Construction of Male Identity : The Relationship Between Cancer Support Groups and Identity for Men who are Living With Cancer

A diagnosis of cancer may have many meanings for a man in tenns of the impact that cancer has on various aspects of his life, including his identity as a man. Subsequent membership of a cancer support group may support men negotiating their changing identity. A review of the relevant literature examines the impact of cancer and its treatments for men, and the various changes resulting from men's experiences with cancer and cancer treatments. An overview of support groups, their function, composition, and benefits is provided with a discussion of the advantages and disadvantages of professional and member facilitated cancer support groups. Men and their membership in various support groups and the role of support groups in the renegotiation of men's identities is explored. The lack of literature regarding the role of cancer support groups in the renegotiation of men's identity following a diagnosis of cancer indicates a need for research in this area. Construction of Male Identity 3 Construction of Male Identity: The Relationship between Cancer Support Groups and Identity for Men who are living with Cancer. A Review of the Literature. It is estimated that at least I in 3 Australian men will be diagnosed with cancer by the age of75 years (National Breast Cancer Centre and National Cancer Controllnitiative [NBCC & NCCl], 2003). During 2001, 4122 new cases were diagnosed in Western Australia, 3206 of which were in the Perth metropolitan area (Threlfall & Thompson, 2003). The most common new incidences of cancer reported for men in 2001 were prostate cancer (22. 7%), followed by colorectal cancer ( 14.8%), melanoma ( 11.5%) and lung cancer (11.3%) (Threlfall & Thompson, 2003). A cancer diagnosis impacts on practical, emotional and psychological areas ofliving as well as having physical effects (NBCC & NCCI, 2003). Impacts such as altered body image and changed body functions, may require men to renegotiate their identity because they no longer 'fit in' with their previous perception of masculine identity (Ofman, 1993). Also, support needs for men who have cancer may be high (Steginga, Pinnock, Gardner, Dunn, & Gardiner, 2002). For example, men who have prostate cancer may have a high need for comprehensive information due to the range of treatments available (Steginga et al., 2002). Additionally, those patients who have a disfigurement resulting from their cancer or associated treatment frequently have high needs for a support network (Richardson, Lee, & Birchall, 2002). A range of supports including behavioural therapies and psychotherapy should be available to assist men_ alleviate the psychological ramifications of a cancer diagnosis. Additionally and/or alternatively, membership of a cancer support group may provide the nt. ~'! ded support through education and assistance with psychological Construction of Male Identity 4 adjustment to changes wrought by disease (Butler & Beltran, 1993; Komblith et al., 2001; Johnson, 2000). The purpose of this review is to argue that cancer support groups may be valuable in assisting men to renegotiate their identities following a diagnosis of cancer, as men may be confused about their masculine identities and be otherwise isolated in their distress. In this literature review, the changes and adjustments that men may make following a diagnosis of cancer are disctJssed followed by an examination of the function and benefits of support groups in general and cancer support groups specifically. Men and their membership in support groups will then be explored, followed by a discussion of the role of support groups in facilitating men's renegotiation of identity. Impact of Cancer Diagnosis on Men A diagnosis of cancer may impact on roles in all facets of men's lives, and may also challenge their beliefs and values, such as their belief that they are the family provider and producing an income takes precedence over nurturing and maintaining relationships (Foltz, 1987). For example, results of a qualitative study of men living with testicular cancer undertaken by Gordon (1995), suggest that many men experience a change in their perceptions of the importance of their personal relationships and a change in their belief that work is a more important priority for them than their family. This suggests that the men feel that their lives prior to the diagnosis of cancer no longer provide what they really want and so rewevaluate their lives and values accordingly (Gordon, 1995). For some men the physical impact of cancer on their lives necessitates areevaluation of their future. For example, interviews by Znajda, Wunder, Bell, and Construction of Male Identity 5 Davis (1999) with men who had been diagnosed with soft tissue sarcoma established that many of the men had to re-evaluate their future working life, especially if they were engaged in physical work that required them to be physically strong and able. Some men also realised that they no longer took their health or life for granted following their diagnosis of cancer (Znajda et al., 1999). As a consequence of this reevaluation, the men in Znajda's study took one day at a time and were more inclined to seek advice and support from their health care team than they had prior to the diagnosis of cancer (Znajda et al., 1999). As well as re-evaluating their lives, men may need to restrict some social activities either because of the cancer or treatment (Charmaz, 1995; NBCC & NCCI, 2003; Templeton, 2003). For example, the side effects of treatment may cause debilitating fatigue and nausea, which, by necessity, require the men to 'slow down'. Feelings of embarrassment because of altered bodily appearance including feminisation of appearance from cancer treatments, may impact on the social activities that some men feel comfortable in continuing to undertake (Templeton,