Restricted accessResearch articleFirst published online 2024-8
Body image in patients with prostate cancer undergoing treatment with hormone therapy: Observational study using both a cross-sectional and longitudinal design
This study aims to examine changes in body image (BI) over time and factors related to BI among patients with prostate cancer who receive hormone therapy (HT). A cross-sectional design and longitudinal design were utilized. Patients with prostate cancer who received HT were recruited from the urology outpatient departments in two hospitals in Taiwan between August 2017 and December 2020. Cross-sectional data were collected from 177 patients who had started HT for prostate cancer. Longitudinal data were collected from 34 newly diagnosed patients before receiving HT and at 1, 3, 6, and 12 months after HT. The variables measured included hormonal symptoms and distress, self-efficacy, and BI. The results showed that BI dissatisfaction ranged from 6.1% to 17.2%. Hormonal symptoms and distress (e.g. lack of vitality) were correlated with BI dissatisfaction. Education on the side effects of HT and coping strategies can be provided to patients to prevent BI dissatisfaction.
ArıkanFKörükçüÖKüçükçakalA, et al. (2020) Determination of self-efficacy, body image and sexual adjustment of women with breast cancer. European Journal of Breast Health16(4): 282–289.
2.
BanduraA (1977) Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review84(2): 191–215.
3.
BowieJBrunckhorstOStewartR, et al. (2020) A systematic review of tools used to assess body image, masculinity and self-esteem in men with prostate cancer. Psycho-Oncology29(11): 1761–1771.
4.
BowieJBrunckhorstOStewartR, et al. (2022) Body image, self-esteem, and sense of masculinity in patients with prostate cancer: A qualitative meta-synthesis. Journal of Cancer Survivorship16: 95–110.
5.
CashTF (2008) The Body Image Workbook: An Eight-Step Program for Learning to Like Your Looks, 2nd edn.Oakland, CA: New Harbinger.
6.
CecilRMc CaughanEParahooK (2010) “It’s hard to take because I am a man’s man”: An ethnographic exploration of cancer and masculinity. European Journal of Cancer Care19(4): 501–509.
7.
ChangYLHuangBSHungTM, et al. (2019) Factors influencing body image in posttreatment oral cavity cancer patients. Psycho-Oncology28(5): 1127–1133.
8.
ChenCLLiaoMNChenSC, et al. (2012) Body image and its predictors in breast cancer patients receiving surgery. Cancer Nursing35(5): E10–E16.
9.
ChenSCHuangBSLinCY, et al. (2017) Psychosocial effects of a skin camouflage program in female survivors with head and neck cancer: A randomized controlled trial. Psycho-Oncology26(9): 1376–1383.
10.
CheungSKSunSY (1999) Assessment of optimistic self-beliefs: Further validation of the Chinese version of the General Self-Efficacy Scale. Psychological Reports85(3 Pt 2): 1221–1224.
11.
ChienCHChuangCKLiuKL, et al. (2018) Effects of individual and partner factors on anxiety and depression in Taiwanese prostate cancer patients: A longitudinal study. European Journal of Cancer Care27(2): e12753.
12.
ChienCHHuangXY (2022) Self-care experiences of advanced prostate cancer survivors who underwent androgen deprivation therapy. Cancer Nursing45(3): 190–200.
13.
ChopraDDe La GarzaRLacourtTE (2021) Clinical relevance of a Body Image Scale cut point of 10 as an indicator of psychological distress in cancer patients: Results from a psychiatric oncology clinic. Supportive Care in Cancer29(1): 231–237.
14.
CohenJ (1988) Statistical Power Analysis for the Behavioral Sciences, 2nd edn.Hillsdale, NJ: Lawrence Erlbaum.
15.
CornfordPvan den BerghRCNBriersE, et al. (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II-2020 update: Treatment of relapsing and metastatic prostate cancer. European Urology79(2): 263–282.
16.
DarnyshireP (1986) Body image. When the face doesn’t fit. Nursing Times82(39): 28–30.
17.
DeFrankJTMehtaCCSteinKD, et al. (2007) Body image dissatisfaction in cancer survivors. Oncology Nursing Forum34(3): E36–E41.
18.
DesaiKMcManusJMSharifiN (2021) Hormonal therapy for prostate cancer. Endocrine Reviews42(3): 354–373.
19.
EdwardsL (1994) Chinese masculinity: Theorizing Wen and Wu. East Asian History8: 135–148.
20.
FaulFErdfelderELangAG, et al. (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods39(2): 175–191.
21.
FosterCFenlonD (2011) Recovery and self-management support following primary cancer treatment. British Journal of Cancer105Suppl 1: S21–S28.
22.
GentiliCMcCleanSHackshaw-McGeaghL, et al. (2019) Body image issues and attitudes towards exercise amongst men undergoing androgen deprivation therapy (ADT) following diagnosis of prostate cancer. Psycho-Oncology28(8): 1647–1653.
23.
GentiliCMcCleanSMcGeaghL, et al. (2022) The impact of hegemonic masculine ideals on self-esteem in prostate cancer patients undergoing androgen deprivation therapy (ADT) compared to ADT-naïve patients. Psycho-Oncology31(11): 1958–1971.
24.
GroganS (2007) Body Image: Understanding Body Dissatisfaction in Men, Women and Children. New York, NY: Taylor & Francis Group.
25.
HamiltonKChambersSKLeggM, et al. (2015) Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer. Supportive Care in Cancer23(1): 133–142.
26.
HarringtonJM (2011) Implications of treatment on body image and quality of life. Seminars in Oncology Nursing27(4): 290–299.
27.
HarringtonJMBadgerTA (2009) Body image and quality of life in men with prostate cancer. Cancer Nursing32(2): E1–E7.
28.
HarringtonJMJonesEGBadgerT (2009) Body image perceptions in men with prostate cancer. Oncology Nursing Forum36(2): 167–172.
29.
Health Promotion Administration, Ministry of Health and Welfare, Taiwan (2022) Cancer registry annual report, 2020. Available at: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=119 (accessed 1 January 2024).
30.
HopwoodPFletcherILeeA, et al. (2001) A body image scale for use with cancer patients. European Journal of Cancer37(2): 189–197.
31.
HorschkeSSteinmannDChristiansenH, et al. (2020) Body image in men with prostate or laryngeal cancer and their female partners. Zeitschrift für Psychosomatische Medizin Und Psychotherapie66(3): 287–301.
32.
KlaesonKSandellKBerteroCM (2013) Talking about sexuality: Desire, virility, and intimacy in the context of prostate cancer associations. American Journal of Men’s Health7(1): 42–53.
33.
LangelierDMCormiePBridelW, et al. (2018) Perceptions of masculinity and body image in men with prostate cancer: The role of exercise. Supportive Care in Cancer26(10): 3379–3388.
34.
LangelierDMD’SilvaAShankJ, et al. (2019) Exercise interventions and their effect on masculinity, body image, and personal identity in prostate cancer—A systematic qualitative review. Psycho-Oncology28(6): 1184–1196.
35.
LittleRJA (1988) A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association83(404): 1198–1202.
36.
MainwaringJMWalkerLMRobinsonJW, et al. (2021) The psychosocial consequences of prostate cancer treatments on body image, sexuality, and relationships. Frontiers in Psychology12: 765315.
37.
National Institutes of Health (2000) The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Bethesda, MA: NIH Publication.
38.
RhondaliWChisholmGBFilbetM, et al. (2015) Screening for body image dissatisfaction in patients with advanced cancer: A pilot study. Journal of Palliative Medicine18(2): 151–156.
39.
RhotenBA (2016) Body image disturbance in adults treated for cancer—A concept analysis. Journal of Advanced Nursing72(5): 1001–1011.
40.
SainiABerrutiACraccoC, et al. (2013) Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy. Urologic Oncology31(3): 352–358.
41.
SalifuYAlmackKCaswellG (2023) “Out of the frying pan into the fire”: A qualitative study of the impact on masculinity for men living with advanced prostate cancer. Palliative Care and Social Practice17: 26323524231176829.
42.
ScandurraCMuziiBLa RoccaR, et al. (2022) Social support mediates the relationship between body image distress and depressive symptoms in prostate cancer patients. International Journal of Environmental Research and Public Health19(8): 4825.
43.
SchwarzerRJerusalemM (1995) General Self-Efficacy Scale (GSE). Washington, DC: APA PsycTests.
44.
SebriVDurosiniITribertiS, et al. (2021) The efficacy of psychological intervention on body image in breast cancer patients and survivors: A systematic review and meta-analysis. Frontiers in Psychology12: 611954.
45.
ShihFJ (1996) Concepts related to Chinese patients’ perceptions of health, illness and person: Issues of conceptual clarity. Accident and Emergency Nursing4(4): 208–215.
46.
SungHFerlayJSiegelRL, et al. (2021) Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians71(3): 209–249.
47.
Taylor-FordMMeyerowitzBED’OrazioLM, et al. (2013) Body image predicts quality of life in men with prostate cancer. Psycho-Oncology22(4): 756–761.
48.
ThieserSDörflerJRudolphI, et al. (2021) Influence of ballroom dancing on fatigue, body image, self-efficacy, and endurance of cancer patients and their partners. Medical Oncology38(2): 15.
49.
TorbitLAAlbianiJJCrangleCJ, et al. (2015) Fear of recurrence: The importance of self-efficacy and satisfaction with care in gay men with prostate cancer. Psycho-Oncology24(6): 691–698.
50.
van den DriesscheHMattelaerPvan OyenP, et al. (2016) Changes in body image in patients with prostate cancer over 2 years of treatment with a gonadotropin-releasing hormone analogue (triptorelin): Results from a Belgian non-interventional study. Drugs-Real World Outcomes3(2): 183–190.
51.
van DongenSIde NooijerKCrammJM, et al. (2020) Self-management of patients with advanced cancer: A systematic review of experiences and attitudes. Palliative Medicine34(2): 160–178.
52.
VyasNBrunckhorstOFanshaweJ, et al. (2023) Prognostic factors for mental wellbeing in prostate cancer: A systematic review and meta-analysis. Psycho-Oncology32(11): 1644–1659.
53.
WangCC (2003) Symptom Distress, Body Image and Quality of Life in Breast Cancer Patient Receiving Surgery. Taipei City: Taiwan Medical University.
54.
WeiJTDunnRLLitwinMS, et al. (2000) Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology56(6): 899–905.
55.
WibowoEWassersugRJRobinsonJW, et al. (2020) An educational program to help patients manage androgen deprivation therapy side effects: Feasibility, acceptability, and preliminary outcomes. American Journal of Men’s Health14(1): 1557988319898991.
56.
WrightSP (1992) Adjusted p-values for simultaneous inference. Biometrics48(4): 1005–1013.
57.
ZhangJXSchwarzerR (1995) Measuring optimistic self-beliefs: A Chinese adaptation of the General Self-Efficacy Scale. Psychologia38(3): 174–181.
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