Crisis in masculinity: prostate cancer and identity

For his research in Concordia’s Department of Sociology and Anthropology, Joseph Folco, MA 13, explored how prostate cancer affects masculine identity in different ways, across culture and sexuality. Following the course of illness and treatment of his own father, a former professional athlete, Folco met other prostate cancer survivors facing similar difficulties.

Under the supervision of Marc Lafrance, an associate professor in Concordia’s Department of Sociology and Anthropology, Folco spent five months researching and listening to the stories of survivors. “Existing research was from a medical standpoint, examining what happens to the body, yet not addressing what men themselves focus on — what they live and how they feel,” says Folco.

Surgery, radiation or hormone therapy can cause incontinence, erectile dysfunction, loss of libido and hot flashes, among other side effects. Sometimes unexpected, these sudden limitations can be crushing to self-esteem or masculine identity. What Folco recognized was a difficulty in accessing necessary support on the human, emotional level, in part because of men’s conditioned avoidance of showing vulnerability or loss of control.

Healing through sharing

“Silence is a huge obstacle. A lot of the time, healing comes from sharing their stories and hearing about other men’s experiences,” says Folco. “Many survivors told me that reading about other men helped them heal themselves because they weren’t able to open up to friends and family.”

He adds, “It’s not about making broad generalizations but exploring men’s individual experiences. Some men were married and had children, others were single or divorced. In that way, sexuality played a different role, post prostate cancer, in some of their lives.”

One survivor told Folco he might have chosen to die from prostate cancer had he fully realized the impact of the treatment on his sexual life.

Addressing diversity

Folco’s findings show that medical conferences and support groups assume the perspective of heterosexual, middle-class white men. “They simplify the situation and try to give as much information to participants as possible. Yet they’re not really looking at who is sitting in the room with them. Whether they’re urologists or social workers, it’s important for panellists to be sensitive to differences and the complexity of each man’s experience.”

Especially in the 50-plus age group, Folco’s research shows that heterosexual men may not be as open to the presence of gay men in their support group discussing their particular sexual issues. A lack of sensitivity to diversity creates even greater isolation and misunderstanding.

Cultural context

Rates of prostate cancer are among the highest in African-American or Afro-Caribbean populations. Yet many of these men avoid being tested for prostate cancer because screening involves rectal penetration, which in certain parts of the world triggers homophobia. “Until cultural attitudes change, they’re afraid of being judged. So they don’t get screened and then end up being diagnosed at a much later stage, when it’s too late to be cured,” Folco explains. “Medical anthropologists try to show that diversity causes people to experience and deal with illnesses in very different ways. We might not be revolutionaries, but our research might bring up topics that initiate the process of change.”

Forward-thinking support

“I had unbelievable support at Concordia,” Folco says. “Whenever I had a question and wanted a different perspective, professors in the department were eager to share their experience and expertise from very different angles. Anthropology is very multidisciplinary and Concordia does a great job of showcasing that.”