Men's Health and Cancer
Our social media campaign this month has covered men’s health, and we’ve looked at a variety of topics including mental health and cancer. One of the key points in the information on mental health is about how men’s needs differ to women’s, and how we can best engage men and encourage them to seek support. It got me wondering about how men and women may differ when it comes to cancer, and specifically how men cope when diagnosed, and undergoing treatment.
A quick look at the research told me that I was right – men and when do cope differently and have different needs when it comes to dealing with cancer. Unfortunately though, most of the research that has been done into coping with cancer hasn’t differentiated the results by gender. So while we know what works, we don’t know who exactly it works for.
Below is an excerpt from an interesting article from the Journal of the National Cancer Institute in the US, looking at how and why gender matters in coping with cancer. It’s almost 20 years old, but the message is still relevant – men have different health care needs that often get overlooked, leading to poorer health outcomes for men.
Men are from Mars, women are from Venus . . . women are better communicators . . . men compartmentalize their lives. During stressful times, women want to talk about it; men would rather not.
These statements are stereotypes — or are they common knowledge? Could these descriptions of gender-specific communication styles help explain how men and women cope with a cancer diagnosis? Many who interact with cancer patients believe they do.
“Sharing feelings is a very feminine perspective,” said Matthew Loscalzo, director of patient and family services and co-director of the Center for Cancer Pain Research at the Johns Hopkins Oncology Center, Baltimore.
“Some people say that if you just expressed your feelings, you would feel better,” he said. “For men, that's not necessarily true. What helps them is to have a plan, to feel that they are making a contribution, not overburdening their families.”
Gender-related ways of coping, Loscalzo said, have “profound differences, with important implications in how you engage women and men in the disease process.”
Because most social work professionals are women, said Loscalzo, it is often easy for them to find ways to communicate with women who have cancer, but “they get frustrated when they try that same [communication style] with men. With men you have to identify a problem and see it as external to the person, and you have to come up with a plan of action.”
Women generally cope better than men, he said, both as cancer patients and as caregivers. However, women also tend to have social support networks that men don't have.
“If you ask a man, ‘Who is your best friend?' it's going to be his wife. If you ask a woman, it's much less likely to be her husband,” he said. “ Most men report that they do not have another man to talk to about emotional issues.”
Jimmie Holland, M.D., chair of the department of psychology and behavioral sciences at the Memorial Sloan-Kettering Cancer Center in New York, agreed.
“Women tend to have a lot of friends and resources — men tend to have very few people on whom they might call,” she said. But men's unwillingness to express what is troubling them does not mean that they don't need support.
“If you said that everyone in a support group must be having trouble — well, that's women,” Holland said. “Men are unwilling to enter a support group. By nature they are more apt to keep things to themselves. The idea of sharing with other people is not a part of their way of coping.”
Different Flavor
“Support” groups for men do exist, but have a different flavor than female-centered groups. Research has found that men and women in Internet-based, “ virtual” support groups have different priorities and concerns.
In the mixed groups, both men and women were more likely to give and seek information, but when they were separate, there were distinct differences between the two. In gender-specific groups, most comments from women were about what they were going through. Men asked about the disease, asked about chemotherapy, or told other men about it.”
Other research has also found that men are more likely to use support groups as an educational outlet, while women tend to share personal experiences and encourage other women.
How men and women deal with a cancer diagnosis may also affect how active they are in seeking treatment. In a 1992 study of Canadian cancer patients, the group found that women with breast cancer were the most assertive, while men with prostate cancer were the least assertive.
Prostate cancer, especially in 1992, had not had anywhere near as much attention [ as breast cancer, nor do men generally discuss such issues quite as readily. Also, at puberty, women begin speaking with health care providers about issues related to the reproductive system, and thus may be more comfortable when a problem arises.
Too Busy
Also, a lot of doctors are so busy they don't have time to ask the right questions, and people often will not mention they're having anxiety or feeling depressed. A good third of the patients in waiting rooms are stressed enough to need help, but less than 10% of them actually will get it.
Psychological aspects of dealing with cancer have focused mainly on newly diagnosed breast cancer cases, Loscalzo said, while “most people who get cancer are over 65 and are men . . . really, we know almost nothing about how men and women cope. I think we really only know about the first 30 days [after diagnosis], and that's mostly crisis intervention rather than psychological adjustment.”
As for the future, Loscalzo said, “The whole psychosocial area is virtually ignored. People have avoided this area; I think it's left over from views of mental health. We need to understand how women and men integrate stress and cope with it, and then we need to learn how they interact and how we can help them to do so more effectively.”
Research in this area may also be hampered by inadequacies in getting at patients' true feelings, which may not fit into prescribed categories on a questionnaire.
“There are different responses and mechanisms of coping,” said Suzanne L. Dibble, D.N.Sc., a researcher at the Institute for Health and Aging at the University of California, San Francisco. “The problem is that we continue to use instruments that have been established in only one gender.”
After testing, these instruments — usually surveys or questionnaires — are then generalized to both genders, a concept that Dibble said may not be valid.
“I question whether we can use the same instrument in both sexes — depression means different things to men than it does to women,” she said. “As long as we use the same instruments that measure depression, for example, maybe women always look worse, but maybe [women are] just responding differently to the questions.”
Dibble and others published a study last year that found gender differences in the concept of cancer-related quality of life. In women, psychosocial well being and physical competence were considered most important for good quality of life, while men indicated that vitality and personal resources were most important.
Taken from ‘In Coping With Cancer, Gender Matters’ by Nancy Volkers
JNCI: Journal of the National Cancer Institute, Volume 91, Issue 20, 20 October 1999, Pages 1712–1714, https://doi.org/10.1093/jnci/91.20.1712
Have a great weekend!
Karen (Psychologist)