7 May 2021

Guest Blogger: Caterina Gentili

Earlier this year Caterina completed a PhD into the effect of hormonal prostate cancer treatment on men's body image.

Here she tells us more about the Above & Beyond funded project.

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In a nutshell, my PhD investigated whether Androgen Deprivation Therapy (a hormonal treatment for prostate cancer which blocks the production of testosterone to slow down cancer growth, and is associated with several side effects such as weight gain, sexual issues, hot flushes, fatigue, and others) might affect prostate cancer patients' masculine identity and body image (which refers to the way we think and feel about how our body looks and functions).

The PhD included three studies. The first consisted of 20 interviews with prostate cancer patients who experienced ADT, and it aimed at better understanding what their lived experience was. The study found that some men did struggle with their body image as well as with their masculinity. The study also found that exercise seemed to be a good strategy to deal with the physical side effects of treatment, as well as to improve patients' mental health. The full study has been published on Psycho Oncology Journal and can be found here.

The second study consisted of a survey investigating body image, masculinity, and attitudes towards exercise. This second study compared three groups of men. One group who was diagnosed with prostate cancer and was undergoing ADT, one group who was diagnosed with prostate cancer but never followed ADT, and a third group of men who were never diagnosed with prostate cancer. This study found that although the three groups did not differ for their level of body image issues (which was an unexpected finding), being on ADT was associated with a higher risk of low masculine self-esteem, and that men with a very traditional model of masculinity were also at higher risk of developing dissatisfaction with their masculinity while following ADT.

The third and last study focused on coping mechanisms (the different ways in which prostate cancer patients undergoing ADT face the challenges that the cancer journey puts in front of them daily). The study was a survey with a mix of multiple answer questions and also open-ended questions and it was administered to 90 men with prostate cancer and following ADT. The study found that most patients adopted the coping strategy of acceptance to deal with ADT side effects. This coping strategy was also associated with positive body image and positive masculinity outcomes. On the other hand, other coping strategies like denial and self-blame, were associated with negative body image and negative masculinity outcomes. However, these coping strategies were employed only by a minority of participants.  

This PhD shed more light on the topic of body image when undergoing ADT - a topic that was truly understudied up until this point.

The main take away of this PhD for both patients and staff is that although many men undergoing ADT might manage to cope with body image and masculinity changes just fine, a smaller group of patients might have a hard time going through these adjustments.

The message of this work is to make sure to be available and ready for these conversations, so that those prostate cancer patients who might be struggling accepting the bodily changes provoked by cancer treatment can feel supported in their concerns. 

I enjoyed the opportunity to work collaboratively with many charitable and community-based organisations which were often led by prostate cancer patients. I learned a lot by working with people who have had a lived experience of prostate cancer and I think this made my research better - and also made me grow into a better researcher.

I want to say, thank you so so much to Above & Beyond for funding this PhD and for continuing to raise funding for health (and health psychology) research. This work would not be possible without your support and it's thanks to organisations like yours that health workers can make improvements to patients' lives. 

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