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Abstract

This study focuses on ageing men treated for prostate cancer receiving androgen deprivation therapy (ADT) linked to a spectrum of side effects, sometimes understood as emasculating. To understand the consequences of ADT and how to counteract side effects related to masculinity, interviews were conducted with treated men participating in an exercise programme. The aim was to analyse how participants experienced and embodied the exercise programme in relation to ageing, illness and masculinity. Findings show that the men experience their bodies as changing, loosing habituated abilities. The beginning of the programme evoked feelings of precarious bodies, whereas further along these feelings evolved into those of bodily remedy. Participation was seen as opportunity to meet other men in the same situation and created a sense of fellowship.

Keywords

embodiment masculinity physical activity prostate cancer

Introduction

Prostate cancer (PCa) is one of the most common cancer diagnoses amongst men, typically occurring more frequently with advancing age (Board, 2023; Rawla, 2019). Treatment usually brings a spectrum of side effects with the potential of burdening the men, negatively affecting their quality of life (Kovač et al., 2023; NICE, NG131, 2019; Trost et al., 2013). Where most research has focused on men undergoing radiation therapy or prostatectomy, this paper focuses on men undergoing androgen deprivation therapy (ADT) aiming at supressing physiological effects of testosterone and thereby tumour growth. Notably, ADT side effects often cause adverse and wide ranging changes to the men’s bodies (Hamilton et al., 2015; Overkamp et al., 2023). Common side effects of ADT include lack of libido, erectile dysfunction, gynecomastia, sarcopenia and increased fat mass around hips (Langelier et al., 2019; Morgia et al., 2016). This comes in addition to physical changes due to increasing age and physical deterioration rendering these men unable to engage in activities they once could (Drummond, 2003). Several of these changes to the body and its constitution challenge traditional masculine norms (Andreasson et al., 2023a; Brüggemann, 2021; Forster et al., 2022; Gentili et al., 2022; Keating et al., 2008; Oliffe, 2006). Consequently, there is a negative impact on the men’s understanding of the self (Muermann & Wassersug, 2022), and notably a lowering of their quality of life when receiving long-term treatment. This is most often the case with ADT (Crump et al., 2023; Gentili et al., 2019; Smith-Palmer et al., 2019).

To deal with PCa and ADT, existing research underscores the significance of physical activity (Campbell et al., 2019; Keating et al., 2008; Tian et al., 2022; Yunfeng et al., 2017), which has the potential to serve as a resource, promoting better quality of life during times where health is compromised. For example, exercise during ADT treatment can mitigate fatigue, counteract negative metabolic changes, and improve physical functions (Taaffe et al., 2017; Østergren et al., 2016). Physical activity does not only promote physical changes, there is also added support for enhanced male body image (Hamilton et al., 2015). Langelier et al. (2022) address how PCa and ADT treated men adopt exercise as a coping strategy by, for example, re-establishing control, practicing resilience and managing self-care. However, a substantial proportion of the men receiving ADT fail to meet the suggested levels of weekly physical activity (Bøhn et al., 2019), and reasons can be that normative masculinity acts as a barrier when men rather tend to have a stoic approach meeting health difficulties (Andreasson et al., 2023b; Piatkowski et al., 2024; Rindhagen et al., 2023). Previous research has pointed to the importance of creating inclusive and safe male environments when promoting physical activity among specific groups of men (Capela et al., 2023; Drummond, 2008; Sims-Gould et al., 2018; Windt et al., 2023). However, there is limited research on men undergoing ADT treatment, their experience of physical activity, and how they motivate their participation.

This article has applied a qualitative approach to the research, leaning on theories and concepts found within critical studies on men and phenomenology. Men over 65 years undergoing ADT treatment were interviewed when participating in an exercise programme with the aim of analysing how participants experienced and embodied the exercise programme in relation to ageing, illness and masculinity. The aim was met with the help of the following research questions:

• In what ways were masculinity, ageing and the treated body addressed in relation to ADT side effects?

• Did the men’s understanding of their ADT treated and ageing body influence physical performance and did their understanding evolve with time?

• How did the men motivate participation in the exercise programme and how was that linked to notions of masculinity?

Background and Survey of the Field

The risk of PCa increases with age and men over 65 years account for over 65% of men affected globally (Rawla, 2019), resulting in it sometimes being referred to as an old man’s disease (Johnson, 2021). The aetiology of PCa is still explorative, and diagnosed men have different treatment options to choose from, with prostatectomy and/or radiation being used most frequently (NICE, NG131, 2019). While it is common to undergo a multifaceted array of therapeutic interventions, one cornerstone resides in ADT and is used primarily in advanced cases or when the tumour has spread (Morgia et al., 2016). ADT treatment consists of different pharmacological drugs that either restrain testosterone receptors or supresses hormonal production leading to it sometimes being presented as chemical castration (Muermann & Wassersug, 2022). These options can be prescribed to patients long term, and to an extent they increase longevity, whereby the patient is more likely to die from something else (Desai et al., 2021; Epstein et al., 2012; Forster et al., 2022).

However, ADT side effects can be severe, and include lack of libido, weight gain, erectile dysfunction, gynecomastia, hot flushes, penile shrinkage, sarcopenia, osteoporosis and also increased risk of cardio vascular disease (Board, 2023; Trost et al., 2013). Simultaneously, physical weakness and the loss of sexual capability can be understood as ageing and therefore more or less accepted, depending on the subjective male self-image and, for example, sexuality where heterosexual, gay or bisexual men relate differently/similarly depending on culture (Danemalm Jägervall et al., 2019; Gentili et al., 2022; Ussher et al., 2016). Research has shown how some of the side effects, when causing physical alterations, could be understood as emasculating due to difficulties living up to masculine ideals and norms (Gentili et al., 2022; Larkin et al., 2022; Oliffe, 2006; Rindhagen et al., 2023). Muermann & Wassersug (2022) highlight how the men´s changing physicality could be compared to transgender experiences because of how ADT alters the men´s biological physicality, and could disrupt gendered affirmations (Ussher et al., 2023). In addition, it can be perceived as demoralizing when men are not able to meet masculine ideals (Bowie et al., 2022; Hamilton et al., 2015), and consequently there is a higher risk of developing depression (Dinh et al., 2016; Nead et al., 2017).

One way of recovering from or countering anticipated side-effects during ADT treatment for prostate cancer, is physical activity (Campbell et al., 2019; Capela et al., 2023; Yunfeng et al., 2017). Research has shown that men undergoing ADT treatment have been fortunate in counteracting physical negative side-effects with increased cardiac health, lean body mass and strength (Ashton et al., 2019; Capela et al., 2023; Tian et al., 2022). The physical outcomes from physical activity also reduce fatigue in men treated with ADT, described as crucial to this group, promoting quality of life (Newton et al., 2018). These benefits also mean that the men increase their general health status due to ageing (Uth et al., 2016).

There are also indications suggesting positive outcomes on self-esteem, as well as the ability to reconnect to normative masculinity (Gentili et al., 2019; Langelier et al., 2019). For example, participation in an exercise programme has the potential to promote social connections, aid recovery from side effects, and impact on physical capability (Langelier et al., 2022). Similar outcomes have been suggested by Bjerre et al. (2019) and also Bruun et al. (2014) where participants were able to reconnect with masculine values when participating in football interventions. Activities with masculine traits have the potential of repairing negative side effects on self-perception related to notions of masculinity.

To summarize, previous research suggests that side effects of PCa disrupt physical health in ways that are related to masculine ideals. How the men understand the effects of their treatment intersects with their experience of ageing and their sexuality. To cope with side effects, it is argued that physical activity and participation in cancer support groups can be advantageous in creating a renewed connection with masculinity. Most literature (as well as this research) has focused on heterosexual men, consequently limiting theoretical discussions about men in general.

Theoretical Framework

To understand the experience of men undergoing ADT treatment, I follow the phenomenological perspective of Merleau-Ponty (1989) who drew a distinction between our habituated bodies and the actual body. By this he meant that the body is understood foremost through accumulated life events and expressed as habits or expectations and not as blank canvases. How the men perceive their bodies is influenced by having a body before and after, for example, PCa or being younger. This perspective enables attention to be placed on embodiment and the men’s subjective experience of ageing, ADT treatment, and how this is situated in the body when participating in an exercise programme. Further, this study also leans on theories found in critical studies on men and masculinity. Connell (2005), for example, argues that hegemonic norms and notions of masculinity most often celebrate a strong, youthful and performance-oriented masculinity. As the prostate becomes cancerous it may evoke feelings of unfamiliarity, especially on the expectations men have of masculine physicality (Rindhagen et al., 2023). Supressing testosterone and experiencing physical changes may bring new perspectives on the body, where gender issues become even more present or conceivably fluid, in line with, for example, Peel et al. (2020) who discuss the link between masculinity and testosterone abrogating through psychosocial factors or chronic physical disorders. The various norms of masculinity are thereby habituated by the men in different ways, depending on former experiences and the condition of the body. Combining the habituated body with masculinity, allows the body to be understood as dynamic, where both societal norms and changing physicality are intertwined.

Changing physicality is also addressed by Wehrle (2020), who discusses temporal bodies, where ageing shifts the perspective from somewhat stable into precarious bodies. For example, the experience of sarcopenia and becoming weakened (Bernabei et al., 2014), also related to the general expectations on ageing men’s physicality associated with fragility and loss of physical abilities (Drummond, 2003; Jackson, 2016). How men understand the physical changes in relation to health is closely intertwined with their masculine identity. This connection can be expressed through hegemonic notions when managing health, however, renegotiated within the male norms, for example, having a useful and workable body (Robertson, 2006; Watson, 2000). Similarly, the experience of disease opposes the functioning and healthy body, disrupting routines and expectations on the body (Aho, 2008). Carel (2016) describes how illness evolves from normality into bodily doubt and “loss of faith in one´s embodied existence”. Both ageing and ADT impose on the familiar body, and even if effects, for example bodily degeneration expectations, are known by the men, the experience is new and opposed. In other words, the processes of both ageing and ADT could be described as a form of precarious embodiment, including lived experiences of both loss of bodily functions and a sense of unfamiliarity.

The precariousness of the ill and ageing body is in this paper situated in the context of physical activity. Expectations on the body seem to be influenced by normative masculinity and associated with, for example, performance, fitness and health (Andreasson et al., 2016; Andreasson & Johansson, 2019; Banbery et al., 2012). Performing physical activity has the potential to alter the men’s experience of their bodies when moving (Grant et al., 2019; Jirásek, 2006). For example, cultural norms may create a sense of exclusion when not living up to expectations, which is relevant when analysing how the men embody physical activity. At the same time, as Jackson (2016) argues that men’s abilities of being resilient and having strong survival skills, it could be argued that participation in the programme and performing physical activity which is coded masculine have the potential to reconnect the men with having capable and masculine bodies. The habituated body intersects different positions of masculinity depending on how capable the body is perceived to be.

Method

This paper utilizes a qualitative approach involving reflecting in-depth focus group and individual interviews (Alvesson, 2018; Silverman, 2011). To be able to collect data I initiated contact with a rehabilitation gym that commissioned an exercise programme with men over 65, undergoing ADT treatment. The initiative for the training programme was introduced by a hospital in the south of Sweden. The aim of the training programme was to offer men undergoing ADT treatment a 12 week, twice-weekly, exercise programme with the intention of reducing expected side effects. I forwarded information leaflets that explained the purpose of the study, and explained how data were to be collected. This was conveyed by the lead physiotherapist who informed participants about the project. Two training groups were recruited this way, one in the autumn of 2022, and one in the spring of 2023. Before collecting data, I met with the participants during a training session to explain the study in detail and answer potential questions. Those interested in participation signed a consent form attached to an information sheet about the project.

Ten men were recruited out of the fourteen participants in the training programme, where some were not able to take part due to time schedules. The men were between 65 and 79 years old, and at the time being treated with ADT (with different medications and combinations). The diagnosed timeframe stretched between 6 months and 18 years. The men identified as heterosexual and White, all but one had children, one was a widower, two were single and seven were married. Their education and work background differed but most were from a middle-class background.

All participants had been examined prior to participation in the exercise programme by a physiotherapist collecting anamnesis, including tests of physical performance, functional performance, and muscle function (for example, balance and core strength). The outcome originated in individual recommendations including choice of exercise, intensity, and volume. Each training session started with cardio exercise, and then changed into strength training; some balance exercises were also included. Three physiotherapists were responsible for the planning and execution, with at least two assisting at each session. The group met in a separate room equipped with strength training machines. The men followed a scheme targeting specific muscle groups, ending in a total body workout. The initial weeks focused on the learning process and kept a low intensity. As the men gained experience, they were allowed to increase the weight load, and at the end of the programme, they were encouraged to push their physical boundaries even further. Progress was assessed through tests similar to those done in the beginning of the programme, when completing the training programme.

Data collection began with focus group interviews and allowed participants to discuss relevant topics within the group (Tausch & Menold, 2016). Due to the interest on embodiment during physical activity it was considered that a fresh experience in/on the body would be preferable in relation to the focus group interviews. The interviews with the participants were, therefore, conducted at the gym/conference room after one of the training sessions. Individual interviews were conducted 1-2 weeks after the focus group interviews. The time in between interviews allowed participants to reflect on their group interview experience (Gubrium & Holstein, 2001). The setting was private and performed in study group rooms at the university. This procedure resulted in rich data emanating from genuine conversations (Chapple & Ziebland, 2002), about difficult topics such as illness, body and masculinity. A total of two focus group interviews (one with each training group) and ten individual interviews were conducted. One group had finished the 12-week programme (n = 5) and the other had completed half (n = 4) the programme. One participant was unable to participate in the group session and was only interviewed individually. All interviews, lasting between 50–75 minutes, were recorded and transcribed verbatim.

In the manner of Nowell et al. (2017) the analysis of the data evolved in a dialectical and reflective process, moving in between reading interviews and previous research, continuously over a six month period. Theoretical concepts led the process of sorting the data, focussing on empirical diversity, shared meaning or patterns (Braun & Clarke, 2019). This involved how the training programme was discussed and how the men embodied ageing and ADT in notions of masculinity and where narratives, such as feeling weak, could be repetitive. This procedure enabled sorting and coding of the data stated, for example, as gender, ageing, illness, changing bodies, inclusiveness, exclusiveness, or physical progress and further reflected on, not only as separate codes but also as intersections between codes. For example, narrative crossings involving side effects and perceptions on gender or expectations of the ageing body and physical capacity. Themes emerged at the end of the analytical process and these are presented below as three topics and sorted with the intention of adding to each theme. This practice was influenced by Braun and Clarke (Braun & Clarke, 2022), resulting in a thematic reflexive analysis, rooted in the framework of phenomenological philosophy and critical theories on men and masculinity.

Ethical approval was carried out by the Swedish Ethical Review Authority (Ref. No. 2021-01955). The identities of participants have been protected by the use of pseudonyms and any information that could reveal them has been excluded.

Findings

The first theme addresses the experience of ADT side effects and ageing where the men reflect on physical changes as moving away from normative masculinity. The second theme focuses on how the men’s understating of loss influenced their performance and how that evolved with time as they earned knowledge about their bodies. The last theme focuses on how notions of masculinity promoted motivation as a result of the opportunity to meet other participants in the same situation and the creation of a sense of fellowship.

Transforming Bodies and Experiences of Loss due to ADT Treatment Side-effects

Participants explain how both ageing and ADT treatment transformed their body composition. The changing body shape were often talked about in terms of developing breasts, a decreased muscle mass, less body hair, and the loss of bodily functions such as erectile dysfunction. The men discussed how these changes were unwanted and were seen as moving away from the masculine body. One example of their understanding was mentioned by Bob, relating his changing body shape to both femininity and ageing:

Interviewer – Has your body changed due to your hormone treatment?

Bob – One becomes feminine. (71 years old, former pilot)

Interviewer – You do?

Bob – Yes, I mean somewhat slenderer.

Interviewer – Can you explain?

Bob – Yes, you become an old man, haha!

Interviewer – Can you be more specific?

Bob – You become leaner, don´t know how to explain it really, your arms and legs become skinny. Not strange though, because of all the medicine.

Bob understood his body as feminine and simultaneously as a sign of becoming an old man. This intersection between gender and ageing could be argued to be linked to normative masculinity, where healthy, young men are endorsed (Andreasson & Johansson, 2019, 2022; Connell, 2005). Not being able to measure up to the norms influenced his perception, where a leaner body had feminine characteristics. Several men discussed their body as altered, evolving into something other and understood as emasculated. These changes were not embraced, mostly because they were seen as a sign of a body in a state of degeneration. This experience was discussed in one of the group interviews:

Owen – It has been difficult, my stamina used to be quite good because I have a history of endurance training. My disease, and the treatments have made me struggle. For example, when cycling to town I get sweaty and out of breath. (71 years old, former CFO)

Interviewer – Your perception is that the treatment is to blame?

Owen – For sure, but also ageing of course, working against you.

Levi – It is hard to accept. (70 years old, former cultivator)

Ethan – One of the most common side effects is fatigue, I experience this. Especially compared to how I was before. (78 years old, former economist)

The men’s experiences conflicted with previous, desirable abilities when they had a younger, healthier body, corresponding with the general discourse about becoming older (Allain, 2022; Drummond, 2003). Ageing and side effects conflicted with performance, and, similar to former research, ageing masculinities became embodied as something threatening to them (Chapple & Ziebland, 2002; Drummond, 2008; Langelier et al., 2022). Owen explains how physical degeneration was hard to accept and made him frustrated, evoking feelings of instability. Presenting hegemonic and normative understandings on the male body where the men rather desired physical capability related to their former physical status (Carel, 2016; Robertson et al., 2010; Watson, 2000).

ADT side effects and feminization entailed unfamiliarity and were combined with expectations about ageing. The habituated body intersects with the feminized and the ageing body influenced by masculine norms and new bodily experiences. Masculinity stood in contrast with precarious bodies (Connell, 2005), consequently understood as losing masculinity and physical abilities. These changes, related to emasculation and ageing, evolved into confusion about their body and what the body was capable of.

From Precarious Bodies to Embodied Remedy

The men had signed up to the exercise programme with the intention of dealing with the side effects of ADT (Rindhagen et al., 2023), described as self-care via trying to be healthy. Exercising early in the programme confronted the men with their changing bodies and they discussed performance as something to be cautious about:

Interviewer - When participating, have you been able to challenge yourself?

Ethan – No, I was deliberately careful in the beginning because I did not know how my body would respond. I increased the load gradually and felt okay doing so, and the last few times I increased the load even more, striving towards the best of my ability.

Understood similarly by Paul:

Paul – If I increase the load too much, more than my body can manage, it might have negative consequences, and I would probably lose motivation. It is really important that the body is able to heal in between the sessions. (aged 75, former carpenter)

Physical activity enabled physical exploration and the men understood their bodies as precarious. This made them reflect further upon what it meant to overstretch their bodily capacity, and what kind of consequences they could experience if they did. Physical exploration leaned on precarious embodiment; in contrast to normative masculinity, more often perceived as being capable and strong (Andreasson & Johansson, 2022; Connell, 2005; Jackson, 2016). Uncertainties due to illness influenced their physical performance (Aho, 2008), and somewhat limiting them. Instead of experiencing themselves as capable and strong they rather embodied a precarious male body.

However, the perception of their bodies evolved further along in the programme, and uncertainties developed gradually into new insights about progression. In the same sense that physical activity enabled knowledge about having a precarious body, exercise also functioned as a means of experiencing physical accomplishments:

Interviewer – Did you have any positive experiences during your participation?

Ethan – Yes, I felt how my body could respond to training. A few times with muscle soreness when I dared to push myself.

Interviewer – You dared to do that?

Ethan – Yes, together with the physiotherapists I pushed my body to my max, and that gave me muscle soreness. I thought that ability was lost, meaning I´m able to do more than I think and push my body further.

Similar perception was discussed by another informant:

Interviewer – Have you increased the resistance?

Frank – Yes, I was cautious in the beginning so as to feel safe, but I realized that it was too easy, and therefore I decided to increase the load, even before the physiotherapists recommended this. When they later in the programme suggested that I should increase the resistance, I did that too! (65 years old, former economist)

Interviewer – How did that feel, being able to increase the resistance?

Frank – It was satisfying realizing that I had some strength left in my body. I also noticed my ability when working in the forest, for example, carrying my chain saw.

Exercise developed into physical insights due to the experience of muscle soreness and realizing that the load was manageable. Like Ethan and Franks experience’s regarding progress, other men mentioned that the participation in the programme had resulted in increased physical capabilities, such as strength, balance and feeling less fatigued. Physical progress made them rethink physical expectations on their habituated bodies and the idea of illness and side effects when experiencing the actual body during exercise (Chouraqui, 2021; Merleau-Ponty, 1989). The men also gave their physical progress meaning in relation to being able to do heavy body work, for example, working in the forest or being able to do house renovations. Arguably reconnecting to masculine activities, similar to previous research on exercise during ADT treatment and the ability to reconnect to masculinity (Gentili et al., 2019, 2019, 2019; Langelier et al., 2022). The men felt more assured when regaining key abilities related to the notion of having an capable body (Drummond, 2008).

After twelve weeks of exercising, Owen summarised his experience as follows: If I am able to exercise, then I feel somewhat normal. What Owen referred to was feelings of familiarity, and his habituated body prior to his sense of bodily loss, and consequently a sense of relief during ADT treatment. Apparently, physical activity has the capacity to create meaning for the participants (Breivik, 2021; Grant et al., 2019), reconnecting both to their bodies prior to treatment, and more specifically to capabilities connected to masculinity (Drummond, 2003; Hamilton et al., 2015). This perception has also been discussed in other research on men and physical rehabilitation, for example, by Robertson et al. (2010) who highlighted how men who were engaged in cardiac rehabilitation most often expressed positive outcomes when they were able to connect to masculine ideals. However, normalcy could also relate to being surrounded by peers, which is explained in the next section.

The Fellowship of the Prostate

Participating in the exercise programme was discussed as a priority in the men’s weekly schedules. Attendance was high and maintained weekly. The decision to show up, although the men were experiencing troubling ADT side effects (especially fatigue), was connected to the opportunity to meet other participants. Steve explained his motivation as follows: Tuesdays mean I’m going exercising with my prostate cancer buddies! (79 years old, former cultivator). Exercising together in a group with other men, with similar experiences, created a companionship and a sense of fellowship. Several men expressed how they felt responsibility toward the group, showing up in order to participate together. This is in line with similar research that has shown how group exercise enabled both social support and solidarity, and was sometimes perceived as even more meaningful than the physical enhancement (Malcolm et al., 2016; Sims-Gould et al., 2018; Stevinson & Fox, 2006). Several men related their participation to previous life events, when having similar experiences, such as being in the military or engaged in team sports. Participation leaned on the opportunity to be a part of activities with masculine values (Connell, 2005). However, the key motivational argument was the opportunity to meet other men in a similar situation as them:

Interviewer – Participating together in a group, how did you experience this?

Owen – This was very meaningful, as well as being able to exercise I found it vital to meet others in the same situation, experiencing the same disease and the same treatment. It has been great! I haven’t found anything similar through other cancer organizations. I also have a few acquaintances, but they haven’t been a good match. However, in the exercise group I felt it was ideal due to having the same experiences.

Interviewer – Why do you think that is?

Owen – I don’t know really but just knowing that we have the same diagnosis, and same treatment makes me curious about their experiences, and how they are affected. Like if I have questions, for example. Some of the men got their diagnosis 18 years ago, and that made me hopeful, being able to live with it for so long. Also, in spite of these tough treatments, if others are able to show up and exercise it means that they are as active as me. With all these circumstances I find it to be hopeful.

Participating in a group where all the members shared the same diagnosis and treatment was eminent, and the men’s bodily experience created an inclusive environment. As Owen also mentioned the collective had the ability to confirm each other’s experiences, providing a sense of being normal. Participation originated in curiosity and was perceived as a way of understanding their own experiences. Although they felt aligned together, some of the men mentioned how the gym environment made them feel unpleasant. Bob describes his perspective:

Interviewer – Did you have any gym experience before?

Bob – No, I have never liked that environment but participating in this group, meeting 5-6 men that have things in common is pleasant. We usually sit and talk about different things and hang out.

Being able to exercise together, in a separate area in the gym, made the men feel even more comfortable, and enhanced their companionship. According to Seidler (2006, p. 42) in his scholarly work Transforming masculinities: men, cultures, bodies, power, sex and love, men congregate through rituals and the structured nature of the exercise regime as a mechanism for fostering inclusivity. Similarly, Thompson and Whearty (2004) argues that normative masculinity is not static but rather changes depending on the different stages of life and culture. Consequently, the setting of the exercise programme enabled an environment where they could feel normal and possible to socialize and furthermore understand their own experiences.

Conclusion and Discussion

The participants in this study understood their bodies in new perspectives due to changing body shape and the degenerating effect of ADT, most often as something affecting them in a negative and unfamiliar way. Their embodied precariousness leaned on the habituated body influenced by masculine ideals and expectations of ageing. The men´s experience is in line with previous studies highlighting similar objectives where elderly men govern their health with the aim to reconnect with a capable body (Green, 2021; Robertson, 2006). Some physical alterations made the men feel less masculine, which was understood as developing a feminine body shape and was in line with Muermann and Wassersug (2022) research where the men expressed similar bodily experiences as transgender men. Treatment, feminisation, and ageing made the men question their physical abilities as precarious, consequently hindering exercise performance. However, participation made the men rediscover their bodily capacity and connection to masculinity. The men found motivation attending the exercise programme in the opportunity to meet others in the same situation and the group constellation was significant to the men as it created an inclusive environment, creating a sense of fellowship.

This study includes a smaller number of heterosexual, White men. The manner in which they understand their bodies could depend on the homosocial constellation. Further research is needed to be able to understand the gendered experience related to side effects from ADT and how different groups of men (hetero/homo, different age groups etc.) undergoing treatment understand their bodies. Further research is needed to understand the consequences of side effects and the gendered complexity, and furthermore to be able to meet men with knowledge of different stages of life (Emslie et al., 2004). This study sheds light on health issues, and further on policy opportunities promoting self-care and group reinforcement, enabling men. Acting on the male reality of everyday life, where having a capable body, maintaining control and being recognised by healthcare in manners related to masculine values would help men during times of compromised health. Summarized, physical activity can have the capacity to reinforce individuals on different levels and as Adamson et al. (2022) argue, could be seen as a multifaceted resource.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Kamprad Family Foundation for Entrepreneurship, Research & Charity, no: 20210010.

ORCID iD

Cecilia Rindhagen

Author Biography

Cecilia Rindhagen is a PhD Candidate in Sport Science in the Department of Sport Science at Linnaeus University, Sweden. Her research focuses on men and masculinity and is interested in how physical activity can be understood during different times of life.

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Precarious Bodies and Masculinities: The Experience of Exercise During Hormonal Treatment for Prostate Cancer

Abstract

Keywords

Introduction

Background and Survey of the Field

Theoretical Framework

Method

Findings

Transforming Bodies and Experiences of Loss due to ADT Treatment Side-effects

From Precarious Bodies to Embodied Remedy

The Fellowship of the Prostate

Conclusion and Discussion

Footnotes

Declaration of Conflicting Interests

Funding

ORCID iD

Author Biography

References