Patients’ Experiences of penile Cancer

Penile cancer is a rare but destructive disease in Western populations. In the United Kingdom, penile cancer accounts for <1% of all new cases of cancer and <1% of deaths due to cancer every year (see Table 1). [Table 1] Surgical removal of the cancer is the primary form of treatment. This involves surgical excision of the primary tumour and of involved inguinal lymph nodes. Chemotherapy and radiotherapy are rarely helpful, with their use restricted either to adjuvant use or for palliative treatment of extensive disease. In treating the primary tumour, the standard of care is to provide a surgical cure (ie, excising the tumour and a margin of normal penile tissue) while maintaining the function of the penis. The traditional view was that at least a 2-cm margin of normal tissue should be removed, but recent publications suggest that more conservative surgery may be safe [1], and [2]. The advantage of such organ-preserving surgery is intuitively advantageous to the patient in that penile function can be better preserved, but the evidence to support this view is limited at present

Conducting interviews about penile cancer: A patient-conducted-interview study

Objectives: Penile cancer is a rare but destructive condition. It has been found to be detrimental to body image, general health and sexual functioning, while increasing anxiety and social problems. The UK now manages penile cancer through specialist multi-disciplinary teams that see at least 25 new patients a year. There is a need to understand patients’ experiences so that treatment can be improved. The aim of this research is to allow patients to participate in the development of a nationwide interview study. Methods: A one-day participative workshop where a range of men diagnosed with penile cancer design and conduct audio and video interviews exploring experiences of treatment within the group. Results: Key themes included the rehabilitation of urinary functioning and strategies for coping with the physical and social impact of treatment. Conclusions: The findings emphasise the importance of day-to-day practicalities for men treated for penile cancer, which can form the basis for larger studies about how to better understand and manage their treatment

Psychology, men and cancer

A disease of the anatomical or social body, cancer raises fears about the uncontrollable division and multiplication of some abnormality that will lead ultimately to the destruction of those very conditions that make possible our lives. Cancer incidence and mortality rates are higher in men than women, raising questions about the roles for psychologists in relation to gender and cancer. Psychologists are wont to question the division of population level statistics by sex rather than other, such as behavioural, categories. Conceptual distinctions between biological sex and psychosocial gender are taught early in the psychology curriculum, but cancer of the breast questions the easy separation of the biological bod

Engaging men with penile cancer in qualitative research: reflections from an interview-based study.

To explore the challenges of engaging men with penile cancer in qualitative interview research

THE IMPACT OF PENILE CANCER TREATMENT ON SEXUAL RELATIONSHIPS: A QUALITATIVE ENQUIRY

Background: Penile cancer is a rare but highly treatable condition. Current guidance recommends the use of a surgical procedure to excise the primary tumour (and a margin of normal penile tissue). Whilst treatment can be effective, treatment often has a significant impact on a patient's sexual and urinary function, and physical and mental wellbeing. The objective of this study was to explore the impact of treatment for penile cancer on sexual function and relationships. Methods: Qualitative data was collected via narrative video interviews. Maximum variation sampling was used to acquire the widest possible range of experiences. All interviews were recorded using either a digital video recorder or digital audio recorder, transcribed. A method of constant comparison analysis was used to illicit themes and outliers. Results: Twenty seven men were interviewed; mean age at diagnosis = 63 (range = 41-82); Mean number of years post-surgery = 3 (range = 0-15 years) 15 men were married, a further two were in a committed relationship, the remaining 10 were single/widowed. All men had received surgical treatment ranging from circumcision to total penectomy. Just two men had attended any form of psychological therapy. The impact of treatment varied considerably. The majority of men talked about still being able to experience arousal and sexual pleasure in some way. However, for many, penetrative sex was awkward and less gratifying than before treatment. One man who had received a total penectomy was surprised to experience a form of orgasm after surgery. For a number of men, the impact of treatment on their ability to satisfy their sexual partners was a key concern. Men who were able to openly talk with their partners about sex and the impact of the treatment on sexual practice found this a great comfort. Conclusion: The significance of sex for a man can differ considerably between individuals; relationship status, age and life stage are all likely to have a bearing on the role that sex plays in a man life. A diagnosis of cancer can also affect how a man (and his partner) views sex and the level of importance which he attaches to it. For men who are sexually active prior to treatment, surgery will undoubtedly result in changes to sexual practice, however, treatment does not have to result in sexual abstinence

On the Nature of Singularities in Plane Symmetric Scalar Field Cosmologies

The nature of the initial singularity in spatially compact plane symmetric scalar field cosmologies is investigated. It is shown that this singularity is crushing and velocity dominated and that the Kretschmann scalar diverges uniformly as it is approached. The last fact means in particular that a maximal globally hyperbolic spacetime in this class cannot be extended towards the past through a Cauchy horizon. A subclass of these spacetimes is identified for which the singularity is isotropic.Comment: 7 pages, MPA-AR-94-

Hands-on, Shoes-off: Multisensory Tools Enhance Family Engagement Within an Art Museum

Families with young children typically struggle to engage with traditional art museum environments. This research examined the impact of multisensory tools on family engagement within Mathaf: Arab Museum of Modern Art, Qatar. Sixty families with at least one child aged 0-11 were observed during two tasks. One task required participants to look at a series of paintings to select their favorite. In another task families were given a toolkit of multisensory items to facilitate interaction with a painting. A semi-structured observational method produced quantitative and qualitative data about participant engagement and intergenerational interaction. Self-rating scores of task enjoyment were also collected. Results indicated that multisensory tools enhance family engagement with museums, artworks and with each other. Results also suggested that word-based interpretation was not necessary. We consider the potential implications of these findings in relation to family programming within art museums and museums more generally

Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates

ObjectivesTo systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage.DesignSystematic review and meta-analysis.Participants4494 patients with prostate cancer from primary research investigations.Primary outcome measureThe prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage.ResultsWe identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively.ConclusionsOur findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated

Pre-Congestion Notification (PCN) Architecture

This document describes a general architecture for flow admission and termination based on pre-congestion information in order to protect the quality of service of established, inelastic flows within a single Diffserv domain.\u