A PHENOMENOLOGICAL INVESTIGATION OF TIME TO PRESENTATION, DIAGNOSIS, AND TREATMENT FOR INDIANA FARMERS WITH PROSTATE CANCER AND MEASUREMENTS OF TRADITIONAL MASCULINITY IDEOLOGY

Abstract

Introduction: The most common and second-deadliest cancer in the U.S. for men is prostate cancer (PCa). Extensive research shows that farmers have higher PCa incidence and mortality than nonfarmers. This study aims to better understand U.S. farmers’ increased risk of PCa by exploring care-seeking behaviors and masculinities in Indiana farmers with a history of PCa. Methods: Eleven farmers with a PCa history completed a questionnaire about their traditional masculinity beliefs and an interview focused on their PCa experiences, from signs and symptoms to after treatment. Interview questions were based on three theories, and the questionnaire was the 21-item Male Role Norms Inventory-Short Form (MRNI-SF). Results: MRNI-SF results showed farmers endorsed traditional masculine norms. Specifically, they agreed with avoiding femininity, having negative attitudes towards sexual minorities, being self-reliant through mechanical skills, toughness, and sex being important. Farmers did not endorse men being dominant nor with men restricting emotions. Seven themes described farmers’ PCa experiences: the body was an occasional guide for detection, routine checkups were the primary method of suspicion, PSA-testing was a powerful predictor, biopsy was somewhat of a bugaboo, diagnosis put psychological health on display, healthcare professional characteristics and others’ experiences reigned paramount in treatment decisions, and treatments invoked physical concerns and side effects. Discussion: Farmers did not agree with men always dominating and restricting emotions, which does not reflect previous studies. More research is suggested utilizing the MRNI-SF with larger populations of farmers. Based on the themes, increased somatic awareness is suggested for farmers, as well as continued routine checkups and PSA-testing. Farmers also require improved health education and resources to prepare for a PCa biopsy, to cope with a diagnosis, to make treatment decisions, and to manage treatment symptoms.