Whats the second leading cause of cancer death in the province?
Most people know that lung cancer is the first cause; ask a woman
and shell 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
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. Its
clear men dont 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. Johns area. Prostate cancer is often
a long-term condition its not just a matter of going
to the hospital and getting pills. There may be a tendency to ignore
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. Its 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 theres 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.