Christopher, a 59 year old man living in the North West of England, discovered he had prostate cancer in 2008 whilst undergoing tests at his local genitourinary medicine (GUM) clinic for an unrelated problem. The diagnosis came as a shock to Christopher, especially after learning that a radical prostatectomy would offer the best outcome based on his cancer type. Following surgery, he endured several weeks of radiotherapy and spent a further two years on hormone suppression treatment. This resulted in Christopher experiencing erectile dysfunction and loss of libido. Despite several bouts of worry and frustration, Christopher tried to frame his cancer journey as a positive experience; one that had facilitated personal growth, led him to discover the joys of sensuality in place of sex, and grow more holistically as a gay man. Christopher had been proactive in searching out various sources of support and information for himself, and for other men with prostate cancer. However, after attending support groups and speaking to other men, he perceived there were certain taboos that prevented men talking about the disease which still needed to be addressed. At the time of our interview, Christopher had recently split up with his partner and was living alone. He was still experimenting with different methods available to aid erectile function, in order to continue enjoying sex. Christopher was also keen to raise awareness and offer support to other gay men who were concerned about the disease.
5.3.2
Alan
Alan, from Yorkshire, was 59 when he was diagnosed with prostate cancer, after
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biopsy revealed that Alan had localised prostate cancer, although it was found to be growing at a very slow rate. As his consultant did not think that it warranted immediate treatment, Alan chose to be placed on active surveillance. He considered that this would provide him with sufficient time to explore all other treatment options for the future and to live a relatively normal life until his prognosis changed. Alan had been retired from work for a year when he was diagnosed. Yet, despite becoming anxious prior to the six monthly PSA tests that checked to ensure his cancer remained stable, Alan described himself as a “glass half full” person. Having successfully recovered from a different type of cancer five years earlier, Alan made the decision not to disclose his prostate cancer diagnosis to his immediate family, unless it became necessary to do so. Alan admitted that he often felt burdened by this decision but had made it in order to prevent his elderly family from worrying. Alan lived with his male partner John, in a relationship spanning almost 20 years.
5.3.3
Joshua
Joshua, from London, was 51 when he was diagnosed with advanced localised prostate cancer. His father had died from the disease 18 years earlier and Joshua was encouraged to have a PSA test as a precautionary measure on the advice of his brother. A raised PSA and biopsy results indicated that Joshua had an aggressive form of cancer, despite being asymptomatic. After initially taking hormone treatment, Joshua opted to undergo nerve- sparing surgery, which was followed by a seven week course of radiotherapy. Joshua was single when he was first diagnosed and had assumed he would have no chance of finding a partner again, given the prominence and expectations of sex within the gay scene4.
However, he did subsequently meet a supportive partner called Daniel, who he shared a home with. Although he was still trying to come to terms with some of the problems
4 The commercial, physical aspect of gay community, characterised by gay bars, nightclubs, saunas,
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associated with erectile dysfunction, Joshua remained optimistic about the future and continued to seek out alternate and inventive ways of achieving sexual and sensual pleasure with his partner Daniel.
5.3.4
Elliot
Elliot, from the South of England, was just 41 when he began having his PSA levels tested, due to his father being diagnosed with prostate cancer whilst in his fifties. Although his levels remained stable for several years, a biopsy confirmed the presence of localised prostate cancer after his PSA levels started to slowly rise. Elliot was given several treatment options due to the cancer’s slow growing nature. Although initially hesitant, Elliot opted for active surveillance to delay active treatment, which would give him the time to consider alternative treatment options. Despite being in a committed relationship with his male partner, Samuel, for almost 20 years, Elliot craved support from other gay men with prostate cancer as he considered that their experience may help him make a decision about what treatment to undergo, if and when it became necessary to do so.
5.3.5
Ian
Ian, a 53 year old man from the West Midlands, was informed he had prostate cancer when he was 50, a few days following his civil partnership to his long term male partner of 16 years, Neil. He had been treated for prostatitis several months prior to his diagnosis and had assumed that this was a sports related problem. Due to the aggressive nature of the cancer, he was advised to have a radical prostatectomy. This was a devastating prospect for Ian, given his relatively young age; however, his clinical team eventually decided that Ian was eligible to take part in a clinical trial combining radiotherapy, chemotherapy and hormone treatment. Ian found this to be a gruelling experience. However, he revealed that overall, his relationship with his partner Neil had been strengthened by his cancer
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overcome this in order to remain intimate. Ian found that having cancer had helped him to re-evaluate his life following his cancer diagnosis and hoped that a better support network to support newly diagnosed gay men would become available in the future.
5.3.6
Charles
Charles, a 70 year old man from the North West of England, was diagnosed with prostate cancer in 2007. This was preceded by a long series of investigations and a transurethral resection of the prostate stemming from repeated bouts of prostatitis. After initially being told a radical prostatectomy would be the best treatment option, Charles decided that more time was needed before making a decision and embarked on a quest to investigate alternative treatments that would not be as invasive. In the meantime, Charles discovered he was HIV positive. Therefore, Charles and his consultant agreed that he should undergo a seven week course of radiotherapy, in order to avoid the surgical complications associated with being HIV positive. Although Charles still lived with his ex-long-term male partner, Ken, they shared a purely platonic and open relationship. One of Charles’ main concerns was how his subsequent erectile dysfunction, in addition to being HIV positive, would be perceived by future partners.
5.3.7
Jerry
Jerry, a 73 year old man from the South of England, was diagnosed with prostate cancer in 2005, following tests for a bladder condition. He subsequently underwent a course of radiotherapy followed by hormone treatment. Notably, Jerry’s cancer journey was conveyed as being one of frustration and disruption, due to the long delays between appointments and administrative errors within the health service. Jerry would have welcomed an opportunity to speak to other gay men with the disease, both prior to and following his treatment, as he struggled to find the support he needed within his local area. Moreover, although a support group was eventually established locally, Jerry felt it did not
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offer him the type of support he required. Jerry shared his life with Tom, his male partner of 10 years.
5.3.8
Francis
Francis was a 60 year old man living in the South East England. He had been diagnosed with advanced prostate cancer, one year prior to our interview, following a routine blood test that reported a high PSA reading; a biopsy confirmed the diagnosis. He subsequently took part in a clinical trial which combined chemotherapy and hormone therapy, before undergoing a course of radiotherapy. Prior to his illness, Francis worked for a Christian organisation, but felt he had been pressured into taking early retirement by his employers, mainly due to the demanding and stressful nature of his job. This decision had resulted in Francis feeling “role-less”, despite him acknowledging that he may have experienced some difficulties fulfilling his obligations to his employers whilst undergoing treatment. Francis had been in a supportive and loving relationship with his long-term partner David for over 30 years, despite them not living together. As David also worked for a Christian
organisation on a full time basis, Francis frequently experienced bouts of loneliness due to his partners work commitments.
5.3.9
Anthony
Anthony, a 77 year old man from the South of England, was diagnosed with prostate cancer in 1998, following a routine company medical check, which revealed a higher than average PSA reading. Sixteen years after undergoing a radical prostatectomy, Anthony considered himself to be “a success story”. In his spare time he was involved in promoting awareness about prostate cancer to both gay and heterosexual men. Anthony felt strongly about the need for men to be provided with enough information and support upon receiving a cancer diagnosis, as he felt this was missing when he was first diagnosed. Anthony said he would like to attend a prostate cancer support group where he could be open about his sexual
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orientation, and where Calvin, his male partner of 35 years, would be made to feel
welcome. Anthony still worried about the impact that his surgery had on his sex life, and its impact on Calvin, who was 12 years younger. Anthony was a man of strong Christian faith, which he credited for helping him get through his cancer experience.
5.3.10 Hugo
Hugo, a 49 year old man from London, was the youngest participant in the study. He had been diagnosed with prostate cancer in 2010 after a painful episode of prostatitis. He was shocked upon learning he had developed the disease at such a young age, particularly as there had been no family history of prostate cancer. Determined that he did not want to be left facing impotency and incontinence as a result of surgery, Hugo fought a lengthy battle with his local council to secure the funding necessary in order for him to undergo CyberKnife treatment. He finally completed his treatment in 2012 and, at the time of interview, had no clinical signs of recurrence. Hugo had also been diagnosed with HIV 11 years prior to his cancer diagnosis and took medication for this condition as well as chronic anxiety. Although Hugo was in a relationship with his male partner upon receiving his cancer diagnosis, Hugo did not receive the support he needed from him whilst undergoing treatment. As a result, their relationship deteriorated and finally ended. At the time of our interview, Hugo still lived with his ex-partner. However, this arrangement was purely for convenience and their relationship was not amicable.
5.3.11 William
William, a retired 75 year old man from London, was diagnosed with localised prostate cancer in 2010, after a routine blood test for an unrelated problem revealed a high PSA reading. Following research on the internet, William was adamant that he would prefer radiotherapy as opposed to surgery, to which his consultant agreed, providing William completed a six month course of hormone treatment beforehand. As William was already
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receiving hormone treatment for gender dysphoria at that time, he did not find the side- effects of the hormone treatment too distressing. On the contrary, they had, what he perceived to be, some positive benefits, such as breast enlargement. During our interview, William was keen to point out that he did not agree with the labels attributed to sexual orientation, perceiving it more as a “continuous spectrum” than any fixed category. Hence, during our interview he stated that if he was forced to apply a standard term to describe his own sexual orientation, this would be “bisexual”.
5.3.12 Matthew
Matthew was a fifty one year old man, from the South East of England. He was diagnosed with localised advanced prostate cancer when he was 48, after suffering from what he initially thought were bladder problems relating to an enlarged prostate. Following a course of hormone therapy, he underwent radiotherapy and was informed that he would have to continue on hormone therapy for the foreseeable future. Matthew had been in a civil partnership with his male partner, Lee, for six years, although they had known each other for many years. Lee was also present during our interview and it was evident that they shared a strong and supportive relationship with one another. Matthew described ‘coming out5’ in his thirties. Hence, being diagnosed with prostate cancer at a young age
had resulted in him feeling that his gay identity had been cut short. Nevertheless, experiencing cancer had also altered Matthew’s perspective on life. He frequently spoke about some of the “positives” that had occurred as a consequence of his diagnosis, such as dealing with past, unresolved issues.