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(November 1, 2001, Gazette)

Prostate cancer in rural Newfoundland
Coping with concern

Dr. Robert Lewis
What’s the second leading cause of cancer death in the province? Most people know that lung cancer is the first cause; ask a woman and she’ll probably correctly identify breast cancer as number two. Ask a man, and the answer varies.

Sociologist Dr. Robert Lewis knows that the correct answer for men is prostate cancer. With the help of funding from the Newfoundland Cancer Treatment and Research Foundation (NCTRF), he and co-investigators Dr. Raoul Andersen, Anthropology, and Dr. Shirley Solberg, Nursing, will explore how rural Newfoundlanders cope with this male-specific cancer.

“My work has been with aging, and prostate cancer is very much a disease of aging, “ explained Dr. Lewis. “More and more, rural Newfoundland is an old community because of out-migration and declining birth rates. Clearly prostate cancer is a concern for aging men and their families too.”

This is the first research grant awarded from NCTRF, and it is significant that the study will look at social aspects of prostate cancer. “We will interview both men and their partners about their experience with the health care system, and community reactions to this disease.”

The prostate is a small walnut-sized gland below the bladder and a common source of ailments in men, such as prostate enlargement, prostatitis and cancer. Dr. Lewis said side effects of treatment for prostate cancer may involve loss of bladder control and impotence. “It’s clear men don’t talk about disease conditions as much as women do, and in fact are less likely to go to the doctor for what might seem like minor annoyances – such as having to get up more to go to the bathroom. It may be that they grew up thinking this was just a normal part of aging.”

While there is a support group for prostate cancer, it is still largely confined to the St. John’s area. “Prostate cancer is often a long-term condition – it’s not just a matter of going to the hospital and getting pills. There may be a tendency to ignore it.”

Dr. Lewis said that because prostate cancer is tied to aging, it highlights fears that people have about aging, such as loss of control and loss of those aspects of life associated with youth. “It’s not something we want to face.”

Prostate cancer also has an element of uncertainty. “We have diagnostic techniques that are quite good, but in the case of the PSA (prostate specific antigen) test it seems to catch a lot of ‘false positives.’ Because of this there’s a debate about whether it should be a general test given to men over a certain age. The PSA is not quite equivalent to the Pap smear for women.”

Part of Dr. Lewis’ study will look at the initial contact men in rural areas have with doctors. “For example, did the doctor offer to do a PSA, or a digital rectal exam?”

Drs. Lewis and Andersen will do telephone interviews with men in the province for this study; Dr. Solberg will talk with spouses and partners.