Implications for Reducing Prostate Cancer Disparities: RESULTS

The qualitative data analysis revealed six themes that can be broadly categorized as knowledge and attitudinal barriers. Specifically, the knowledge barriers were: 1) lack of accurate information 2) misunderstanding and half truths, and 3) myths. The attitudinal barriers were: 1) fear, 2) denial, and 3) apathy. Participants reported that the presence of these barriers resulted in either poor participation or no participation in prostate health or prevention and control activities. Table 1 highlights individual quotes extracted to emphasize the significance and depth of the barriers.

Knowledge Barriers

Having identified cancer among their major health concerns, the participants admitted they knew very little or nothing about the prostate or prostate cancer. They were very unclear about the specific function of the organ but were certain that it was related to sexual performance.

The participants’ comments revealed an overall lack of accurate information regarding prostate cancer risks, symptoms, screening methods, treatment, and cure. They did not perceive themselves at high risk for prostate cancer unless a close relative (e.g., father, brother, grandfather) had experienced the disease. In addition, they were unaware of the relationship between race and prostate cancer incidence, and the relationship between age and prostate cancer onset. Although the respondents ranged in age from 33-47 years old, the absence of age as a perceived risk was poignantly expressed in the words of one participant:

“If we don’t have it [by] now, we’re in good shape.”

Participants expressed that they did not know the warning signs for prostate cancer but assumed they would experience some discomfort if they had the disease. They were shocked to learn that prostate cancer could be present without symptoms.

Of the commonly recommended screening prac­tices, they were unaware of PSA testing, but most had heard about the DRE, although they did not use that term. It was referred to as the “finger test.” They knew half-truths in that they were somewhat knowledgeable about the basics of how the examination was conducted; hence, they called it the “finger test.” However, the consensus was that “they weren’t quite sure what it was for.” During that discourse, the general opinion was discomfort with the idea that someone (regardless of it being a medical professional) would perform the finger test, because of the perceived sexual overtones.
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One participant graphically described his perception of what was involved in prostate cancer screening by stating:

“They run a tube up there and collect saliva or moistness from your penis.”

The other men cringed at the thought of what had been described, muttered undertones about not being willing to undergo that procedure, and either nodded or gestured a high-five in agreement. For them, this myth about screening had become a reality that could influence their decisions not to participate in screening in the future.

In terms of treatment, they believed that surgery was the only option, which would undoubtedly result in impotence. Again, the muttered undertones and gestures indicated that this was very unsettling for them as poignantly expressed by one of the participants:

“You don’t wanna hear that your jewels are gonna be cut off.” kamagra soft tablets

In this instance, due to the lack of knowledge about treatment options, the respondent’s comment reflects his understanding that whenever the disease is treated surgically, it means removing the testicles. Such self-perpetuating misinformation and myths block African-American men from participating in prostate health activities.

Attitudinal Barriers

The respondents’ comments uncovered fears of the actual screening procedures and the consequences if prostate cancer were found. Specifically, they expected and feared pain during DRE as well as the procedure they described involving a tube inserted into the penis. Their greatest fear was of the possible consequences of a prostate cancer diagnosis, including: impotence, the loss of masculine appeal, a negative reaction from their romantic partner, embarrassment, debilitating illness, loss of employment, suffering, and death. kamagra jelly uk

To repress their fears, several participants assumed a posture of denial that prostate cancer could happen to them. Being in denial allowed them to negate their risks and to accept as truth such myths as “they had passed the age to be at risk.” In addition, it allowed them to psychologically protect their sexual potency, the primary symbol of their masculinity. Thinking otherwise was emasculating.

Others expressed apathetic indifference to the risks, early detection, diagnosis, and treatment of prostate cancer. Their stoicism defended their masculinity but resulted in no participation in prostate health or prostate cancer prevention and control activities.

Category: Cancer

Tags: African Americans, disparities, health education, myths, prostate cancer