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We must fight the social stigma of prostate cancer.
Last year, I travelled to the Eastern Cape twice to visit my paternal grandfather, whose fight with prostate cancer was coming to an end. My third visit was for his funeral, and I was reminded that my late maternal grandfather had also had prostate cancer. During my stay in our beautiful village, I came face to face with the secrecy, stigma and gossip that still surround
the disease.
For a while, I thought I was reliving the years during which HIV/Aids was spoken of in harsh tones.
In confusion, I started reading more about the cancer. I found that embarrassment and feelings of emasculation were key inhibitors to speaking out and seeking help before it was too late to benefit from treatment. Specifically, the diagnostic procedure is thought to be invasive and obscene. In fact, conversations with male friends about prostate cancer highlighted the perceived obscenity of the diagnostic procedure. Why?
Well, for the test, “a gloved, lubricated finger is inserted into the rectum to feel for any bumps or hard areas on the prostate that might be cancer”. Fortunately, prostate cancer can also be detected using a blood test, but this is less well known.
In my village, another barrier to seeking medical care is the preconceived idea that prostate cancer is a sexually transmitted disease, a belief that is rampant. This is because the cancer affects a sex organ.
Having read about the sociology of health and society, I know how people’s health concerns cannot be divorced from their multiple, complementary and/or contradictory frames of reference. The reference points can be biomedical, religious, cultural or all the above. Many in my village primarily drew on cultural explanations.
At the centre of cultural explanations was a problematic gender blame game. Cultural explanations of prostate cancer shame dignified old men, who are said to be preoccupied with sex. Women are vilified and pathologised because prostate cancer is seen as a sexually transmitted illness that is contracted from “unclean” women. Such explanations pit women against men
and frustrate interventions in a battle that has
no winners.
The gossip surrounding those with the disease perpetuates the problem. In fact, the higher the man’s social status in his community, the more devastating the gossip. Regardless of their status, old men suffer in silence, seeking help far
too late.
I am glad my grandfather, the man I adored like no other, sought help throughout, despite the gossip. As the cancer ravaged his body, I wondered about the many other victims who would continue to die with the added burden of the social stigma. I am glad my aunt (his daughter) was there to take care of him until the end. I will always treasure the opportunity she afforded me to participate intimately in his
care. I now know exactly how much of a struggle it was. That experience allowed us to reciprocate the love my grandfather had used so well to glue us all together.
How do you know you or a loved one should seek help? Men must consult a health practitioner if they experience problems passing urine, see blood in their urine or have trouble getting an erection, among other symptoms. Prostate cancer is more prevalent among men over the
age of 65, and the prevalence increases with age. However, more and more men above the age of 50 (and even earlier) are encouraged to undergo tests.
To dispel the myths, we need to raise awareness about prostate cancer. Programmes such as Movember are a step in the right direction in terms of creating awareness about men’s health in general. Socially, unless we challenge the deep-seated disdain for women’s bodies, which is constructed to create the misconception that they are carriers of impurities – and until women refuse to be scapegoats for a society’s refusal to examine its toxic gender conceptions – we are guaranteed to see more untimely deaths.
Health practitioners and local leaders should work together to educate communities about cancer in general. Efforts should take into account the tension between biomedical and cultural explanations of the causes of illnesses.
More specifically, and importantly, we must work to end the shame and social stigma related to prostate cancer.
Bingma is with the department of Sociology at the University of Pretoria.
Visit The Cancer Association of SA at cansa.org.za, or call the toll free number on 0800 22 66 22.
Also see za.movember.com and prostate-ca.co.za for more information
