public; anxieties about neediness and vulnerability negating their efforts to initiate or maintain an intimate relationship; and ruptured ideologies about a mind–body dualism whereby severe depression negatively impacted physical wellbeing.

Prospective survey of sexual function among patients with clinically localized prostate cancer referred for definitive radiotherapy and the impact of radiotherapy on sexual function

PurposeThe purpose of this study is to assess sexual function among patients with clinically localized prostate cancer referred for radiotherapy and to prospectively evaluate the effect of radiotherapy on sexual function, using the Brief Sexual Function Inventory (BSFI).Materials and methodsA descriptive study, approved by the local research ethics committee, was prospectively conducted. At baseline, patients were asked to complete a self-administered BSFI, along with other questionnaires describing their clinical condition. Patients with normal erection at baseline were asked to complete a follow-up BSFI at 6, 12, and 24xa0months postradiotherapy. The collected data was analyzed using the SAS software.ResultsThe study accrued a total of 117 eligible patients. The mean age was 66xa0years. Forty-two patients (35.9%) were considered to have erectile dysfunction (ED) at baseline. They were older and more likely on one or more medications affecting potency, compared with those with normal erectile function. They had a consistently lower mean score for all the five domains of BSFI and considered sexual activity less important. Of the 75 patients reporting normal erectile function at baseline, 61 completed a follow-up BSFI questionnaire. Among the 61 patients, 52 underwent radiotherapy with external beam radiotherapy or brachytherapy. Mean scores for all the BSFI domains declined after radiotherapy, suggesting that radiotherapy adversely affected not only erectile function but also other aspects of sexual function including sexual drive and ejaculation.ConclusionAmong the patients with clinically localized prostate cancer referred for radiotherapy, sexual dysfunction was prevalent with 35.9% reporting ED at presentation. Radiotherapy adversely affected all aspects of sexual function.

Health Psychology and the Arts : A conversation

Critical approaches within health psychology continue to explore new methods of working and new theoretical ideas from other disciplines. One area that remains under-explored is the potential links with the arts. This special issue contains a selection of empirical and theoretical reports on the linkages between health psychology and the arts. It includes arts and health projects in clinical, community and educational contexts; projects with young and old people, projects with people from different social and ethnic background and projects using different forms of art. This article introduces the special issue and uses a dialogic format to consider some of the broader issues.

The health and well-being of prostate cancer patients and male-to-female transsexuals on androgen deprivation therapy: A qualitative study with comments on expectations and estrogen

Both male-to-female transsexuals and advanced prostate cancer (PCa) patients are treated with androgen-suppressing drugs that have emasculating effects. Additionally, transsexuals take estrogenic compounds to feminize their bodies. We explore the quality of life of these populations, based on interviews with 12 individuals from each group. Overall, the transsexuals had a better psychological response to chemical castration than the PCa patients. The transsexuals showed more enthusiasm about the changes in their life; they viewed their lives as beginning anew, accepted their reduced libido, and were more comfortable with their increased emotionality. Different responses in the two groups are not surprising given that they undergo androgen deprivation under very different medical contexts. However, the fact that the transwomen are able to conceptualize the effects as positive suggests that some androgen-deprived PCa patients may benefit from reconceptualizing their changes within a positive framework. Additionally, difference in the two populations may be attributed, in part, to the fact that the transsexuals take supplemental estrogen. Circumstantial evidence suggests that estrogen in androgen-deprived males may improve sleep quality, help retain sexual interest, and protect cognitive function. This suggests that PCa patients may benefit from using estradiol for androgen suppression.

L’impact du cancer de la prostate du point de vue des survivants: répercussions pour les soins infirmiers en oncologie

La prestation de soins efficaces aux patients souffrant du cancer de la prostate est un enjeu important pour les infirmieres en oncologie. Cependant, la penurie d’etudes empiriques sur l’impact du cancer de la prostate presente un obstacle a la conception et a la mise en oeuvre d’interventions infirmieres pertinentes. Cet article presente les resultats d’une enquete nationale realisee aupres de 621 Canadiens atteints du cancer de la prostate et portant sur l’impact de la maladie et la disponibilite du soutien. Les problemes le plus souvent identifies comprennent le fonctionnement sexuel, les effets secondaires, la peur de la mort, l’incontinence, la colere et la douleur. Environ un tiers des repondants ont vu leurs habitudes de vie se modifier, mais peu d’entre eux ont rapporte un impact negatif des changements ainsi eprouves. Dans leur majorite, les repondants indiquaient qu’ils avaient ete bien informes sur le traitement, mais ils exprimaient leur insatisfaction au sujet du manque d’information sur les reactions emotionnelles, les therapies paralleles, sur la facon dont ils pourraient communiquer avec d’autres patients atteints du cancer de la prostate et la disponibilite de services de consultation et de groupes d’entraide. De toute evidence, ces resultats ont des repercussions pour les infirmieres en oncologie.

Book Review: Judith A. Rubin, Art Therapy Has Many Faces [Film] Pittsburg, PA: Expressive Media, 2004.

that is both lively and thought provoking, that would be of interest to either a novice or to an experienced arts or health practitioner, particularly to those working in the field of mental health. The book is full of sensible argument and bristles with case studies. That it fails to address all the ephemeral concerns of this particular reader is probably not the most important point. That it lays its material out logically, is easy to read and is very informative should be of much more overriding importance. I can therefore give this book a strong recommendation, and given the lack of books that cover this field in general, this is a welcome addition to any book list that I will create and I would encourage everyone to pop out to their library and order it today.