A cancer diagnosis can come with a lot of stigma, especially if you have prostate cancer.
People may delay the screening due to stigma but also feel guilty for not having an exam sooner. Stigma may come about due to treatment side effects, which can affect your appearance, ability to pee, and sexual function.
“Sexual function, sexuality, and normal bodily acts … are understandably very sensitive and intimate subjects,” says Neha Vapiwala, MD, a professor and vice chair of education in radiation oncology at the University of Pennsylvania.
“The diagnosis of prostate cancer can be emasculating,” says Alyssa Middleton, PhD, a cancer coach from Mt. Washington, Kentucky, who’s also an adjunct professor at the University of Louisville.
“Immediately, the diagnosis can be a blow to their perceived sexual abilities and prowess,” she says. “Each of these can further increase the stigma of the disease and dramatically harm one’s mental health beyond the initial diagnosis.”
Prostate cancer affects Black men more than other races – and self-stigma, public stigma, and structural stigma are common in the Black community, a 2024 report finds. In the U.S., Black men are 1.76 times more likely to be diagnosed with prostate cancer than White men.
Understanding the Stigma
The negativity that’s linked to the disease may stem from self-blame or not wanting to talk about issues (like erectile dysfunction) that can happen with prostate cancer, says Trevor Royce, MD, a radiation oncologist and adjunct faculty at the Wake Forest University School of Medicine.
That can be isolating and lead to more anxiety and depression. This can affect your physical health, too, Royce adds.
“Another layer of this experience is that prostate cancer treatment, specifically androgen deprivation therapy (ADT), can have negative side effects,” says Royce. The treatment can be beneficial for some people, but studies show radiotherapy alone can be just as effective.
Having to weigh if ADT is an option may bring more uncertainty to your decision-making process. This can further affect your mental health and overall quality of life during an already difficult time, he says.
Even if you don’t want to talk, having someone to talk to is vital for your overall health.
Research shows that peer support may be linked with high satisfaction and positive psychological outcomes for those with prostate cancer.
Even if you think there’s no point in talking, that’s not true, says Russell J. Ledet, MD, PhD, a Triple Board Resident at Indiana University Health.
“The reality is that clinicians like myself, and so many others, need to create environments where men feel safe to express themselves—because there’s real help and support on the other end of that expression,” he says.
Stigma or No Stigma
Not every person feels stigma. But for some, it’s overwhelming.
Stigma wasn’t really part of Ed Anderson’s journey. The 68-year-old resident of El Paso, Texas, was diagnosed with stage IV and terminal prostate cancer in 2019. His prostate gland was removed 4 months after diagnosis. But his PSA levels didn’t go down, which meant that the cancer had spread, Anderson recalls.
He went to MD Anderson for a second opinion and joined several clinical trials. Today, he’s free of cancer.
Though Anderson was shocked by his diagnosis, he didn’t feel a lot of stigma because he was focused on survival. He did have friends who were concerned about feeling less masculine without a prostate gland, but Anderson thinks that belief is ill-informed because the disease is relatively treatable.
“If detected early, it’s curable, which is unbelievable,” Anderson says. “Once they tell you it’s cancer, it’s an oncology issue, definitely not a stigma issue.”
Jeffrey L. Reynolds, PhD, a resident of Commack, New York, who survived prostate cancer, took a similar approach to fight stigma.
“There's certainly some internal strife that goes along with the diagnosis, and any threat to your nether regions is a blow to your masculinity,” says Reynolds.
Like Anderson, Reynolds armed himself with knowledge and focused on recovery.
“Supporting others through screening, diagnosis, and treatment has reinforced my idea of brotherhood between men. And sometimes just speaking openly about a challenge can help smash any lingering stigma,” Reynolds says.
Where to Turn for Support
A few resources may help you learn more and feel empowered as you process your diagnosis and any stigma linked to it.
Middleton suggests reading The Prostate Cancer Owner’s Manual: What You Need to Know about Diagnosis, Treatment, and Survival by Harley Haynes, MD, and Richard Miles.
Vapiwala recommends the ZERO's MENtor Program’s peer support group. The Prostate Cancer Foundation offers support groups online, and Gilda’s Club provides in-person support groups around the U.S.
“I think the general population talks about prostate cancer more often, but it’s still in a very superficial way,” says Middleton. “It centers more around getting screened and knowing your PSA numbers – but not about how the disease can impact a patient. And definitely not normalizing the side effects of the disease and treatment.”
“Whatever feelings you’re having—they are real, valid, and you are not alone in dealing with this,” says Ledet. “Prostate cancer affects so many different men, and the truth is, nobody talks about it enough. If you’re feeling the stigma, you must reach out to someone you trust and start small. Talk about how you feel on your way to work, how you feel at work, what you felt when you first heard the diagnosis, or even just how you’re feeling in general.”
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Neha Vapiwala, MD, professor, vice chair of education in radiation oncology, University of Pennsylvania, Philadelphia.
Alyssa Middleton, PhD, cancer coach, Mt. Washington, Kentucky.
Jeffrey L. Reynolds, PhD, prostate cancer survivor, Commack, New York.
Trevor Royce, MD, radiation oncologist, adjunct faculty, Wake Forest School of Medicine, North Carolina.
Russell J. Ledet, MD, PhD, Indiana University Health, Indianapolis.
Ed Anderson, prostate cancer survivor, El Paso, Texas.
Journal of Racial and Ethnic Health Disparities: “A Scoping Review of Stigma Related to Prostate Cancer in Black Men.”
Cancer Letters: “Racial disparities in prostate cancer: A complex interplay between socioeconomic inequities and genomics.”
Oncology: “Complications of Androgen Deprivation Therapy in Men With Prostate Cancer.”
Frontiers in Endocrinology: “Androgen deprivation therapy and radiotherapy in intermediate-risk prostate cancer: A systematic review and meta-analysis.”
Illness, Crisis & Loss: “Understanding Prostate Cancer Patients’ Support Needs: How Do They Manage Living With Cancer?”
Zero Prostate Cancer: “ZERO's MENtor Program.”
Prostate Cancer Foundation: “Support Groups.”
Gilda’s Club: “Everyone's cancer is unique. Your support should be too.”
