**2.6.2 Questions**

42 Prostate Cancer – Diagnostic and Therapeutic Advances

Mellstrom, 2004) and technological advances in prostate-cancer-risk identification, early detection, treatment, and rehabilitation, men still perceive that technological interventions reduce their capacity to control the responses of their bodies and emotions to such

Widespread public access to prostate cancer information in popular and scientific media has uncovered current discourse surrounding uncertainty about prostate cancer among researchers and health care professionals. Certainly, men are less likely to trust the health care system's assurance that current technologies are helpful and to rely on information from health care professionals in their decision making. Regardless of men's personal level of education and health literacy, they should be supported in enhancing their ability to perceive and differentiate levels of risk when making informed decisions about treatments. Gender-related experiences are, again, important to consider in the clinical context, because men's health experiences tend not to be solitary. Men's experiences are, instead, influenced by the roles of women (mothers, wives, partners, daughters, nieces, aunts, etc.) and other caring figures (fathers, same-sex partners, coaches, etc.) in their lives. Together, caring figures influence men's decisions to seek medical help, adhere to treatments, and most important, transcend the limitations and changes imposed by prostate cancer. Such a collective view of men's health experiences challenges current organizational policies requiring that personal information remain private and neglects the social and cultural fact that men are human beings, who (in less publicly demonstrative ways than women) are influenced by intimate others in seeking health and well being (Zanchetta et al., 2010).

**2.6 Reflecting on control in men's experiences with prostate cancer screening** 

construct appropriate answers to the reflection questions.

be less invasive than the DRE test.

**2.6.1 Clinical vignettes** 

why fix it?"

Below are some true stories with fictitious names as clinical vignettes and reflection questions to help readers identify control as a key concept in men's experience of prostate cancer and reflect on how control plays out in clinical practice. No answers are provided, because we want to stimulate readers' recall of their own experience so that they can

 John, a 56-year-old accountant, was urged by his wife to get screened for prostate cancer. After months of postponing his decision, he agrees to make an appointment for an annual physical. During the history taking, he tells the doctor that he feels fine and does not understand why he should have a physical. John says, "If it isn't broken,

 Charles, a 50-year-old engineer, comes to the clinic for his annual physical and discusses prostate screening with his family doctor. They discuss the merits of DRE versus PSA testing. His doctor explains both screening tests. Charles is reluctant to have a DRE test, given the invasive nature of the procedure. In spite of the information his doctor provides about the limited sensitivity and specificity of the PSA test, Charles decided to have the PSA test done, because he believes that it will

 Silvio, a 50-year-old computer designer, is a newcomer to Canada who speaks and understands English at an intermediate level. After arriving, he looked for a family doctor to monitor a recurrent inflammation in his prostate as well as have his annual PSA test. Due to pain and urinary troubles, the doctor ordered an abdominal

interventions (Chapple & Ziebland, 2002).

