"Gay & Bisexual Men Living with Prostate Cancer (from Diagnosis to Recovery)" is the latest book from LGBTQ scholarly publisher Harrington Park Press and like previous titles from the imprint, such as "Transgender Sex Work and Society" and "LGBTQ Hospice and Palliative Care," the book is one of the first of its kind.
The book, edited by Jane M. Ussher, Janette Perz B.R., Simon Rosser was written not only for the medical community treating gay and bi men with prostate cancer, but also as a supportive resource for gay and bi men diagnosed with prostate cancer. It is the most current and comprehensive book on the subject published to date, incorporating the tremendous new developments in cancer treatment from the past ten years.
Here, Dr. Simon Rosser and Dr. Bill West, coauthors of several chapters in "Gay & Bisexual Men Living with Prostate Cancer,” answer 12 questions and offer advice to gay and bi men facing prostate cancer. Simon and Bill are married, out and living with prostate cancer.
12 Things Every Gay/Bisexual Man should Know about Prostate Cancer
B. R. Simon Rosser and William West
1. How common is prostate cancer in our community?
Prostate cancer is the #1 invasive cancer for men and the most common cancer in the gay male community. One in seven gay men will be diagnosed in their lifetimes. Since gay male couples have two prostates, they have twice the risk than heterosexual couples or a one-in-three chance.
2. What are the symptoms of prostate cancer?
Prostate cancer typically develops without symptoms which is why it needs to be detected through a blood test (the Prostate Specific Antigen or PSA test) and by a doctor feeling for any abnormalities during a digital rectal (or finger up the butt) exam. Two common prostate problems should not be confused with prostate cancer. As we age, our prostates typically get larger which can lead to problems urinating. This is called benign prostatic hyperplasia or BPH. Prostatitis refers to when the prostate gets infected or inflamed.
3. So, what causes prostate cancer?
Older men, men with a family history of prostate cancer, and African American men are at greater risk of diagnosis and/or worse outcomes. Our research indicates that HIV positive men and bisexual-identified men have worse outcomes than HIV negative men and gay-identified men, respectively. Gay “lifestyle” factors – such as being gay versus straight, lots of sex or no sex, amount and rigor of receptive anal sex, smoking, drug and alcohol use, a history of sexually transmitted diseases and long-distance cycling – have not been associated with greater risk or worse outcomes.
4. So, why is prostate cancer in gay men an issue?
Different prostate cancer treatments have different effects on our sexual functioning. About 20 percent of patients treated with radiation experience radiated bowel, which makes receptive anal sex painful to impossible. Conversely, almost all men treated with surgery (and many with radiation as well) will have erection difficulties, after treatment, making insertive sex very challenging. Treatment can also effect penis size, ability to ejaculate, experience of orgasm, pleasure in receptive sex, and urinary problems during sex or at orgasm. This makes it important to discuss gay sex with your specialist as part of choosing which treatment will have the least side effects for you.
5. If I want to be checked for prostate cancer, what should I know?
The typical test for prostate cancer involves both a blood test and a digital rectal exam. Because massage of the prostate may hypothetically affect the blood results, we recommend you refrain from receptive anal sex or other anal stimulation for 48 hours before the blood is drawn and make sure the blood is drawn before the digital exam.