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Try out PMC Labs and tell us what you think. Learn More. Prostate cancer in sexual and gender minorities is an emerging medical and public health concern. The purpose of this review is to summarize the state of the science on prostate cancer in gay, bisexual, and other men who have sex with men GBM and transgender women TGW. We undertook a literature review of all publications on this topic through February With 88 unique papers 83 on prostate cancer in GBM and 5 case reports of prostate cancer in TGWa small but robust literature has emerged.

The first half of this review critiques the literature to date, identifying gaps in approaches to study. The second half summarizes the key findings in eleven areas. In light of this admittedly limited literature, GBM appear to be screened for prostate cancer less than other men, but they are diagnosed with prostate cancer at about the same rate. Compared to other men, GBM have poorer urinary, bowel, and overall quality-of-life outcomes but better sexual outcomes after treatment; all these findings need more research.

Prostate cancer in TGW remains rare and under researched, as the literature is limited to single-case clinical reports. Research on prostate cancer in sexual and gender minorities is an emerging field of study. Gay sex in Davenport craigslist purpose of this review is to provide an informed overview of the state of the science regarding prostate cancer in gay, bisexual, and other men who have sex with men GBM and transgender women TGW.

Some of the studies reviewed in this chapter are described in more detail in subsequent chapters in this book.

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In February we performed a systematic literature Gay sex in Davenport craigslist and review. A supplemental search of bibliographies added 39 references. Excluding three duplicate citations, the complete search yielded a total of 88 original works. Allowing for multiple papers from the same study, there were 28 case studies table 1.

The main of the literature to date have addressed the following eleven key questions. Prostate cancer is the second-most common cancer among men; 2, men in the United States were living with prostate cancer in It is impossible to estimate the prevalence of prostate cancer among TGW. Because the development of prostate cancer after orchidectomy is rare, 9 the of TGW with prostate cancer in a country is probably a function of the availability of gender-reasment surgery and hormone therapy. Three epidemiologic case-control studies inform this question, and their conclusions differ. One study comparing men with prostate cancer with a control group of men matched on age and race found that members of the prostate cancer group were more likely to have a history of STIs, and more likely to report homosexual partners, than the control group.

Though sex with 20 or more men was associated with elevated risk, neither history of STIs nor sexual orientation identity as gay or bisexual was ificantly associated with risk. Though early studies suggested an increased risk of prostate cancer among HIV-positive than among HIV-negative men, 1617 studies in the era of ARV treatment show an inverse association. Unfortunately, the HIV studies to date have not reported data on sexual orientation, so it is impossible to tease out what may be HIV effects from effects due to sexual orientation.

A Chicago-based study found that HIV-positive men were as likely to receive treatment for prostate cancer, less likely to undergo a radical prostatectomy, and more likely to be over treated compared to HIV-negative men. Though HIV and immunodeficiency may alter the risk of prostate cancer 11122223 and cancer virulence, 11 ARV treatment appears to be protective. GBM appear to have worse urinary and possibly bowel outcomes, but better sexual outcomes, than published norms. Some studies conclude that the better sexual outcomes GBM report compared to heterosexual peers may be due to GBM being more open, innovative, or committed to restoring their sexual function.

GBM report more bother as a result of the inability to ejaculate than heterosexual men.

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In one study, Gleason scores were ificantly lower for GBM than for heterosexual men, which suggests that GBM may be diagnosed ear-lier than heterosexual men. A second hypothesis is that physical trauma to the prostate e.

LGBT health disparities in accessing medical care exist.

INTRODUCTION

Like other men, GBM report reduced sense of masculinity, 39 — 41 identity, 4243 or self-esteem or a combination of these. While prostate cancer affects GBM in many of the same ways as heterosexual men, GBM prostate cancer survivors face unique challenges, including the loss of the prostate as a site for sexual pleasure in receptive sex, 1149 loss of ejaculate which authors emphasize is more central in gay sex355254 persistent rectal irritation or pain sufficient to prevent receptive anal sex, 3655 and erections too weak for insertive anal sex.

None of the GBM who were exclusively receptive before treatment changed roles afterward. Prostate cancer and its treatment have ificant effects on mental health 3558 as well as quality of life. Compared to heterosexuals, GBM experience less familial 6749 — 51 and social support.

The effects of such support have not been evaluated. Male partners may have unique concerns, such as fear of infectivity, that female partners may not experience.

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Caring for a partner with prostate cancer may be experienced differently by male spouses. Multiple studies all describe prostate cancer in GBM as a severely under-researched area.

The key finding of this review is that a small but robust literature is emerging on the experience of GBM prostate cancer survivors. The same cannot be said of TGW, where the literature is limited to a single case report every two to three years. Multiple challenges have stymied research in this area. Recruitment of GBM in meaningful s for study is also a barrier, exacerbated by a lack of sexual history taking as standard practice, as well as clinical systems not collecting systematic data on sexual orientation or gender of sexual partners.

This situation leaves GBM with prostate cancer as an invisible, geographically dispersed, hard-to-recruit population. Language is a separate challenge.

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As tables 1. Similarly, prostate cancer professionals may use the term survivor for patients five or more years out, whereas GBM created, and are more familiar with, the nomenclature persons living with [HIV]. Heterocentric definitions of sexual functioning and scales limited to penetrative sex are problematic.

Six directions for future research are identified. First, methodological research is needed to identify ways to locate, recruit, and retain GBM with prostate cancer in studies and to develop population-appropriate definitions and measures.

Second, as the detail, more formative research in specific areas is needed. Third, empirical studies to quantify the prevalence and incidence of problems, and the effects of different treatments, will be critical to informing clinical care. Fourth, comparative studies of treatment preferences for GBM and heterosexual men should confirm whether GBM are more likely than, as likely as, or less likely than heterosexuals to choose surgical intervention.

Fifth, intervention studies to address the rehabilitation needs of GBM with prostate cancer are critical to develop evidence-based interventions tailored to this population. Finally, the training needs of urologists, surgeons, oncologists, and other specialists providing services to GBM with prostate cancer remain to be identified, and curricula developed, to ensure culturally competent providers capable of addressing the sexual health needs and care of this population.

CA; principal investigator B. This article was originally published as a chapter in: Jane M. Ussher, Janette Perz and B. Simon Rosser Eds. Reprinted with Permission. Conflict of interest: The authors declare no conflict of interest. National Center for Biotechnology InformationU. Curr Sex Health Rep.

Author manuscript; available in PMC Dec 1.

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Simon Rosser1 Shanda L. Hunt2 Benjamin D. Capistrant3 Nidhi Kohli4 Badrinath R. Konety5 Darryl Mitteldorf6 Michael W. Ross7 Kristine M. Talley8 and William West 9. Simon Rosser. Shanda L. Benjamin D. Badrinath R. Michael W. Kristine M. Author information Copyright and information Disclaimer.

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Corresponding Author : B. Copyright notice. The publisher's final edited version of this article is available at Curr Sex Health Rep. See other articles in PMC that cite the published article.

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Keywords: bisexual, cancer, gay, prostate, sexual rehabilitation. TABLE 1. Surveillance: study analyzing secondary data from large data set 1014209798 b.

Open in a separate window. No formal comparison of heterosexual versus gay survivors seems to have been performed; authors concluded that the commonalities, not differences, were striking. Authors note that all the heterosexual men were partnered, whereas only 1 of the 4 gay men were, and that black heterosexual men were particularly concerned about loss of sexual ability and perhaps less willing to participate in treatment. Some hold beliefs that rough sex can cause or prevent prostate cancer.

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In Latino and black gay men, machismo and medical skepticism may prevent screening, respectively. Gay men overstressed prostate cancer being fatal. ZIP: 52802 52803 52801 52806 52807 52804 52805 52808 52809

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