The psychological implications of surviving testicular cancer : impact on body image, sexuality and masculinity

Abstract

INTRODUCTION: Men's health generally and testicular cancer in particular are neglected areas of research. This particular malignancy is the most common among young men in the western world (Champion, 1996), and its prevalence is on the increase, however, so too are cure rates. As a consequence there are an increasing number of young male survivors. Impact on sexual function of survivors is well documented in the literature, yet little is mentioned about the impact on the sexuality and masculinity of the young man following treatment. The objective of the research therefore was to explore the impact on survivor's self-perceptions,in particular focusing on the areas of sexuality, masculinity and body image. METHOD: The research followed a cross-sectional design, comparing men at four different stages post-illness. Repertory grid technique was utilised for data collection purposes, which combined qualitative and quantitative methods. Semi-structured interviews (n = 10) were analysed using content analysis, which formed the basis of a generic repertory grid. Quantitative data from subsequent grid completion (n = 37)were analysed using a beta version of SPSS to carry out 3-way 3-mode multidimensional unfolding. RESULTS: The results suggest that men's self-perceptions change as a consequence of testicular cancer, and that sexuality, masculinity and body image play a part in these changes for some, but not all men. The constructs rated in this study all contribute to the differences in patterns across groups. Results suggest the occurrence of an adjustment process, showing current perceptions of the self as more aligned with retrospective pre-illness perceptions by 24 months post-illness. The majority of men judged repertory grid technique to be a satisfactory means of evaluating self-perceptions relating to the illness experience. DISCUSSION: The results of the study have implications for the level of professional support received by men with testicular cancer, both generally and with specific reference to issues of sexuality, masculinity and body image. However the innovative style of this research and the absence of pre-existing evidence in support of the findings, mean that further research will be required to gain a thorough understanding of the psychological implications of surviving testicular cancer with regards to these issues. Specific recommendations are made for further researc