El cáncer de próstata y la construcción social de la masculinidad en Puerto Rico

El cáncer de próstata en los puertorriqueños compara con las tendencias a nivel mundial siendo la enfermedad de mayor incidencia y mortalidad entre los hombres. En muchos casos cuando no se descubre a tiempo se debe a la renuencia de los hombres a ser examinados por un proctólogo lo que pone en riesgo su salud. Aquellos que se examinan y salen positivos han de someterse a tratamientos que conllevan efectos secundarios que tienen un impacto tanto en su salud física como emocional. En este trabajo se presentan los resultados de un estudio fenomenológico más amplio llevado a cabo en Puerto Rico con parejas cuyo compañero experimentó cáncer de próstata. Se discute la construcción social de la masculinidad y el impacto de la misma en la búsqueda de diagnóstico y en la reacción a los efectos secundarios del tratamiento. Se encontró: a) una renuencia a realizarse el examen de detección de cáncer de próstata asociada al concepto de machismo y a la posibilidad de impotencia, b) falta de orientación para trabajar efectos secundarios como la incontinencia y la disfunción eréctil, c) escasa atención a la concepción de masculinidad que pone en riesgo y en una posición de vulnerabilidad emocional a estos pacientes. Se ofrecen recomendaciones para los profesionales de la salud.

The prevalence of prostate cancer among Puerto Ricans compares with worldwide tendencies regarding incidence and mortality rates. With frequency it is not diagnosed in time due to male reticence to be examined by a proctologist thus placing them at risk. Those who decide to be examined and are diagnosed must undergo treatments with secondary effects that impact not only their physical but their mental health as well. In this work results of a broader Phenomenological study with couples where the spouse had prostate cancer are presented. We discuss the social construction of masculinity and its impact on the diagnosis, and on the reactions to secondary effects of prostate cancer. We found: a) a resistance to the prostate cancer detection exam due to machismo and fear of impotence, b) lack of orientation from health professionals on how to deal with secondary effects of treatment such as incontinence and erectile dysfunction, c) lack of attention to mens concept of masculinity which constitutes a risk to their health and puts them in a place of emotional vulnerability. Recommendations for health practitioners are offered.

The return to the community after cancer treatment: from safety to reality check.

The survivorship of children diagnosed with cancer has risen during the last decade. After the end of treatment those children and their families return to the community where another period of crisis unfolds. In this article, the findings of a larger qualitative study in Puerto Rico related to the return to the community of these patients and their families are discussed, including financial difficulties, the burden of responsibility, and transition to school. These findings provide a rationale for the implementation of a bio-psycho-social model of health that emphasizes reciprocal interactions among the multiple systems in which these families are embedded.

Cultural aspects of the Puerto Rican cancer experience: the mother as the main protagonist.

Pediatric cancer survivors are a growing group whose needs extend to multiple contexts and systems. Most studies dealing with the emotional sequelae of childhood cancer have neglected patients' and parents' perspectives. Few have dealt with issues faced by the treatment team. Our research constitutes the first attempt to gather a collective view of such experience in Puerto Rico. Using a phenomenological approach, in-depth interviews were conducted with acute lymphoblastic leukemia (ALL) patients, their mothers, and their oncology treatment team (18) at a children's hospital in Puerto Rico. Analysis followed the model proposed by Strauss and Corbin. In this article, findings directly associated with the cultural aspects of the Puerto Rican cancer experience are presented, including the mother's role--devotion and abandonment; the father's role--masculine vulnerability; and the family paradox. Mothers' protagonism was the central theme that emerged from these three categories.