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Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
JournalJournal of cancer survivorship : research and practice
Early online date8 May 2021
Accepted/In press13 Feb 2021
E-pub ahead of print8 May 2021

Bibliographical note

Funding Information: OB, PD, and KA acknowledge research support from the Medical Research Council (MRC) Centre for Transplantation and funding from the King’s Medical Research Trust. PD further acknowledges funding from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), The King’s College London (KCL)-Vattikuti Institute of Robotic Surgery, and the GSTT Charity. KA also acknowledges funding from the Royal College of Surgeons of England, The Urology Foundation, Coptcoat Charity, and the Pelican Foundation. RS is part-funded by (i) the NIHR BRC at the South London and Maudsley NHS Foundation Trust and KCL; (ii) a MRC Mental Health Data Pathfinder Award to KCL; (iii) an NIHR Senior Investigator Award; and (iv) the NIHR Applied Research Collaboration South London at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.


King's Authors


Purpose: Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. Methods: A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men’s experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. Results: Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: ‘Becoming a Prostate Cancer Patient’ and ‘Becoming a Prostate Cancer Survivor’. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. Conclusions: Prostate cancer has an important effect on men’s health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men’s coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. Implications for Cancer Survivors: This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.

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