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The Role of Prostate Cancer Support Groups (PCSGs) in Health Promotion
Executive Summary: 2009
T. Gregory Hislop
Michael McKenzie
University of British Columbia
Centre for Nursing and Health Behaviour Research
(http://www.nahbr.nursing.ubc.ca/), NEXUS (http://www.nexus.ubc.ca/ ) and the
Men Health Research Program (http://www.menshealthresearch.ubc.ca/ ), 2009.
This work has been produced with the support of the Canadian Institutes of Health
Research, Institute of Gender and Health, with addition establishment funds made
available to Dr. John Oliffe by the Michael Smith Foundation for Health Research.
ISBN: 978-0-88865-274-4 print version.
ISBN: 978-0-88865-874-6 web version.
This report is downloadable from NAHBR at http://www.nahbr.nursing.ubc.ca/
NEXUS at http://www.nexus.ubc.ca/ and the Men's Health Research Program at
Table of Contents:
Introduction. 4
Prostate cancer support groups in British Columbia . 4
Methods . 5
Table 1. Prostate cancer support group characteristics. 6
Key Findings . 7
1. Prostate cancer support group sustainability. 7
2. Health promotion and illness demotion. 8
3. The function of humour . 11
4. Women and prostate cancer support groups . 12
5. Canadian newspapers' portrayals of prostate cancer . 15
Recommendations . 17
Publications. 18
Presentations. 19
Acknowledgements. 21
Appendix 1 – BC prostate cancer support groups. 23
References . 27
References
1. Hsing AW, Tsao L, Devesa SS. International trends and patterns of prostate cancer
In Canada, no cancer is more common to men than prostate cancer (PCa).1 In 2007,
incidence and mortality. Int J Cancer. 2000;85 (1):60–7.
22,300 Canadian men were diagnosed with PCa, and an additional 4,300 died of the
2. Canadian Cancer Society. Canadian cancer statistics; Prostate cancer stats [database on
disease.2 Old age is the strongest predictor of PCa development3,4 and it is estimated that
the Internet]. 2008 [updated 2008 April 9; cited 2008 August 11]. Available from:
the proportion of elderly Canadians (>65 years of age) will increase from 13.2% (4.2
million) of the total population (2005) to 24.5% (9.8 million) by 2036.5 Men are also
3. Albertson P. Prostate disease in older men: Cancer. Hosp Pract. 1997;32(10): 159–66,
living longer with PCa, and the death rate continues to be significantly lower than the
incidence rate.6 In the absence of a known cause or cure, the number of men diagnosed
4. Kozlowski J, Grayhack J. Carcinoma of the prostate. In: Gillenwater J, Grayhack J,
with PCa will increase with the aging population, and for many men it will become a
Howards S, Mitchell M, editors. Adult and Pediatric Urology. Vol. 2, 4th ed.
Philadelphia: Lippincott Williams and Williams; 2002. p. 1471–1654.
chronic, long-term illness.6,7 Diverse health issues are encountered by men and their
5. Statistics Canada (2006).
families as a result of PCa and its treatments, many of which influence gender roles and
6. Ellison LF, Stokes J, Gibbons L, Lindsay J, Levy I, Morrison H. Monograph Series on
gender relations,8-17 and quality of life.18-20 The roles of breadwinner, husband and father
Aging-related Diseases: X. Prostate Cancer. Chronic Diseases in Canada [monograph on
are often altered, and pursuits of work and leisure can be undermined.8-9,15-17
the Internet] 2000 [cited 2004 March 5]; 19(1). Available from: http://www.phac-
Furthermore, most PCa treatments affect potency and urinary continence, which directly
7. Remzi M, Waldert M, Djavan B. Prostate cancer in the ageing male. J Mens Health
affect men's sexuality and intimate relationships.12-13, 14-17, 21-24
Gend. 2004;1(1):47–54.
8. Oliffe JL. In search of a social model of prostate cancer: Finding out about Bronch. In:
Health and illness information are integral to the well-being of men who have PCa, and
Pearce S, Muller V, editors. Manning the next millennium: Studies in masculinities
prostate cancer support groups (PCSGs) have emerged as important community-based
Western Australia: Black Swan Press; 2002. p. 69–84.
resources. Underpinned by the basic premise that PCSGs have much to offer, we
9. Oliffe JL. Prostate Cancer: Anglo-Australian heterosexual perspectives [dissertation].
designed a study to better understand how groups operate as a means of describing their
Geelong (Victoria, Australia): Deakin University; 2003.
10. Oliffe J. Anglo-Australian Masculinities and Trans Rectal Ultrasound Prostate Biopsy
role in health promotion. The three-year study was funded by the Canadian Institutes of
(TRUS-Bx): Connections and Collisions. Int J Mens Health. 2004;3: 43–60.
Health Research (CIHR), Institute of Gender and Health and through their generous
11. Oliffe JL. Trans rectal ultrasound prostate biopsy (TRUS-Bx): Patient perspectives. Urol
support we were able to explore:
Nurs. 2004;5(4): 395–400.
12. Oliffe JL. Constructions of masculinity following prostatectomy-induced impotence. Soc
• the feasibility of survivor-volunteer led PCSGs,
Sci Med. 2005; 60(10): 2249–59.
13. Oliffe J. Embodied Masculinity and Androgen Deprivation Therapy. Sociol Health Illn.
men's and women's patterns of engagement with, and perspectives about PCSGs, and
14. Chapple A, Ziebland S. Prostate cancer: Embodied experience and perceptions of
masculinity. Sociol Health Illn. 2002; 24(6): 820–41.
• factors shaping men's health promotion practices at PCSGs.
15. Fergus K, Gray R, Fitch M. Sexual dysfunction and the preservation of manhood:
experiences of men with prostate cancer. J Health Psychol. 2002; 7(3): 303–16.
The purpose of this report is to summarize the findings drawn from the study and make
16. Gray R, Fitch M, Fergus K, Mykhalovskiy E, Church K. Hegemonic masculinity and the
practice and research recommendations. The content shared in this report has been
experience of prostate cancer: A narrative approach. Journal of Aging and Identity.
2002;7(1): 43–62.
published in academic journals, the ‘Our Voice' PCa survivor magazine and on the
17. Fergus K, Gray R, Fitch M. Active consideration: Conceptualizing patient-provided
Canadian Prostate Cancer Network (CPCN) web site (http://www.cpcn.org/) and
support for spouse caregivers in the context of prostate cancer. Qual Health Res. 2002;12:
presented at conferences, workshops and PCSG meetings in Canada, the USA, Australia
18. Kirschner-Hermanns R, Jakse G. Quality of life following radical prostatectomy. Crit
Rev Oncol Hematol. 2002;43: 141-151.
19. Meuleman EJH, Mulders PFA. Erectile function after radical prostatectomy: A review.
Prostate Cancer Support Groups in British Columbia
Eur Urol. 2003;43: 95-102.
20. Palmer MH, Fogarty LA, Somerfield MR, Powel LL. Incontinence after prostatectomy:
PCSGs are relatively recent phenomena, and the Vancouver group in British Columbia
Coping with incontinence after prostate cancer surgery. Oncol Nurs Forum. 2003;30(2):
(BC), established June 1992, was among the first groups to operate in Canada. Previous
21. Charmaz K. Identity, dilemmas of chronically ill men. In: Sabo D, Gordon DF, editors.
studies of Canadian PCSGs, including an interview study of 12 men mostly in leadership
Men's health and illness: Gender, power and the body. Thousand Oaks, CA: Sage
roles in Winnipeg, Toronto and Ottawa-based groups, indicated that men derive a sense
Publications; 1995. p. 266–91.
22. Navon L, Morag A. Advanced prostate cancer patients' ways of coping with the
hormonal therapy's effect on body, sexuality, and spousal ties, Qual Health Res.
* Please refer to Publications and Presentations (page 18 through 20) for specific details.
2003;13(10):1378–92.
of meaning and purpose through attending support group meetings.25 A survey of men
Vernon PSA (Prostate Cancer Support & Awareness) Group
attending a professionally-led Montreal-based PCSG indicated that the sharing of PCa
Contact: Ed Eyford 250-545-6220 or Lloyd Mitchell 250-549-2362
experiences with others gave men reassurance, helped alleviate anxiety, and provided a
Email: [email protected] or [email protected]
more positive outlook and a perception of being actively involved in their treatment.26
When: The 4th Monday of Jan., Feb., Mar., Apr., May, Sept., Oct., & Nov.
Time: 7:30 to 9:30 p.m.
Both studies recommended further research to more fully understand how PCSGs operate
Where: The People Place 104–3402 27th Avenue
in Canada, and in 2005 we were able to build upon these earlier studies.
Victoria PSA (Prostate Cancer Support Association)
Contact: David Durksen or Andrew Godon 250-382-6531
Email: [email protected] or [email protected]
When: The 2nd Tuesday of each month
Time: 7:00 to 9:00 p.m.
Study design
Where: Begbie Hall Royal Jubilee Hospital grounds, 2101 Richmond Ave. Victoria
A qualitative ethnographic design, including fieldwork, participant observations, and
individual interviews provided an effective way to establish understandings about
White Rock/South Surrey Prostate Cancer Support & Awareness Group
PCSGs.27 The primary characteristic of the study was its commitment to cultural
Contact: John Morton 604-538-0011
interpretations of the practices and social norms at the PCSGs.28-29
Email: [email protected]
When: No Longer meeting but John is willing to take calls.
We attended and observed meetings at 16 groups in diverse rural and urban locations in
BC, Canada. The PCSG meeting details based on fieldwork and participant observations
are included in Table 1. Five groups focused their meetings on psycho-educational
presentations, six groups were discussion-based, and five groups combined psycho-
education with discussion. All the groups were led by PCa survivor volunteers and the
number of attendees ranged from 4 to 100 people (M = 27). Potential interviewees
volunteered from each PCSG and from that pool we interviewed 54 men with varying
group associations. Specifically, 22 men held leadership roles (e.g., leader, facilitator,
secretary), 16 were long-term members (attending for more than 12 months) and 16 were
short-term members (attending for less than 12 months); all completed individual semi-
structured interviews. In total, the 54 interviewees accounted for approximately 16% of
all the men observed at the group meetings, and they ranged in age from 53 to 87 years
(M = 71.27 years; SD = 8.52 years) and had attended PCSGs for an average of 5 years
(SD = 4 years)†. The majority of the men were married (n = 51) and retired (n = 44). The
interviewee's mean time since PCa diagnosis was 6 years (SD = 5 years)†. Three men had
not been treated; of the 51 men who had been treated, 15 had a prostatectomy, 6 received
androgen deprivation therapy, 4 brachytherapy, 4 radiation therapy, and 22 a combination
thereof. We also expected to recruit one woman from each PCSG to participate in the
interview component of the study. However, many women were eager to talk with us,
and we interviewed 20 women from 11 of the 16 groups. On average, 5.6 (21%) of the
attendees at each of the PCSG meetings that we observed were women. Women
interviewees self-identified as Anglo-Canadian (n = 14) and Northern European (n = 6),
ranged in age from 54 to 84 years (M = 68.5 years), and most were retired (n = 15). Most
participants (n = 16) attended with their husbands and, at the time of the interview, had
attended group meetings from 6 months to 13 years (M = 6.5 years). The women's
demographic data reflected what was typically observed at the group meetings.
† Length of time attending the group varied widely, ranging from 1 month to 13 years as did time since
diagnosis (1 month to 19 years).
Prince Rupert Prostate Cancer Support & Awareness Group
Contact: Judy Rea 250-622-6533
When: The 1st Wednesday of each month
9/16 – one leader
Where: Health Unit
Qualicum Beach Prostate Cancer Support & Awareness Group
Contact: Jack Rossiter 250-951-2083
When: The 1st Tuesday of each month
Time: 7:00 to 9:00 p.m.
Where: St Stephen Church
ears lish
Quesnel Prostate Cancer Support & Awareness Group
Contact: Ron Campbell 250-992-2726
Email: [email protected]
When: meet on an as needs basis
Where: 332 Front St., Quesnel
Revelstoke Prostate Cancer Support Group
Contact: Darrell Goodman 250-837-3663
Email: [email protected]
When: under development (some fellows meet casually at a coffee shop)
unicipal ealth C ospital
Time: Being arranged – call Darrell
Salts Spring Island Prostate Cancer Support & Awareness Group
Contact: Chris Rieder 250-537-2720
orm haring
Email: [email protected]
When: The 3rd Tuesday of each month
Time: 1:30 to 3:30 p.m.
Where: Farmers' Institute
Sunshine Coast Pc Support Awareness Group
Contact: John Keates, Chair 604-885-4181
roup characteristics
Email: [email protected]
When: The 1st Tuesday
M urationD (M
Where: St. John's United Church, Davis Bay, Sechelt
ancer Society
Surrey Prostate Cancer Support & Awareness Group
Contact: Leno Zecchel 604-596-2640 or George Main 604-574-5554
Email: [email protected] or [email protected]
When: The last Saturday of each month (not December)
anadian C
Time: 10:00 am to 12:00 noon
Where: Cafeteria, Surrey Memorial Hospital 13750 96 Ave. Surrey, BC
Vancouver PSA (Prostate Cancer Support & Awareness) Group
Contact:Len Gross 604- 434-2100 or Gordon Dunn 604-739-5900
Email: [email protected] or [email protected]
ffice provided by C
When: The 1st Thursday of each month
Table 1. Prostate Cancer Support G
Time: 11:00 a.m. to 1:00 p.m.
428 (100% 4 – 100 26.8 25.0
Where: Canadian Cancer Society Board Room. 565 West 10th Ave. Vancouver.
Cowichan Valley Prostate Cancer Support & Awareness Group
Contact: Gordon Thomas 250-743-6960
The key study findings related to (1) group sustainability, (2) health promotion strategies,
Email: [email protected]
When: The last Thursday of each month
(3) the use of humour and (4) the roles of women in PCSGs. We also assessed the PCa
Time: 7:00 to 9:00 p.m.
information shared by Canadian newspapers to better understand how that medium
Where: Lecture Room, Cowichan Dist. Hospital, Duncan
messages the public about PCa.
East Kootenay Pc Support Group
Contact: Peter Wightman 250-427-4822 or Kevin Higgins 250-427-3322
1. Prostate cancer support group sustainability
Email: [email protected] OR [email protected]
When: The 3rd Wednesday of each month
Early on in the study we noted that the groups often struggled and some groups had
Time: 7:00 to 8:30 p.m.
Where: College of the Rockies, Cranbrook Campus
stopped meeting; while others were enduring, meeting regularly, and attracting large
numbers of attendees. While collecting data from the 16 groups in this study, we became
Kamloops Prostate Cancer Support & Awareness Group
aware of 9 BC-based PCSGs that had recently disbanded, and many of the groups that we
Contact: Larry Reynolds 250-376-4011
attended were challenged to attract and retain members, maintain cohesive leadership,
Email: [email protected]
and provide up-to-date information in a rapidly changing field. Group sustainability was
When: Once a month (Please call 250-374-9188 for more info.)
formally investigated to better understand these issues.
Where: Interior Health meeting room at 450 Lansdowne St
Kelowna Prostate Cancer Support & Awareness Group
While collecting data from
Contact: Bren Witt 250-764-1031
Email: [email protected]
the 16 groups for this study,
When: The 2nd Saturday of each month
we became aware of 9 BC-
Time: 9:00 a.m. to 11:00 noon
Where: Kelowna Health Centre, 1340 Ellis Street.
based PCSGs that had
recently disbanded, and
many of the groups that we
Nanaimo Prostate Cancer Support Group
Contact: Malcolm W. Reville 250-756-3116
attended were challenged
Email: [email protected]
to attract and retain
When: The 2nd Tuesday of each month
Where: Nanaimo Cancer Society
Leadership and management
North Shore Prostate Cancer Support & Awareness Group
As others have observed in professionally-led cancer support groups,30 the success and
Contact: Tom Sayle 604-929-3125
Email: [email protected]
longevity of PCSGs is reliant on effective leadership and management. PCSG leadership
When: The 4th Tuesday of each month January to November (November – social night) no
can be challenging for lay volunteers. The groups attract men and women with a wide
meeting in December
diversity of needs that fluctuate considerably from one meeting to the next. Cohesive
Time: 7:00 to 9:00 p.m.
leadership, shared management, and specific group facilitation strategies were integral to
Where: Lions Gate Hospital, Basement Auditorium
meeting the needs of attendees and fostering their camaraderie and commitment to the
Parksville (DISTRICT 69) Prostate Cancer Support & Awareness Group
group. Group members were adamant that PCSGs needed to be survivor-led, yet being a
Contact: Doug Bamford 250-954-0887
group leader required significant time, energy, and commitment that only a few men were
Email: [email protected]
able or willing to provide. Similar to problems described by both professional and
When: The 1st Wednesday of each month
nonprofessional leaders of cancer support groups,31 PCSGs' dependence on one or two
leaders and lack of defined terms and tenure, meant that group leaders were at risk for
Where: 361 Willow Street, Parksville, B.C.
burnout. In these situations, the long-term viability of the group was uncertain. Finding
Pender Island Prostate Cancer Support & Awareness Group
ways to support the leadership of PCSGs and the development of succession planning
Contact: Jim Dunn 250-629-3273
was critical to ensuring group sustainability.
Email: [email protected]
When: No Longer meets but Jim is willing to take calls.
Appendix 1 - British Columbian Prostate Cancer Support Groups
Collaboration or emancipation
PCSG sustainability was also influenced by linkages with professional organizations.
ProCan Support Web site & Publication
One option for the PCSGs in this study was to affiliate with cancer fundraising
(A Virtual BC Prostate Cancer Support Group)
agencies. However, concerns were expressed by some PCSG attendees that the
Contact: George Main 604-574-5554
Email: [email protected]
groups would end up working for organizations that dictated the terms and conditions
Where: www.procansupport.com
under which they operated. Many PCSGs were resistant to anything resembling a
"takeover" or "branding" by organizations that did not have the capacity to provide
Abbotsford PSA (Prostate Cancer Support & Awareness) Group
resources to the groups and willingness to negotiate mutually acceptable terms of
Contact: Val Strijack 604-856-5863 or Bill Lantz 604-858-1826
Email: [email protected] or [email protected]
When: The 3rd Thursday of each month (no meetings July/August and December)
Time: 7:30 to 9:30 p.m.
Where: Peace Lutheran Church, at Ware and Marshall Rd. Abbotsford, B.C.
Ashcroft "Men's Health Matters" Group
Contact: David Durksen 250-453-9864 – cell 250-457-3226
Email: [email protected]
When: The 2nd Tuesday of each month
Where: Ashcroft Health Centre (Hospital)
Burnaby/New Westminster Prostate Cancer Support & Awareness Group
(East Vancouver, Burnaby, New Westminster)
Contact: Ian Baxter 604-421-8813
Email: [email protected]
When: The 1st Saturday of each month
Time: 10:00 to 12:00 Noon
The study findings about PCSG sustainability are available in more detail at:
Where: 2nd floor Education Room ‘A'. Burnaby General Hospital - 3935 Kincaid Ave.
Oliffe, J.L., Halpin, M., Bottorff, J.L., Hislop, T.G., McKenzie, M. & Mroz,
L. (2008). How prostate cancer support groups do and do not survive: A
Campbell River/West Coast Prostate Awareness Group
British Columbian perspective. American Journal of Men's Health, 2(2),
Contact: Frank Greens 250-923-1357 or 250-286-9696, Merv Rotzien 250-926-0076 or Al
Hodgkinson 250-923-1357
Email: [email protected] (Merv)
When: The 3rd Tuesday of each month
Time: 7:00 p.m. – 9:30 p.m.
Where: Altrusa House, # 12 142 Larwood Road, Campbell River
2. Health promotion and illness demotion
Comox Valley Prostate Cancer Support & Awareness Group
Contact: Brian Lunn 250-338-8235
There is strong evidence that men are reluctant to engage with health promotion
Email: [email protected] or [email protected]
programs; typically men react to severe symptoms rather than attempt to maintain their
Web site is www.members.shaw.ca/prostatecancer/
health, and are more likely to deny than discuss illness-related issues.32 Men at PCSGs
When: The 2nd Monday of each month (except July & August)
October this year is the
revealed an intriguing exception to these longstanding commentaries by routinely
20th, the 3rd Monday, to avoid Thanksgiving Day
Time: 7:30 to 9:00 p.m.
discussing ordinarily private illness experiences and engaging with self-health. We
Where: Community Health Centre, 961a England Ave., Courtenay, B. C.
observed how an environment conducive to men's talk was established to normalize PCa,
and to promote individuals and the collective health of group members. Group members
Coquitlam Prostate Cancer Support & Awareness Group
often focused on the facts (e.g., the latest biomedical research) and figures (e.g., Prostate
Contact: Norm Sherling 604-936-8703
Specific Antigen [PSA] and Gleason biopsy scores) and this enabled many men to
Email: [email protected]
When: The 1st Tuesday of each month
objectify and position their PCa as a manageable disease. At the same time, through
Time: 7:00 to 9:00 p.m.
group discussions, the men shared their health promotion practices. Three PCSG
Where: Pinetree Community Centre, 1260 Pinetree Way. Coquitlam, B.C.
strategies are outlined to detail the specificities of how PCSGs achieved this activity.
Living examples of healthy men
Administrative Staff
Participants drew reassurances from survivors who attended the
An environment conducive to
meetings. Many men explained how they observed the practices
men's talk was established to
and progress of other men as a means to engage with and, in
normalize PCa, and to promote
some cases, assess their own health. This was due, in part, to the
The administrative assistance afforded by the
the individual and collective
complexities and ambiguities associated with the science of
UBC School of Nursing, the Centre for Nursing
health of group members.
PCa. As such, the presence of healthy men at the groups
and Health Behaviour Research (NAHBR) and
provided important "proof" and "hope" that survival was
NEXUS were instrumental in completing this
possible, regardless of the specificities of men's PCa
research. Special thanks to Merrilee Hughes,
biomarkers. For example, an 81-year-old participant connected
Joanna Ho, Mary Sun, Joyce Wu, Gladys
with another man at the monthly PCSG meetings who had the
Tecson, Meghan Mathieson and Christina Han
same treatment and similar PCa biomarkers. When the man
for ALL their help.
missed a few meetings the participant telephoned him at home to
make sure he was doing well:
Investigative Team
John Oliffe, RN, MEd, PhD. Lead Investigator and
Associate Professor, School of Nursing, University of
I phoned him and talked to his wife. And I said ‘Is [support group
British Columbia. Email [email protected]
member] sick? ‘ And she said, ‘No he's cross-country skiing'…and
I said, ‘Well, if he can do it, I can do it too'…This is extremely
important to me that you find a guy that has a Gleason of 9, that's
Joan Bottorff, RN, PhD, FCAHS. Co-investigator,
gone through the same treatment I'm going through now a couple
Professor of Nursing, and Chair in Health Promotion and
years later because his was 3 years ago. He's doing really good.
Cancer Prevention at the University of British Columbia,
He's cross-country skiing.
T. Gregory Hislop, MSc, MD, CM. Co-investigator and
Mixing health and illness information
research consultant. His research focuses on cancer
The ability of PCSGs to mix PCa and health information afforded the "light and shade"
epidemiology, diet and on the development and
to maintain the men's interest without overwhelming them. Rather than an exclusive
evaluation of cancer screening programs.
focus on PCa, opportunities were available for the men to promote their health and well-
being rather than to remedy or ruminate on an existing PCa. Many men detailed specific
dietary supplements or strategies for modifying the consumption of potentially beneficial
(i.e., fruits/vegetables) and detrimental (i.e., sugar, alcohol, coffee) foods.
Michael McKenzie, MD, FRCPC. Co-investigator,
Complementary and alternative medicines were also discussed as a means to maintaining
radiation oncologist and member of The Genitourinary
and improving health. A 74-year-old man who had been attending group meetings for
Tumour Site Group at the British Columbia Cancer
less than 12 months talked about the impact of group conversations, specifically citing
meditation as key to reducing his PCa induced anxiety:
A lot of the apprehension, the trauma that is associated with first
hearing about cancer, a couple of fellows there talked about
meditation and I was never big on that, but I do that now.
Trajectory and problem-specific information
Information was solicited by and tailored to individuals to counter specific problems
based on where they were within the illness trajectory. The most common example of
tailored information related to treatment decision-making for newly diagnosed men who
were deciding if and what treatment they would have. Group members were quick to
Special thanks to the PCSGs for welcoming us to their meetings, endorsing this study,
share their perspectives, but careful to be impartial about the treatment options. Some
and assisting us in furthering our understanding of men's health and PCa. Sincere thanks
larger PCSGs formed treatment sub-groups (i.e., prostatectomy, radiation therapy,
to the men and women who participated in the individual interview portion of this study.
brachytherapy, etc.) which newly diagnosed men could access to discuss specific
In addition, we would like to thank the Canadian Prostate Cancer Network (CPCN at
information. A 72-year-old participant who had recently undergone brachytherapy
http://www.cpcn.org/) and Bob Shiell, Murray Gordon and Wally Seely for their
explained that he was able to provide more information than otherwise would have been
assistance. Thanks to the British Columbia Foundation for Prostate Disease (BCFPD at
available to a man wanting to make a treatment decision:
http://www.bcprostatecancer.org/) especially Ted Butterfield, Ian Baxter, Val Strijack,
Dan Cohen, Len Gross, George Main, Don Stewart and Bren Witt for their ongoing
support. The CPCN and BCFPD's inclusion of us and endorsement of the study at
national and provincial meetings ensured the feasibility of completing the research. The
It set his mind at ease because he was finally able to talk to
CPCN published findings drawn from this study on their web site and in the Our Voice,
somebody who has been through the brachytherapy process. Prior
newsletter, thus greatly assisting our knowledge dissemination efforts. The expertise and
to that, the information he had, had come from the urologist and
hard work of the investigative team, research staff and administrators was also integral to
his family doctor who have never gone through the whole process.
achieving the deliverables derived from this research.
Funding Agencies
This study was made possible by the generous support of the
Canadian Institutes of Health Research (CIHR); Institute of Gender
and Health; #11R91563). Additional career support for Dr. John
Oliffe was provided by the CIHR Institute of Gender and Health
(New Investigator award).
Additional project funding and career support for Dr. John Oliffe
was also made available by the Michael Smith Foundation for Health
Research (MSFHR) Scholar award.
Coalition Advisory Committee
A Coalition Advisory Committee was a vital component of this research. The committee
members were: Mr. Len Gross, Ms. Diane Marshall, Ms. Cheri Van Patten and Mr. Bren
Witt. These dedicated individuals provided key input regarding study findings and
advised us on how best to disseminate findings to key stakeholders. As future projects are
developed, we are seeking the committee's advice on how best to continue our work and
apply the study findings to extend and promote the work of PCSGs.
The study findings about health promotion and illness demotion are available in detail at:
Research Staff
Oliffe, J.L., Gerbrandt, J., Bottorff, J.L., & Hislop, T.G. (In Press). Health
Sincere thanks to the project research staff who assisted on the project in various
promotion and illness demotion at prostate cancer support groups. Health
capacities including: project management (Michael Halpin and Melanie Phillips), data
Promotion Practice.
collection (Lawrence Mroz, Graham McLean, Michael Halpin, Joanne Carey and Mary
Kelly) and data synthesis and manuscript preparation (Julieta Gerbrandt, Michael Halpin,
Melanie Phillips, Graham McLean, Lawrence Mroz, Tina Thornton, Valerie Oglov,
Kristy Hoyak and Anna Chan).
3. The function of humour
Oliffe, J.L. (July, 2007). Sustainability and PCSGs. Presentation at the Victoria Prostate
Cancer Support Group, Victoria, British Columbia, Canada.
Psychosocial benefits, including improved mood and mental health, and increased quality
of life, have been reported among men who routinely attend PCSG meetings.33-36 We
Oliffe, J.L. (June, 2007). Qualitative research methods for clinicians. Invited workshop at
noticed that humour was frequently a part of the groups' interactions, and this prompted
Vancouver Coastal Health, June, Vancouver, British Columbia, Canada.
us to formally examine the function of humour at PCSGs. The study findings revealed
how humour could disarm men's stoicism and mark the boundaries for providing and
Oliffe, J.L., Halpin, M., Bottorff, J.L., Mroz, L., Hislop, G., & McKenzie, M. (June,
receiving mutual help.
2007). The sustainability of prostate cancer support groups: Are the grassroots burning?
Paper presented at the 19th IUHPE World Conference on Health Promotion and Health
Education. Vancouver, British Columbia, Canada.
Disarming stoicism
By opening with a joke or inserting a humourous remark, regardless of whether it brought
Oliffe, J.L., Bottorff, J.L., Halpin, M., Phillips, M., McLean, G., & Mroz, L. (June,
shrieks of laughter or a few sniggers, the men were able to manufacture something that
2007). He said, she said: Women's commentary about men who attend prostate cancer
others could actively engage with and react to. Humour often subtly disarmed stoicism in
support groups (PCSGs). Paper presented at the 19th IUHPE World Conference on
ways that did not necessarily demand talk from each and every man who attended the
Health Promotion and Health Education. Vancouver, British Columbia, Canada.
group. Instead, a shared joke or laughter constituted a group activity, and there was often
a central character(s) in each who enjoyed sharing ‘their' humour as a remedy. A 74-
Bottorff, J.L., Oliffe, J.L., Halpin, M., Mroz, L., McLean, G., & Phillips, M. (March,
year-old man explained that understanding and empathy existed within the group and
2007). The benefits, roles and reasons for women attending prostate cancer support
humour was used to signal that, and to reassure newcomers that their cancer and group-
groups. Paper presented at the Canadian Conference on Men's Health, Victoria, British
related anxiety would dissipate over time:
Columbia, Canada.
There are a couple of fellows there that didn't say a word all night.
Halpin, M., Phillips, M., & Oliffe, J.L. (March, 2007). Prostate cancer in the Canadian
I could tell by their posture that they have just been diagnosed and
news media: A case of inconsistent messaging? Paper presented at the Canadian
they were obviously terrified as I was when I was first diagnosed.
Conference on Men's Health, Victoria, British Columbia, Canada.
There's a lot of anxiety there and those fellows were not prepared
to open up. Others were there who have been through this, sort of
Oliffe, J.L. (March, 2007). Prostate cancer support groups in British Columbia. Keynote
around the road on this thing. Some of them were quite humorous
presentation at the Annual General Meeting and Banquet, British Columbia Foundation
about this and that was a nice balance between these guys.
for Prostate Disease. Vancouver, British Columbia, Canada.
Oliffe, J.L. (October, 2006). Study outline – the role of PCSGs in health promotion.
Presentation at the Surrey Prostate Cancer Support Group, Surrey, British Columbia,
A shared joke or laughter constituted
a group activity, and there was often
Oliffe, J.L. (April, 2006). Preliminary findings – PCSG sustainability. Presentation at the
a central character(s) in each who
Vancouver Prostate Cancer Support Group, Vancouver, British Columbia, Canada.
enjoyed sharing ‘their' humour as a
Oliffe, J.L. (September, 2005). The role of PCSGs in health promotion – an overview and
invitation to participate in a new study. Presentation at the first BC Foundation for
Prostate Disease Workshop, Vancouver General Hospital, Vancouver, British Columbia,
Marking the boundaries
Men also used humour to introduce potentially sensitive PCa issues such as urinary
incontinence, sexual dysfunction, and death. A quip or joke was often put forward to
gauge the group's interest, and to assess whether the discussion of ordinarily taboo topics
was permissible. A long group discussion about treating erectile dysfunction (ED) took
place after a 66-year-old participant who had been attending PCSG meetings for three
years signalled his intact male libido but acknowledged the challenges of successfully
I was talking about using Viagra to see whether it will help, well it
gave me a headache—maybe that's a good thing!? There was
Oliffe, J.L. (May, 2009). Findings from our PCSG study. Presentation at the Victoria
humour about that, that went into the room. It's kind of light-
Prostate Cancer Support Group, Victoria, British Columbia, Canada.
hearted and people are trying to make the best of it, of a bad joke.
Oliffe, J.L. (March, 2009). Findings from our PCSG study. Presentation at the Surrey
Prostate Cancer Support Group, Surrey, British Columbia, Canada.
Although the humour was well-intended, many group leaders were aware of the need to
Oliffe, J.L. (December, 2008). Your PCSG and Active Surveillance. Presentation to the
strategize the use of humour to ensure the comfort of all attendees. A 65-year-old group
Calgary PCSG. Calgary, Canada.
leader of 10 years explained:
Oliffe, J.L. (December, 2008). PSCGs – What next? Presentation to the PCSGs Alberta
Board of Directors. Calgary, Canada.
You've got to be very careful. The humour is clean, non-
Oliffe, J.L. (October, 2008). Gendering prostate cancer in the context of support groups.
judgmental and you've got to be very, very careful on how you
Panel Keynote presented at the Spanish Ministry of Health, Women's Health Observatory
deliver the humour…You've got to know your group and what
Workshop, Madrid, Spain.
people are in the group. The people that I was giving a bad time to,
[they] enjoyed the bantering back and forth…They would egg me
Oliffe, J.L. (August, 2008). The role of humour at PCSGs. Presentation at the Vancouver
on and I would egg them on and it was fun and they loved it. Other
Prostate Cancer Support Group, Vancouver, British Columbia, Canada.
individuals, you can't do that.
Oliffe, J.L. (June, 2008). Qualitative research methods for clinicians. Invited workshop at
Vancouver Coastal Health, Vancouver, British Columbia, Canada.
Our analyses revealed how humour can be integral to legitimizing men's support group
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T. G., & Halpin, M. (May, 2008).
involvement and engagement with self-health. A sense of humour can give a group
Connecting humor, health and masculinities at prostate cancer support groups. Paper
member a tool for expressing complicated emotional states, while the wit itself may buoy
presented at the Canadian Association of Psychosocial Oncology, Halifax, Nova Scotia,
self-esteem and silence self-criticism. In the PCSG settings, humour can regulate the
emotional atmosphere by enlivening social interactions. Thus, the sharing of laughter is
an indication of a degree of shared safety and establishes an intimacy in interpersonal
Bottorff, J.L., Oliffe, J.L., Halpin, M., Mroz, L., McLean, G., & Phillips, M. (May,
relations and facilitates communication by, for example, promoting cohesion among
2008). Women attending prostate cancer support groups: The gender connect? Paper
group members. Additionally, humour itself can be therapeutic because of the way it
presented at the Canadian Association of Psychosocial Oncology, Halifax, Nova Scotia,
Oliffe, J.L. (October, 2007). International perspectives in men's health research. Panel
Member, Australian National Men's Health Conference. Adelaide, South Australia.
The study findings about the use of humour at PCSGs are available in more detail at:
Oliffe, J.L. (October, 2007). Empirical, methodological and theoretical: The men's health
trifector. Invited Workshop, Australian National Men's Health Conference. Adelaide,
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T.G., & Halpin, M. (In
South Australia.
Press) Connecting humor, health and masculinities at prostate cancer
support groups. Psycho-Oncology.
Oliffe, J.L. (October, 2007). Prostate cancer support groups: Canadian group
sustainability. Keynote presentation at Prostate Cancer Foundation of Australia, Public
Lecture. Adelaide, South Australia.
4. Women and prostate cancer support groups
Oliffe, J.L. (September, 2007). Prostate cancer support groups – How are we doing?
Keynote presentation at the Canadian Prostate Cancer Network (CPCN) and Canadian
Women influence their spouses' experiences of PCa, and are also significantly affected
Prostate Cancer Research Initiative (CPCRI) Conference. Toronto, Ontario, Canada.
by living with a partner who has PCa. So much so, that PCa has emerged as a "couple's
illness"37-39 in which the disease, as well as its treatments, affect gender identities and
relations across the entire illness trajectory.10,12-14,17 We focused our analysis to better
• How can on-line PCSGs inform and influence PCa consumers and service
understand how PCa was situated and negotiated as a ‘couple's illness', by describing
women's participation at PCSGs. The reasons why women attended the groups and the
roles they played at group meetings are detailed below.
• How might professionally facilitated psychosocial PCa interventions be
administered on-line and at face-to-face PCSGs?
Reasons for attending
Despite feeling anxious and wondering whether they would fit in at a men's group
• What community-based PCa supports will best meet the needs of women?
meeting, most women decided to attend group meetings as a means to support their
husbands. In addition, attending groups allowed the women to obtain much needed
information about PCa treatments and access the experiences of other women. A 64-year-
old woman who had been attending group meetings for one year explained:
Oliffe, J.L., Halpin, M., Bottorff, J.L., Hislop, T.G., McKenzie, M., & Mroz, L. (2008).
How prostate cancer support groups do and do not survive: A British Columbian
I went to support my husband because he was newly diagnosed but
perspective. American Journal of Men's Health, 2(2), 143–155.
I also was quite overwhelmed by the amount of information there
was….So I found that maybe the support group there would be an
Oliffe, J.L., Gerbrandt, J., Bottorff, J.L., & Hislop, T.G. (In Press). Health promotion and
opportunity to begin to make more sense of …the medical aspect of
illness demotion at prostate cancer support groups. Health Promotion Practice.
it but also maybe the psychological, also to hear people's stories
and then for myself to be able to not only discuss things with my
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T.G., & Halpin, M. (In Press)
husband but hopefully to discuss things with other women.
Connecting humor, health and masculinities at prostate cancer support groups. Psycho-
Oncology.
Bottorff, J.L., Oliffe, J.L., Halpin, M., Phillips, M., McLean, G., & Mroz, L. (2008).
Women and prostate cancer support groups: The gender connect? Social Science and
Medicine, 66, 1217–1227.
Halpin, M., Phillips, M., & Oliffe, J.L. (In Press) Prostate cancer in Canadian newspaper
media: Representations of illness, disease and masculinities. Sociology of Health and
Work in progress:
Continued attendance centered on the women's need to manage their experience of their
partner's illness, as well as to give back to the group as a couple. A 75-year-old woman
Oliffe, J.L., Bottorff, J.L., McKenzie., M., Hislop, T.G., Gerbrandt, J., & Oglov, V.
who had been attending group meetings for 10 years explained:
Prostate cancer support groups, health literacy and consumerism: Are community-based
volunteers redefining older men's health?
I only go with him….Every once in a while he would say, "I do not
know why I am going anymore." I always come back with, "Well it
Oliffe, J.L., Bottorff, J.L., Austin, D., Hislop, T.G., & McKenzie, M. Taking care of
is for the other fellows that are there, the new people, because you
business: Prostate cancer support group leaders.
are a survivor." I think it is important for them to hear the
survivors….I sometimes wonder why we go too, but it is for the
Oliffe, J.L., Haines, R., Bottorff, J.L., & Phillips, M. Women's commentaries about
prostate cancer survivors' health and illness practices.
Oliffe, J.L., & Bottorff, J.L. Couples at Prostate cancer support groups: A gender
Women's roles
relations analysis.
Within the groups we examined, women assumed three roles that were strongly
influenced by the composition of the group and the length of time they had been
attending. Most commonly, women were social facilitators, establishing and sustaining
social connections within the group by welcoming new members and serving
refreshments, or organizing social events. Although these women downplayed their
contributions, they were vital to the social life. A 60-year-old woman, who had attended
group meetings with her husband for ten years, explained her role:
Implications for practice
I'm the refreshment lady…The tea, coffee, actually I used to make
The findings detailed in this report enabled us to thoughtfully consider how to maximize
everything at one time…they had a meeting, I wasn't there,
the impact of PCSGs. As such, the following recommendations are offered as strategies
[laughs] and they voted me to do it [laughter]…Because there's a
to ensure the continuation and growth of PCSGs:
lot of people that didn't want to do it, it doesn't have to be the
woman, it could be the guys but they didn't want to do the coffee,
• Although PCSGs will not appeal to all men, using the word "support" is
‘How much coffee do I put in, how much water do I put in?' you
associated with indebtedness or weakness and may discourage men from
know, and they'd really stress themselves out about it.
attending. We recommend a name change to mutual help or men's health to
more accurately reflect the core business of education and information and
attract more men to group meetings.
• The World Wide Web offers an important medium to extend and promote the
work of PCSGs. That said, the ultimate success of virtual PCSGs is contingent
upon having sufficient resources to design, deliver, and regularly evaluate and
update information in ways that men can easily access and understand, and
explain to others.
• The permission of others at PCSGs to talk about health and illness afforded men
Women also operated as background supporters, wanting to be there for their husbands
the freedom to actively engage in self-health. Therefore, men's health promoters
without disrupting the men's ownership of the group because they believed this would
need to tailor content and encourage and expect men to talk, rather than
inhibit men's support for each other. Positioning themselves in this way helped minimize
disseminating generic information or telling men how to look after their health
the women's anxiety about attending a men's group, and provided a way to encourage
and respond to illness.
men's self-disclosure. A 65-year-old woman who had been attending group meetings for
one year explained that during group discussions and the associated question period, she
• Humour played a central role in how men interacted at the groups and this might
remained quiet because her husband was the one who needed to talk:
also be useful in the delivery of other men's health promotion programs.
• Balancing PCa information with discussions about healthful practices
maintained the attendee's interest, but avoided overloading men with information.
I don't get involved with the questioning because it's [husband]
This was important because rather than an exclusive focus on PCa, many
that has it, and he's the one that knows how he feels so if he has a
opportunities existed for men to link health and illness and promote their health
question he'll ask but I don't really say anything.
for reasons other than heeding expert advice or seeking a PCa remedy.
• The needs of female partners are underserved by professional health care
services and, as such, women's PCSGs might be an important additional resource
Conversely, some women explicitly positioned the experience of PCa as a couple's
to meet the needs of a greater number of women.
illness and adopted the role of a cancer co-survivor. These women shared and solicited
psychosocial support, and did not downplay their involvement in the group, realizing that
it's just not a man's disease, it's their disease too. It was also clear that PCSGs offered
Future Research
important opportunities for women to access much needed support, as suggested by a
59-year-old woman who had been attending group meetings for 12 years:
We recommend that the following research questions be addressed to extend and promote
the work of PCSGs in Canada:
• What are health care professionals' connections to, expectations of, and
recommendations for PCSGs?
I had a need to talk desperately, I had my friends who had empathy
The good fight
and caring but they had no idea what I was going through and if
Ideologies emphasizing courage in men's PCa battles predominated in 117 articles
any of them were losing their husbands, they were losing them
(28%), and the commentaries routinely featured men in sports, politics, and the
through divorce not this. As much as your family and friends love
entertainment industry to detail the specificities of the good fight. Typically, men's
you and care about you, often they don't really have the
achievements were detailed and PCa was background but linked to men's willingness to
knowledge, this group can give you that knowledge. I believe that
fight the cancer across the illness trajectory.
the groups can help enormously, emotionally, and I think that
emotion plays a huge role in the disease. I think people
Self-health and public awareness
underestimate the importance of it.
Sixty-three articles (15%) detailed dietary intervention and supplementation strategies
including the integration of foods containing lycopene and other nutrients proposed to be
implicated in delaying cancers – including PCa development. The articles lacked detail
The study findings about women and PCSGs are available in more detail at:
but pointed to specific foods as health- enhancing and cancer- preventing. Some articles
indicated that men should take responsibility for their health; however, it was women
Bottorff, J.L., Oliffe, J.L., Halpin, M., Phillips, M. McLean, G., & Mroz, L.
who were most often portrayed as the lynchpin in surveying and informing men's health
(2008). Women and prostate cancer support groups: The gender connect?
practices. An example of this included an article describing how Theresa Heinz-Kerry's
Social Science and Medicine, 66, 1217–1227.
medical knowledge – and knowledge of her husband's health – may have saved her
Ms Kerry knew enough to have her husband's blood retested for C-
reactive protein, a little-known indicator of potentially cancerous
5. Canadian newspapers' portrayals of PCa
inflammation. Two days before Christmas, his doctor told Mr.
[John] Kerry his wife's fears were well placed; he was in the very
Providing information to men and their families is the primary role of PCSGs. However,
early stages of PCa.41
there is implicit and sometimes explicit concern that "lay" perspectives might be
inaccurate or biased. In thinking about where else men and their partners might access
Overall, our analyses indicated that PCa is depicted most often in commerce based
PCa information we decided to systematically analyze how two national Canadian
articles and stories about men's courage. In addition, there is little consistency in the PCa
newspapers, The Globe and Mail and the National Post, portray PCa. Articles published
screening and treatment information presented, nor are there directions or strategies
between 2001 and 2006 that contained the term "prostate cancer" in the title or text were
provided to guide men about how best to engage in self-health.
collected and a total of 417 PCa articles were analyzed to reveal the following three
Treatment imperative
The study findings about PCa and Canadian newspapers are available in more detail at:
PCa screening and treatment technologies were detailed in 178 (42%) articles. Seventy-
two articles mentioned the prostate specific antigen (PSA); however, uncertainty about
Halpin, M., Phillips, M., & Oliffe, J.L. (In Press) Prostate cancer in
the efficacy of the PSA test was discussed in approximately half of the articles (n = 35).
Canadian newspaper media: Representations of illness, disease and
In terms of PCa treatment modalities, articles focused on hormone treatments (n = 64),
masculinities. Sociology of Health and Illness.
surgery (n = 29), radiation therapy (n = 29) and brachytherapy (n = 10). The vast majority
of these articles appeared in the business section, and hormone treatments (as the most
expensive PCa therapy heavily subsidized by the federal government) were often linked
to pharmaceutical companies' stock market prices. When PCa treatment side effects,
including erectile dysfunction (ED) were discussed, typically it was combined with the
marketing of pharmaceutical remedies. For example, the unveiling of Viagra's™
competitor, Cialis™ detailed the testimonial of a 54-year-old man who had developed ED
following PCa surgery. The advantages of Cialis'™ longer half-life were highlighted in
the man's testimonial, "because it lasts for 36 hours, [sex] doesn't have to be a planned
event, which is very attractive. It leads you back to a much more normal life".40
I had a need to talk desperately, I had my friends who had empathy
The good fight
and caring but they had no idea what I was going through and if
Ideologies emphasizing courage in men's PCa battles predominated in 117 articles
any of them were losing their husbands, they were losing them
(28%), and the commentaries routinely featured men in sports, politics, and the
through divorce not this. As much as your family and friends love
entertainment industry to detail the specificities of the good fight. Typically, men's
you and care about you, often they don't really have the
achievements were detailed and PCa was background but linked to men's willingness to
knowledge, this group can give you that knowledge. I believe that
fight the cancer across the illness trajectory.
the groups can help enormously, emotionally, and I think that
emotion plays a huge role in the disease. I think people
Self-health and public awareness
underestimate the importance of it.
Sixty-three articles (15%) detailed dietary intervention and supplementation strategies
including the integration of foods containing lycopene and other nutrients proposed to be
implicated in delaying cancers – including PCa development. The articles lacked detail
The study findings about women and PCSGs are available in more detail at:
but pointed to specific foods as health- enhancing and cancer- preventing. Some articles
indicated that men should take responsibility for their health; however, it was women
Bottorff, J.L., Oliffe, J.L., Halpin, M., Phillips, M. McLean, G., & Mroz, L.
who were most often portrayed as the lynchpin in surveying and informing men's health
(2008). Women and prostate cancer support groups: The gender connect?
practices. An example of this included an article describing how Theresa Heinz-Kerry's
Social Science and Medicine, 66, 1217–1227.
medical knowledge – and knowledge of her husband's health – may have saved her
Ms Kerry knew enough to have her husband's blood retested for C-
reactive protein, a little-known indicator of potentially cancerous
5. Canadian newspapers' portrayals of PCa
inflammation. Two days before Christmas, his doctor told Mr.
[John] Kerry his wife's fears were well placed; he was in the very
Providing information to men and their families is the primary role of PCSGs. However,
early stages of PCa.41
there is implicit and sometimes explicit concern that "lay" perspectives might be
inaccurate or biased. In thinking about where else men and their partners might access
Overall, our analyses indicated that PCa is depicted most often in commerce based
PCa information we decided to systematically analyze how two national Canadian
articles and stories about men's courage. In addition, there is little consistency in the PCa
newspapers, The Globe and Mail and the National Post, portray PCa. Articles published
screening and treatment information presented, nor are there directions or strategies
between 2001 and 2006 that contained the term "prostate cancer" in the title or text were
provided to guide men about how best to engage in self-health.
collected and a total of 417 PCa articles were analyzed to reveal the following three
Treatment imperative
The study findings about PCa and Canadian newspapers are available in more detail at:
PCa screening and treatment technologies were detailed in 178 (42%) articles. Seventy-
two articles mentioned the prostate specific antigen (PSA); however, uncertainty about
Halpin, M., Phillips, M., & Oliffe, J.L. (In Press) Prostate cancer in
the efficacy of the PSA test was discussed in approximately half of the articles (n = 35).
Canadian newspaper media: Representations of illness, disease and
In terms of PCa treatment modalities, articles focused on hormone treatments (n = 64),
masculinities. Sociology of Health and Illness.
surgery (n = 29), radiation therapy (n = 29) and brachytherapy (n = 10). The vast majority
of these articles appeared in the business section, and hormone treatments (as the most
expensive PCa therapy heavily subsidized by the federal government) were often linked
to pharmaceutical companies' stock market prices. When PCa treatment side effects,
including erectile dysfunction (ED) were discussed, typically it was combined with the
marketing of pharmaceutical remedies. For example, the unveiling of Viagra's™
competitor, Cialis™ detailed the testimonial of a 54-year-old man who had developed ED
following PCa surgery. The advantages of Cialis'™ longer half-life were highlighted in
the man's testimonial, "because it lasts for 36 hours, [sex] doesn't have to be a planned
event, which is very attractive. It leads you back to a much more normal life".40
refreshments, or organizing social events. Although these women downplayed their
contributions, they were vital to the social life. A 60-year-old woman, who had attended
group meetings with her husband for ten years, explained her role:
Implications for practice
I'm the refreshment lady…The tea, coffee, actually I used to make
The findings detailed in this report enabled us to thoughtfully consider how to maximize
everything at one time…they had a meeting, I wasn't there,
the impact of PCSGs. As such, the following recommendations are offered as strategies
[laughs] and they voted me to do it [laughter]…Because there's a
to ensure the continuation and growth of PCSGs:
lot of people that didn't want to do it, it doesn't have to be the
woman, it could be the guys but they didn't want to do the coffee,
• Although PCSGs will not appeal to all men, using the word "support" is
‘How much coffee do I put in, how much water do I put in?' you
associated with indebtedness or weakness and may discourage men from
know, and they'd really stress themselves out about it.
attending. We recommend a name change to mutual help or men's health to
more accurately reflect the core business of education and information and
attract more men to group meetings.
• The World Wide Web offers an important medium to extend and promote the
work of PCSGs. That said, the ultimate success of virtual PCSGs is contingent
upon having sufficient resources to design, deliver, and regularly evaluate and
update information in ways that men can easily access and understand, and
explain to others.
• The permission of others at PCSGs to talk about health and illness afforded men
Women also operated as background supporters, wanting to be there for their husbands
the freedom to actively engage in self-health. Therefore, men's health promoters
without disrupting the men's ownership of the group because they believed this would
need to tailor content and encourage and expect men to talk, rather than
inhibit men's support for each other. Positioning themselves in this way helped minimize
disseminating generic information or telling men how to look after their health
the women's anxiety about attending a men's group, and provided a way to encourage
and respond to illness.
men's self-disclosure. A 65-year-old woman who had been attending group meetings for
one year explained that during group discussions and the associated question period, she
• Humour played a central role in how men interacted at the groups and this might
remained quiet because her husband was the one who needed to talk:
also be useful in the delivery of other men's health promotion programs.
• Balancing PCa information with discussions about healthful practices
maintained the attendee's interest, but avoided overloading men with information.
I don't get involved with the questioning because it's [husband]
This was important because rather than an exclusive focus on PCa, many
that has it, and he's the one that knows how he feels so if he has a
opportunities existed for men to link health and illness and promote their health
question he'll ask but I don't really say anything.
for reasons other than heeding expert advice or seeking a PCa remedy.
• The needs of female partners are underserved by professional health care
services and, as such, women's PCSGs might be an important additional resource
Conversely, some women explicitly positioned the experience of PCa as a couple's
to meet the needs of a greater number of women.
illness and adopted the role of a cancer co-survivor. These women shared and solicited
psychosocial support, and did not downplay their involvement in the group, realizing that
it's just not a man's disease, it's their disease too. It was also clear that PCSGs offered
Future Research
important opportunities for women to access much needed support, as suggested by a
59-year-old woman who had been attending group meetings for 12 years:
We recommend that the following research questions be addressed to extend and promote
the work of PCSGs in Canada:
• What are health care professionals' connections to, expectations of, and
recommendations for PCSGs?
relations across the entire illness trajectory.10,12-14,17 We focused our analysis to better
• How can on-line PCSGs inform and influence PCa consumers and service
understand how PCa was situated and negotiated as a ‘couple's illness', by describing
women's participation at PCSGs. The reasons why women attended the groups and the
roles they played at group meetings are detailed below.
• How might professionally facilitated psychosocial PCa interventions be
administered on-line and at face-to-face PCSGs?
Reasons for attending
Despite feeling anxious and wondering whether they would fit in at a men's group
• What community-based PCa supports will best meet the needs of women?
meeting, most women decided to attend group meetings as a means to support their
husbands. In addition, attending groups allowed the women to obtain much needed
information about PCa treatments and access the experiences of other women. A 64-year-
old woman who had been attending group meetings for one year explained:
Oliffe, J.L., Halpin, M., Bottorff, J.L., Hislop, T.G., McKenzie, M., & Mroz, L. (2008).
How prostate cancer support groups do and do not survive: A British Columbian
I went to support my husband because he was newly diagnosed but
perspective. American Journal of Men's Health, 2(2), 143–155.
I also was quite overwhelmed by the amount of information there
was….So I found that maybe the support group there would be an
Oliffe, J.L., Gerbrandt, J., Bottorff, J.L., & Hislop, T.G. (In Press). Health promotion and
opportunity to begin to make more sense of …the medical aspect of
illness demotion at prostate cancer support groups. Health Promotion Practice.
it but also maybe the psychological, also to hear people's stories
and then for myself to be able to not only discuss things with my
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T.G., & Halpin, M. (In Press)
husband but hopefully to discuss things with other women.
Connecting humor, health and masculinities at prostate cancer support groups. Psycho-
Oncology.
Bottorff, J.L., Oliffe, J.L., Halpin, M., Phillips, M., McLean, G., & Mroz, L. (2008).
Women and prostate cancer support groups: The gender connect? Social Science and
Medicine, 66, 1217–1227.
Halpin, M., Phillips, M., & Oliffe, J.L. (In Press) Prostate cancer in Canadian newspaper
media: Representations of illness, disease and masculinities. Sociology of Health and
Work in progress:
Continued attendance centered on the women's need to manage their experience of their
partner's illness, as well as to give back to the group as a couple. A 75-year-old woman
Oliffe, J.L., Bottorff, J.L., McKenzie., M., Hislop, T.G., Gerbrandt, J., & Oglov, V.
who had been attending group meetings for 10 years explained:
Prostate cancer support groups, health literacy and consumerism: Are community-based
volunteers redefining older men's health?
I only go with him….Every once in a while he would say, "I do not
know why I am going anymore." I always come back with, "Well it
Oliffe, J.L., Bottorff, J.L., Austin, D., Hislop, T.G., & McKenzie, M. Taking care of
is for the other fellows that are there, the new people, because you
business: Prostate cancer support group leaders.
are a survivor." I think it is important for them to hear the
survivors….I sometimes wonder why we go too, but it is for the
Oliffe, J.L., Haines, R., Bottorff, J.L., & Phillips, M. Women's commentaries about
prostate cancer survivors' health and illness practices.
Oliffe, J.L., & Bottorff, J.L. Couples at Prostate cancer support groups: A gender
Women's roles
relations analysis.
Within the groups we examined, women assumed three roles that were strongly
influenced by the composition of the group and the length of time they had been
attending. Most commonly, women were social facilitators, establishing and sustaining
social connections within the group by welcoming new members and serving
I was talking about using Viagra to see whether it will help, well it
gave me a headache—maybe that's a good thing!? There was
Oliffe, J.L. (May, 2009). Findings from our PCSG study. Presentation at the Victoria
humour about that, that went into the room. It's kind of light-
Prostate Cancer Support Group, Victoria, British Columbia, Canada.
hearted and people are trying to make the best of it, of a bad joke.
Oliffe, J.L. (March, 2009). Findings from our PCSG study. Presentation at the Surrey
Prostate Cancer Support Group, Surrey, British Columbia, Canada.
Although the humour was well-intended, many group leaders were aware of the need to
Oliffe, J.L. (December, 2008). Your PCSG and Active Surveillance. Presentation to the
strategize the use of humour to ensure the comfort of all attendees. A 65-year-old group
Calgary PCSG. Calgary, Canada.
leader of 10 years explained:
Oliffe, J.L. (December, 2008). PSCGs – What next? Presentation to the PCSGs Alberta
Board of Directors. Calgary, Canada.
You've got to be very careful. The humour is clean, non-
Oliffe, J.L. (October, 2008). Gendering prostate cancer in the context of support groups.
judgmental and you've got to be very, very careful on how you
Panel Keynote presented at the Spanish Ministry of Health, Women's Health Observatory
deliver the humour…You've got to know your group and what
Workshop, Madrid, Spain.
people are in the group. The people that I was giving a bad time to,
[they] enjoyed the bantering back and forth…They would egg me
Oliffe, J.L. (August, 2008). The role of humour at PCSGs. Presentation at the Vancouver
on and I would egg them on and it was fun and they loved it. Other
Prostate Cancer Support Group, Vancouver, British Columbia, Canada.
individuals, you can't do that.
Oliffe, J.L. (June, 2008). Qualitative research methods for clinicians. Invited workshop at
Vancouver Coastal Health, Vancouver, British Columbia, Canada.
Our analyses revealed how humour can be integral to legitimizing men's support group
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T. G., & Halpin, M. (May, 2008).
involvement and engagement with self-health. A sense of humour can give a group
Connecting humor, health and masculinities at prostate cancer support groups. Paper
member a tool for expressing complicated emotional states, while the wit itself may buoy
presented at the Canadian Association of Psychosocial Oncology, Halifax, Nova Scotia,
self-esteem and silence self-criticism. In the PCSG settings, humour can regulate the
emotional atmosphere by enlivening social interactions. Thus, the sharing of laughter is
an indication of a degree of shared safety and establishes an intimacy in interpersonal
Bottorff, J.L., Oliffe, J.L., Halpin, M., Mroz, L., McLean, G., & Phillips, M. (May,
relations and facilitates communication by, for example, promoting cohesion among
2008). Women attending prostate cancer support groups: The gender connect? Paper
group members. Additionally, humour itself can be therapeutic because of the way it
presented at the Canadian Association of Psychosocial Oncology, Halifax, Nova Scotia,
Oliffe, J.L. (October, 2007). International perspectives in men's health research. Panel
Member, Australian National Men's Health Conference. Adelaide, South Australia.
The study findings about the use of humour at PCSGs are available in more detail at:
Oliffe, J.L. (October, 2007). Empirical, methodological and theoretical: The men's health
trifector. Invited Workshop, Australian National Men's Health Conference. Adelaide,
Oliffe, J.L., Ogrodniczuk, J., Bottorff, J.L., Hislop, T.G., & Halpin, M. (In
South Australia.
Press) Connecting humor, health and masculinities at prostate cancer
support groups. Psycho-Oncology.
Oliffe, J.L. (October, 2007). Prostate cancer support groups: Canadian group
sustainability. Keynote presentation at Prostate Cancer Foundation of Australia, Public
Lecture. Adelaide, South Australia.
4. Women and prostate cancer support groups
Oliffe, J.L. (September, 2007). Prostate cancer support groups – How are we doing?
Keynote presentation at the Canadian Prostate Cancer Network (CPCN) and Canadian
Women influence their spouses' experiences of PCa, and are also significantly affected
Prostate Cancer Research Initiative (CPCRI) Conference. Toronto, Ontario, Canada.
by living with a partner who has PCa. So much so, that PCa has emerged as a "couple's
illness"37-39 in which the disease, as well as its treatments, affect gender identities and
3. The function of humour
Oliffe, J.L. (July, 2007). Sustainability and PCSGs. Presentation at the Victoria Prostate
Cancer Support Group, Victoria, British Columbia, Canada.
Psychosocial benefits, including improved mood and mental health, and increased quality
of life, have been reported among men who routinely attend PCSG meetings.33-36 We
Oliffe, J.L. (June, 2007). Qualitative research methods for clinicians. Invited workshop at
noticed that humour was frequently a part of the groups' interactions, and this prompted
Vancouver Coastal Health, June, Vancouver, British Columbia, Canada.
us to formally examine the function of humour at PCSGs. The study findings revealed
how humour could disarm men's stoicism and mark the boundaries for providing and
Oliffe, J.L., Halpin, M., Bottorff, J.L., Mroz, L., Hislop, G., & McKenzie, M. (June,
receiving mutual help.
2007). The sustainability of prostate cancer support groups: Are the grassroots burning?
Paper presented at the 19th IUHPE World Conference on Health Promotion and Health
Education. Vancouver, British Columbia, Canada.
Disarming stoicism
By opening with a joke or inserting a humourous remark, regardless of whether it brought
Oliffe, J.L., Bottorff, J.L., Halpin, M., Phillips, M., McLean, G., & Mroz, L. (June,
shrieks of laughter or a few sniggers, the men were able to manufacture something that
2007). He said, she said: Women's commentary about men who attend prostate cancer
others could actively engage with and react to. Humour often subtly disarmed stoicism in
support groups (PCSGs). Paper presented at the 19th IUHPE World Conference on
ways that did not necessarily demand talk from each and every man who attended the
Health Promotion and Health Education. Vancouver, British Columbia, Canada.
group. Instead, a shared joke or laughter constituted a group activity, and there was often
a central character(s) in each who enjoyed sharing ‘their' humour as a remedy. A 74-
Bottorff, J.L., Oliffe, J.L., Halpin, M., Mroz, L., McLean, G., & Phillips, M. (March,
year-old man explained that understanding and empathy existed within the group and
2007). The benefits, roles and reasons for women attending prostate cancer support
humour was used to signal that, and to reassure newcomers that their cancer and group-
groups. Paper presented at the Canadian Conference on Men's Health, Victoria, British
related anxiety would dissipate over time:
Columbia, Canada.
There are a couple of fellows there that didn't say a word all night.
Halpin, M., Phillips, M., & Oliffe, J.L. (March, 2007). Prostate cancer in the Canadian
I could tell by their posture that they have just been diagnosed and
news media: A case of inconsistent messaging? Paper presented at the Canadian
they were obviously terrified as I was when I was first diagnosed.
Conference on Men's Health, Victoria, British Columbia, Canada.
There's a lot of anxiety there and those fellows were not prepared
to open up. Others were there who have been through this, sort of
Oliffe, J.L. (March, 2007). Prostate cancer support groups in British Columbia. Keynote
around the road on this thing. Some of them were quite humorous
presentation at the Annual General Meeting and Banquet, British Columbia Foundation
about this and that was a nice balance between these guys.
for Prostate Disease. Vancouver, British Columbia, Canada.
Oliffe, J.L. (October, 2006). Study outline – the role of PCSGs in health promotion.
Presentation at the Surrey Prostate Cancer Support Group, Surrey, British Columbia,
A shared joke or laughter constituted
a group activity, and there was often
Oliffe, J.L. (April, 2006). Preliminary findings – PCSG sustainability. Presentation at the
a central character(s) in each who
Vancouver Prostate Cancer Support Group, Vancouver, British Columbia, Canada.
enjoyed sharing ‘their' humour as a
Oliffe, J.L. (September, 2005). The role of PCSGs in health promotion – an overview and
invitation to participate in a new study. Presentation at the first BC Foundation for
Prostate Disease Workshop, Vancouver General Hospital, Vancouver, British Columbia,
Marking the boundaries
Men also used humour to introduce potentially sensitive PCa issues such as urinary
incontinence, sexual dysfunction, and death. A quip or joke was often put forward to
gauge the group's interest, and to assess whether the discussion of ordinarily taboo topics
was permissible. A long group discussion about treating erectile dysfunction (ED) took
place after a 66-year-old participant who had been attending PCSG meetings for three
years signalled his intact male libido but acknowledged the challenges of successfully
Trajectory and problem-specific information
Information was solicited by and tailored to individuals to counter specific problems
based on where they were within the illness trajectory. The most common example of
tailored information related to treatment decision-making for newly diagnosed men who
were deciding if and what treatment they would have. Group members were quick to
Special thanks to the PCSGs for welcoming us to their meetings, endorsing this study,
share their perspectives, but careful to be impartial about the treatment options. Some
and assisting us in furthering our understanding of men's health and PCa. Sincere thanks
larger PCSGs formed treatment sub-groups (i.e., prostatectomy, radiation therapy,
to the men and women who participated in the individual interview portion of this study.
brachytherapy, etc.) which newly diagnosed men could access to discuss specific
In addition, we would like to thank the Canadian Prostate Cancer Network (CPCN at
information. A 72-year-old participant who had recently undergone brachytherapy
http://www.cpcn.org/) and Bob Shiell, Murray Gordon and Wally Seely for their
explained that he was able to provide more information than otherwise would have been
assistance. Thanks to the British Columbia Foundation for Prostate Disease (BCFPD at
available to a man wanting to make a treatment decision:
http://www.bcprostatecancer.org/) especially Ted Butterfield, Ian Baxter, Val Strijack,
Dan Cohen, Len Gross, George Main, Don Stewart and Bren Witt for their ongoing
support. The CPCN and BCFPD's inclusion of us and endorsement of the study at
national and provincial meetings ensured the feasibility of completing the research. The
It set his mind at ease because he was finally able to talk to
CPCN published findings drawn from this study on their web site and in the Our Voice,
somebody who has been through the brachytherapy process. Prior
newsletter, thus greatly assisting our knowledge dissemination efforts. The expertise and
to that, the information he had, had come from the urologist and
hard work of the investigative team, research staff and administrators was also integral to
his family doctor who have never gone through the whole process.
achieving the deliverables derived from this research.
Funding Agencies
This study was made possible by the generous support of the
Canadian Institutes of Health Research (CIHR); Institute of Gender
and Health; #11R91563). Additional career support for Dr. John
Oliffe was provided by the CIHR Institute of Gender and Health
(New Investigator award).
Additional project funding and career support for Dr. John Oliffe
was also made available by the Michael Smith Foundation for Health
Research (MSFHR) Scholar award.
Coalition Advisory Committee
A Coalition Advisory Committee was a vital component of this research. The committee
members were: Mr. Len Gross, Ms. Diane Marshall, Ms. Cheri Van Patten and Mr. Bren
Witt. These dedicated individuals provided key input regarding study findings and
advised us on how best to disseminate findings to key stakeholders. As future projects are
developed, we are seeking the committee's advice on how best to continue our work and
apply the study findings to extend and promote the work of PCSGs.
The study findings about health promotion and illness demotion are available in detail at:
Research Staff
Oliffe, J.L., Gerbrandt, J., Bottorff, J.L., & Hislop, T.G. (In Press). Health
Sincere thanks to the project research staff who assisted on the project in various
promotion and illness demotion at prostate cancer support groups. Health
capacities including: project management (Michael Halpin and Melanie Phillips), data
Promotion Practice.
collection (Lawrence Mroz, Graham McLean, Michael Halpin, Joanne Carey and Mary
Kelly) and data synthesis and manuscript preparation (Julieta Gerbrandt, Michael Halpin,
Melanie Phillips, Graham McLean, Lawrence Mroz, Tina Thornton, Valerie Oglov,
Kristy Hoyak and Anna Chan).
Living examples of healthy men
Administrative Staff
Participants drew reassurances from survivors who attended the
An environment conducive to
meetings. Many men explained how they observed the practices
men's talk was established to
and progress of other men as a means to engage with and, in
normalize PCa, and to promote
some cases, assess their own health. This was due, in part, to the
The administrative assistance afforded by the
the individual and collective
complexities and ambiguities associated with the science of
UBC School of Nursing, the Centre for Nursing
health of group members.
PCa. As such, the presence of healthy men at the groups
and Health Behaviour Research (NAHBR) and
provided important "proof" and "hope" that survival was
NEXUS were instrumental in completing this
possible, regardless of the specificities of men's PCa
research. Special thanks to Merrilee Hughes,
biomarkers. For example, an 81-year-old participant connected
Joanna Ho, Mary Sun, Joyce Wu, Gladys
with another man at the monthly PCSG meetings who had the
Tecson, Meghan Mathieson and Christina Han
same treatment and similar PCa biomarkers. When the man
for ALL their help.
missed a few meetings the participant telephoned him at home to
make sure he was doing well:
Investigative Team
John Oliffe, RN, MEd, PhD. Lead Investigator and
Associate Professor, School of Nursing, University of
I phoned him and talked to his wife. And I said ‘Is [support group
British Columbia. Email [email protected]
member] sick? ‘ And she said, ‘No he's cross-country skiing'…and
I said, ‘Well, if he can do it, I can do it too'…This is extremely
important to me that you find a guy that has a Gleason of 9, that's
Joan Bottorff, RN, PhD, FCAHS. Co-investigator,
gone through the same treatment I'm going through now a couple
Professor of Nursing, and Chair in Health Promotion and
years later because his was 3 years ago. He's doing really good.
Cancer Prevention at the University of British Columbia,
He's cross-country skiing.
T. Gregory Hislop, MSc, MD, CM. Co-investigator and
Mixing health and illness information
research consultant. His research focuses on cancer
The ability of PCSGs to mix PCa and health information afforded the "light and shade"
epidemiology, diet and on the development and
to maintain the men's interest without overwhelming them. Rather than an exclusive
evaluation of cancer screening programs.
focus on PCa, opportunities were available for the men to promote their health and well-
being rather than to remedy or ruminate on an existing PCa. Many men detailed specific
dietary supplements or strategies for modifying the consumption of potentially beneficial
(i.e., fruits/vegetables) and detrimental (i.e., sugar, alcohol, coffee) foods.
Michael McKenzie, MD, FRCPC. Co-investigator,
Complementary and alternative medicines were also discussed as a means to maintaining
radiation oncologist and member of The Genitourinary
and improving health. A 74-year-old man who had been attending group meetings for
Tumour Site Group at the British Columbia Cancer
less than 12 months talked about the impact of group conversations, specifically citing
meditation as key to reducing his PCa induced anxiety:
A lot of the apprehension, the trauma that is associated with first
hearing about cancer, a couple of fellows there talked about
meditation and I was never big on that, but I do that now.
Appendix 1 - British Columbian Prostate Cancer Support Groups
Collaboration or emancipation
PCSG sustainability was also influenced by linkages with professional organizations.
ProCan Support Web site & Publication
One option for the PCSGs in this study was to affiliate with cancer fundraising
(A Virtual BC Prostate Cancer Support Group)
agencies. However, concerns were expressed by some PCSG attendees that the
Contact: George Main 604-574-5554
Email: [email protected]
groups would end up working for organizations that dictated the terms and conditions
Where: www.procansupport.com
under which they operated. Many PCSGs were resistant to anything resembling a
"takeover" or "branding" by organizations that did not have the capacity to provide
Abbotsford PSA (Prostate Cancer Support & Awareness) Group
resources to the groups and willingness to negotiate mutually acceptable terms of
Contact: Val Strijack 604-856-5863 or Bill Lantz 604-858-1826
Email: [email protected] or [email protected]
When: The 3rd Thursday of each month (no meetings July/August and December)
Time: 7:30 to 9:30 p.m.
Where: Peace Lutheran Church, at Ware and Marshall Rd. Abbotsford, B.C.
Ashcroft "Men's Health Matters" Group
Contact: David Durksen 250-453-9864 – cell 250-457-3226
Email: [email protected]
When: The 2nd Tuesday of each month
Where: Ashcroft Health Centre (Hospital)
Burnaby/New Westminster Prostate Cancer Support & Awareness Group
(East Vancouver, Burnaby, New Westminster)
Contact: Ian Baxter 604-421-8813
Email: [email protected]
When: The 1st Saturday of each month
Time: 10:00 to 12:00 Noon
The study findings about PCSG sustainability are available in more detail at:
Where: 2nd floor Education Room ‘A'. Burnaby General Hospital - 3935 Kincaid Ave.
Oliffe, J.L., Halpin, M., Bottorff, J.L., Hislop, T.G., McKenzie, M. & Mroz,
L. (2008). How prostate cancer support groups do and do not survive: A
Campbell River/West Coast Prostate Awareness Group
British Columbian perspective. American Journal of Men's Health, 2(2),
Contact: Frank Greens 250-923-1357 or 250-286-9696, Merv Rotzien 250-926-0076 or Al
Hodgkinson 250-923-1357
Email: [email protected] (Merv)
When: The 3rd Tuesday of each month
Time: 7:00 p.m. – 9:30 p.m.
Where: Altrusa House, # 12 142 Larwood Road, Campbell River
2. Health promotion and illness demotion
Comox Valley Prostate Cancer Support & Awareness Group
Contact: Brian Lunn 250-338-8235
There is strong evidence that men are reluctant to engage with health promotion
Email: [email protected] or [email protected]
programs; typically men react to severe symptoms rather than attempt to maintain their
Web site is www.members.shaw.ca/prostatecancer/
health, and are more likely to deny than discuss illness-related issues.32 Men at PCSGs
When: The 2nd Monday of each month (except July & August)
October this year is the
revealed an intriguing exception to these longstanding commentaries by routinely
20th, the 3rd Monday, to avoid Thanksgiving Day
Time: 7:30 to 9:00 p.m.
discussing ordinarily private illness experiences and engaging with self-health. We
Where: Community Health Centre, 961a England Ave., Courtenay, B. C.
observed how an environment conducive to men's talk was established to normalize PCa,
and to promote individuals and the collective health of group members. Group members
Coquitlam Prostate Cancer Support & Awareness Group
often focused on the facts (e.g., the latest biomedical research) and figures (e.g., Prostate
Contact: Norm Sherling 604-936-8703
Specific Antigen [PSA] and Gleason biopsy scores) and this enabled many men to
Email: [email protected]
When: The 1st Tuesday of each month
objectify and position their PCa as a manageable disease. At the same time, through
Time: 7:00 to 9:00 p.m.
group discussions, the men shared their health promotion practices. Three PCSG
Where: Pinetree Community Centre, 1260 Pinetree Way. Coquitlam, B.C.
strategies are outlined to detail the specificities of how PCSGs achieved this activity.
Cowichan Valley Prostate Cancer Support & Awareness Group
Contact: Gordon Thomas 250-743-6960
The key study findings related to (1) group sustainability, (2) health promotion strategies,
Email: [email protected]
When: The last Thursday of each month
(3) the use of humour and (4) the roles of women in PCSGs. We also assessed the PCa
Time: 7:00 to 9:00 p.m.
information shared by Canadian newspapers to better understand how that medium
Where: Lecture Room, Cowichan Dist. Hospital, Duncan
messages the public about PCa.
East Kootenay Pc Support Group
Contact: Peter Wightman 250-427-4822 or Kevin Higgins 250-427-3322
1. Prostate cancer support group sustainability
Email: [email protected] OR [email protected]
When: The 3rd Wednesday of each month
Early on in the study we noted that the groups often struggled and some groups had
Time: 7:00 to 8:30 p.m.
Where: College of the Rockies, Cranbrook Campus
stopped meeting; while others were enduring, meeting regularly, and attracting large
numbers of attendees. While collecting data from the 16 groups in this study, we became
Kamloops Prostate Cancer Support & Awareness Group
aware of 9 BC-based PCSGs that had recently disbanded, and many of the groups that we
Contact: Larry Reynolds 250-376-4011
attended were challenged to attract and retain members, maintain cohesive leadership,
Email: [email protected]
and provide up-to-date information in a rapidly changing field. Group sustainability was
When: Once a month (Please call 250-374-9188 for more info.)
formally investigated to better understand these issues.
Where: Interior Health meeting room at 450 Lansdowne St
Kelowna Prostate Cancer Support & Awareness Group
While collecting data from
Contact: Bren Witt 250-764-1031
Email: [email protected]
the 16 groups for this study,
When: The 2nd Saturday of each month
we became aware of 9 BC-
Time: 9:00 a.m. to 11:00 noon
Where: Kelowna Health Centre, 1340 Ellis Street.
based PCSGs that had
recently disbanded, and
many of the groups that we
Nanaimo Prostate Cancer Support Group
Contact: Malcolm W. Reville 250-756-3116
attended were challenged
Email: [email protected]
to attract and retain
When: The 2nd Tuesday of each month
Where: Nanaimo Cancer Society
Leadership and management
North Shore Prostate Cancer Support & Awareness Group
As others have observed in professionally-led cancer support groups,30 the success and
Contact: Tom Sayle 604-929-3125
Email: [email protected]
longevity of PCSGs is reliant on effective leadership and management. PCSG leadership
When: The 4th Tuesday of each month January to November (November – social night) no
can be challenging for lay volunteers. The groups attract men and women with a wide
meeting in December
diversity of needs that fluctuate considerably from one meeting to the next. Cohesive
Time: 7:00 to 9:00 p.m.
leadership, shared management, and specific group facilitation strategies were integral to
Where: Lions Gate Hospital, Basement Auditorium
meeting the needs of attendees and fostering their camaraderie and commitment to the
Parksville (DISTRICT 69) Prostate Cancer Support & Awareness Group
group. Group members were adamant that PCSGs needed to be survivor-led, yet being a
Contact: Doug Bamford 250-954-0887
group leader required significant time, energy, and commitment that only a few men were
Email: [email protected]
able or willing to provide. Similar to problems described by both professional and
When: The 1st Wednesday of each month
nonprofessional leaders of cancer support groups,31 PCSGs' dependence on one or two
leaders and lack of defined terms and tenure, meant that group leaders were at risk for
Where: 361 Willow Street, Parksville, B.C.
burnout. In these situations, the long-term viability of the group was uncertain. Finding
Pender Island Prostate Cancer Support & Awareness Group
ways to support the leadership of PCSGs and the development of succession planning
Contact: Jim Dunn 250-629-3273
was critical to ensuring group sustainability.
Email: [email protected]
When: No Longer meets but Jim is willing to take calls.
Prince Rupert Prostate Cancer Support & Awareness Group
Contact: Judy Rea 250-622-6533
When: The 1st Wednesday of each month
9/16 – one leader
Where: Health Unit
Qualicum Beach Prostate Cancer Support & Awareness Group
Contact: Jack Rossiter 250-951-2083
When: The 1st Tuesday of each month
Time: 7:00 to 9:00 p.m.
Where: St Stephen Church
ears lish
Quesnel Prostate Cancer Support & Awareness Group
Contact: Ron Campbell 250-992-2726
Email: [email protected]
When: meet on an as needs basis
Where: 332 Front St., Quesnel
Revelstoke Prostate Cancer Support Group
Contact: Darrell Goodman 250-837-3663
Email: [email protected]
When: under development (some fellows meet casually at a coffee shop)
unicipal ealth C ospital
Time: Being arranged – call Darrell
Salts Spring Island Prostate Cancer Support & Awareness Group
Contact: Chris Rieder 250-537-2720
orm haring
Email: [email protected]
When: The 3rd Tuesday of each month
Time: 1:30 to 3:30 p.m.
Where: Farmers' Institute
Sunshine Coast Pc Support Awareness Group
Contact: John Keates, Chair 604-885-4181
roup characteristics
Email: [email protected]
When: The 1st Tuesday
M urationD (M
Where: St. John's United Church, Davis Bay, Sechelt
ancer Society
Surrey Prostate Cancer Support & Awareness Group
Contact: Leno Zecchel 604-596-2640 or George Main 604-574-5554
Email: [email protected] or [email protected]
When: The last Saturday of each month (not December)
anadian C
Time: 10:00 am to 12:00 noon
Where: Cafeteria, Surrey Memorial Hospital 13750 96 Ave. Surrey, BC
Vancouver PSA (Prostate Cancer Support & Awareness) Group
Contact:Len Gross 604- 434-2100 or Gordon Dunn 604-739-5900
Email: [email protected] or [email protected]
ffice provided by C
When: The 1st Thursday of each month
Table 1. Prostate Cancer Support G
Time: 11:00 a.m. to 1:00 p.m.
428 (100% 4 – 100 26.8 25.0
Where: Canadian Cancer Society Board Room. 565 West 10th Ave. Vancouver.
of meaning and purpose through attending support group meetings.25 A survey of men
Vernon PSA (Prostate Cancer Support & Awareness) Group
attending a professionally-led Montreal-based PCSG indicated that the sharing of PCa
Contact: Ed Eyford 250-545-6220 or Lloyd Mitchell 250-549-2362
experiences with others gave men reassurance, helped alleviate anxiety, and provided a
Email: [email protected] or [email protected]
more positive outlook and a perception of being actively involved in their treatment.26
When: The 4th Monday of Jan., Feb., Mar., Apr., May, Sept., Oct., & Nov.
Time: 7:30 to 9:30 p.m.
Both studies recommended further research to more fully understand how PCSGs operate
Where: The People Place 104–3402 27th Avenue
in Canada, and in 2005 we were able to build upon these earlier studies.
Victoria PSA (Prostate Cancer Support Association)
Contact: David Durksen or Andrew Godon 250-382-6531
Email: [email protected] or [email protected]
When: The 2nd Tuesday of each month
Time: 7:00 to 9:00 p.m.
Study design
Where: Begbie Hall Royal Jubilee Hospital grounds, 2101 Richmond Ave. Victoria
A qualitative ethnographic design, including fieldwork, participant observations, and
individual interviews provided an effective way to establish understandings about
White Rock/South Surrey Prostate Cancer Support & Awareness Group
PCSGs.27 The primary characteristic of the study was its commitment to cultural
Contact: John Morton 604-538-0011
interpretations of the practices and social norms at the PCSGs.28-29
Email: [email protected]
When: No Longer meeting but John is willing to take calls.
We attended and observed meetings at 16 groups in diverse rural and urban locations in
BC, Canada. The PCSG meeting details based on fieldwork and participant observations
are included in Table 1. Five groups focused their meetings on psycho-educational
presentations, six groups were discussion-based, and five groups combined psycho-
education with discussion. All the groups were led by PCa survivor volunteers and the
number of attendees ranged from 4 to 100 people (M = 27). Potential interviewees
volunteered from each PCSG and from that pool we interviewed 54 men with varying
group associations. Specifically, 22 men held leadership roles (e.g., leader, facilitator,
secretary), 16 were long-term members (attending for more than 12 months) and 16 were
short-term members (attending for less than 12 months); all completed individual semi-
structured interviews. In total, the 54 interviewees accounted for approximately 16% of
all the men observed at the group meetings, and they ranged in age from 53 to 87 years
(M = 71.27 years; SD = 8.52 years) and had attended PCSGs for an average of 5 years
(SD = 4 years)†. The majority of the men were married (n = 51) and retired (n = 44). The
interviewee's mean time since PCa diagnosis was 6 years (SD = 5 years)†. Three men had
not been treated; of the 51 men who had been treated, 15 had a prostatectomy, 6 received
androgen deprivation therapy, 4 brachytherapy, 4 radiation therapy, and 22 a combination
thereof. We also expected to recruit one woman from each PCSG to participate in the
interview component of the study. However, many women were eager to talk with us,
and we interviewed 20 women from 11 of the 16 groups. On average, 5.6 (21%) of the
attendees at each of the PCSG meetings that we observed were women. Women
interviewees self-identified as Anglo-Canadian (n = 14) and Northern European (n = 6),
ranged in age from 54 to 84 years (M = 68.5 years), and most were retired (n = 15). Most
participants (n = 16) attended with their husbands and, at the time of the interview, had
attended group meetings from 6 months to 13 years (M = 6.5 years). The women's
demographic data reflected what was typically observed at the group meetings.
† Length of time attending the group varied widely, ranging from 1 month to 13 years as did time since
diagnosis (1 month to 19 years).
References
1. Hsing AW, Tsao L, Devesa SS. International trends and patterns of prostate cancer
In Canada, no cancer is more common to men than prostate cancer (PCa).1 In 2007,
incidence and mortality. Int J Cancer. 2000;85 (1):60–7.
22,300 Canadian men were diagnosed with PCa, and an additional 4,300 died of the
2. Canadian Cancer Society. Canadian cancer statistics; Prostate cancer stats [database on
disease.2 Old age is the strongest predictor of PCa development3,4 and it is estimated that
the Internet]. 2008 [updated 2008 April 9; cited 2008 August 11]. Available from:
the proportion of elderly Canadians (>65 years of age) will increase from 13.2% (4.2
million) of the total population (2005) to 24.5% (9.8 million) by 2036.5 Men are also
3. Albertson P. Prostate disease in older men: Cancer. Hosp Pract. 1997;32(10): 159–66,
living longer with PCa, and the death rate continues to be significantly lower than the
incidence rate.6 In the absence of a known cause or cure, the number of men diagnosed
4. Kozlowski J, Grayhack J. Carcinoma of the prostate. In: Gillenwater J, Grayhack J,
with PCa will increase with the aging population, and for many men it will become a
Howards S, Mitchell M, editors. Adult and Pediatric Urology. Vol. 2, 4th ed.
Philadelphia: Lippincott Williams and Williams; 2002. p. 1471–1654.
chronic, long-term illness.6,7 Diverse health issues are encountered by men and their
5. Statistics Canada (2006).
families as a result of PCa and its treatments, many of which influence gender roles and
6. Ellison LF, Stokes J, Gibbons L, Lindsay J, Levy I, Morrison H. Monograph Series on
gender relations,8-17 and quality of life.18-20 The roles of breadwinner, husband and father
Aging-related Diseases: X. Prostate Cancer. Chronic Diseases in Canada [monograph on
are often altered, and pursuits of work and leisure can be undermined.8-9,15-17
the Internet] 2000 [cited 2004 March 5]; 19(1). Available from: http://www.phac-
Furthermore, most PCa treatments affect potency and urinary continence, which directly
7. Remzi M, Waldert M, Djavan B. Prostate cancer in the ageing male. J Mens Health
affect men's sexuality and intimate relationships.12-13, 14-17, 21-24
Gend. 2004;1(1):47–54.
8. Oliffe JL. In search of a social model of prostate cancer: Finding out about Bronch. In:
Health and illness information are integral to the well-being of men who have PCa, and
Pearce S, Muller V, editors. Manning the next millennium: Studies in masculinities
prostate cancer support groups (PCSGs) have emerged as important community-based
Western Australia: Black Swan Press; 2002. p. 69–84.
resources. Underpinned by the basic premise that PCSGs have much to offer, we
9. Oliffe JL. Prostate Cancer: Anglo-Australian heterosexual perspectives [dissertation].
designed a study to better understand how groups operate as a means of describing their
Geelong (Victoria, Australia): Deakin University; 2003.
10. Oliffe J. Anglo-Australian Masculinities and Trans Rectal Ultrasound Prostate Biopsy
role in health promotion. The three-year study was funded by the Canadian Institutes of
(TRUS-Bx): Connections and Collisions. Int J Mens Health. 2004;3: 43–60.
Health Research (CIHR), Institute of Gender and Health and through their generous
11. Oliffe JL. Trans rectal ultrasound prostate biopsy (TRUS-Bx): Patient perspectives. Urol
support we were able to explore:
Nurs. 2004;5(4): 395–400.
12. Oliffe JL. Constructions of masculinity following prostatectomy-induced impotence. Soc
• the feasibility of survivor-volunteer led PCSGs,
Sci Med. 2005; 60(10): 2249–59.
13. Oliffe J. Embodied Masculinity and Androgen Deprivation Therapy. Sociol Health Illn.
men's and women's patterns of engagement with, and perspectives about PCSGs, and
14. Chapple A, Ziebland S. Prostate cancer: Embodied experience and perceptions of
masculinity. Sociol Health Illn. 2002; 24(6): 820–41.
• factors shaping men's health promotion practices at PCSGs.
15. Fergus K, Gray R, Fitch M. Sexual dysfunction and the preservation of manhood:
experiences of men with prostate cancer. J Health Psychol. 2002; 7(3): 303–16.
The purpose of this report is to summarize the findings drawn from the study and make
16. Gray R, Fitch M, Fergus K, Mykhalovskiy E, Church K. Hegemonic masculinity and the
practice and research recommendations. The content shared in this report has been
experience of prostate cancer: A narrative approach. Journal of Aging and Identity.
2002;7(1): 43–62.
published in academic journals, the ‘Our Voice' PCa survivor magazine and on the
17. Fergus K, Gray R, Fitch M. Active consideration: Conceptualizing patient-provided
Canadian Prostate Cancer Network (CPCN) web site (http://www.cpcn.org/) and
support for spouse caregivers in the context of prostate cancer. Qual Health Res. 2002;12:
presented at conferences, workshops and PCSG meetings in Canada, the USA, Australia
18. Kirschner-Hermanns R, Jakse G. Quality of life following radical prostatectomy. Crit
Rev Oncol Hematol. 2002;43: 141-151.
19. Meuleman EJH, Mulders PFA. Erectile function after radical prostatectomy: A review.
Prostate Cancer Support Groups in British Columbia
Eur Urol. 2003;43: 95-102.
20. Palmer MH, Fogarty LA, Somerfield MR, Powel LL. Incontinence after prostatectomy:
PCSGs are relatively recent phenomena, and the Vancouver group in British Columbia
Coping with incontinence after prostate cancer surgery. Oncol Nurs Forum. 2003;30(2):
(BC), established June 1992, was among the first groups to operate in Canada. Previous
21. Charmaz K. Identity, dilemmas of chronically ill men. In: Sabo D, Gordon DF, editors.
studies of Canadian PCSGs, including an interview study of 12 men mostly in leadership
Men's health and illness: Gender, power and the body. Thousand Oaks, CA: Sage
roles in Winnipeg, Toronto and Ottawa-based groups, indicated that men derive a sense
Publications; 1995. p. 266–91.
22. Navon L, Morag A. Advanced prostate cancer patients' ways of coping with the
hormonal therapy's effect on body, sexuality, and spousal ties, Qual Health Res.
* Please refer to Publications and Presentations (page 18 through 20) for specific details.
2003;13(10):1378–92.
23. Navon L, Morag A. Advanced prostate cancer patients' relationships with their spouses
following hormonal therapy. Eur J Oncol Nurs. Jun 2003;7(2):72–81.
24. Navon L, Morag A. Liminality as biographical disruption: unclassifiability following
hormonal therapy for advanced prostate cancer, Soc Sci Med .2004;58: 2337–47.
25. Gray RE, Fitch M, Davis C, Phillips C. Interviews with men with prostate cancer about
their self help group experience. J Palliat Care. 1997;13(1):15–21.
26. Gregoire I, Kalogeropoulos D, Corcos J. The effectiveness of a professionally led support
group for men with prostate cancer. Urol Nurs. 1997;17(2):58–66.
27. Lieberman MA, Golant M. Leader behaviours as perceived by cancer patients in
professionally directed support groups and outcomes. Group Dyn. 2002. 6(4):267–76.
28. Wolcott HF. Writing up qualitative research. Newbury Park: Sage; 1990.
29. Boyle J. Styles of ethnography. In: Morse J, editor. Critical issues in qualitative research
methods. Thousand Oaks, CA: Sage; 1994. p. 159–85.
30. Muecke MA. On the evaluation of ethnographies. In: Morse J, editor. Critical issues in
qualitative research methods. Thousand Oaks, CA: Sage; 1994. p. 187–209.
31. Kirsten L, Butow P, Price M, Hobbs K, Sunquist K. Who helps the leaders? Difficulties
experienced by cancer support group leaders. Support Care Cancer. 2006;14(7): 770–8.
32. Lee C, Owens R. The psychology of men's health series. Philadelphia: Open University
33. Manne SL. Prostate cancer support and advocacy groups: their role for patients and
family members. Semin Urol Oncol 2002;20:45–54.
34. Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J. The supportive
care needs of men with prostate cancer. Psycho-Oncology 2001;10:66–75.
35. Katz D, Koppie TM, Wu D et al. Socio-demographic characteristics and health related
quality of life in men attending prostate cancer support groups. J Urol 2002;168:2092–6.
36. Cordova MJ, Giese-Davis J, Golant M et al. Mood disturbance in community cancer
support groups. The role of emotional suppression and fighting spirit. J Psychosom Res
2003;55:461–7.
37. Arrington MR, Grant CH, Vanderford ML. Man to man and side by side, they cope with
prostate cancer: Self-help and social support. J Psychosoc Oncol. 2005;23(4): 81–102.
38. Boehmer U, Clark, JA. Married couples' perspectives on prostate cancer diagnosis and
treatment decision-making. Psycho-Oncology. 2001;10(2): 147–55.
39. Soloway CT, Soloway MS, Kim SS, Kava BR. Sexual, psychological and dyadic
qualities of the prostate cancer ‘couple'. BJU Int. 2005; 95(6): 780–5.
40. Taylor P. Dubbed ‘le weekender,' new drug to rival Viagra. The Globe and Mail; 2003,
September 19: A.2.
41. Halbfinger DM. The Teresa factor. National Post; 2004, Feb 23: A.11.
Source: http://menshealthresearch.webi.it.ubc.ca/wp-content/uploads/2013/11/The-role-of-prostate-cancer-support-groups-in-health-promotion.pdf
Highlights of the RRP meeting/CME course at Johns Hopkins, 30 May 2014: RRP patients/family members' perspectives [The following report is based on coordinated input from all those RRP families who attended the meeting] On Friday May 30, 2014, a CME course, "Updates in Recurrent Respiratory Papilloma: Clinical and Research Perspective", was held at Johns Hopkins in Baltimore, MD.
J. ENTOMOL. SOC. BRIT. COLUMBIA 100, DECEMBER 2003 Testing an attracticide hollow fibre formulation for control of Codling Moth, Cydia pomonella ALAN L. KNIGHT YAKIMA AGRICULTURAL RESEARCH LABORATORY, AGRICULTURAL RESEARCH SERVICE, USDA. 5230 KONNOWAC PASS RD., WAPATO, WA 98951 Laboratory and field tests were conducted to evaluate the use of an experimentalsprayable formulation of chopped hollow fibres loaded with codlemone and mixed with1.0% esfenvalerate and an adhesive to control codling moth, Cydia pomonella (L.)(Lepidoptera: Tortricidae). Moths were not repelled by the addition of the insecticide tothe adhesive and were rapidly killed following brief contact. A significantly greaterproportion of male moths flew upwind and contacted individual fibres for a longerperiod of time when fibres had been aged > 7 d versus fibres 0 – 7 days-old in flighttunnel tests. Field tests using sentinel fibres placed in 10.0 mg drops of adhesive onplastic disks stapled to the tree found that fibres were not touched until they had aged >8 d. Conversely, moth mortality following a 3-s exposure to field-collected fibresdeposited on the top of leaves was low in bioassays with fibres aged > 8 d. Thedeposition and adhesion of fibres within the apple canopy appear to be two majorfactors influencing the success of this approach. Fibres were found adhering to foliage,fruit, and bark within the orchard; however, visual recovery of fibres following each ofthe three applications was < 5.0%. Both the substrate and the positioning of the fibre onthe substrate influenced fibre retention. The highest proportion of fibres was foundinitially on the upper surface of leaves and this position also had the highest level offibre retention. Fibres on the underside of leaves or partially hanging off of a substratewere dislodged within two weeks.
