In Chicago, a New Approach to Gay and Bisexual Men With Prostate Cancer - The New York Times

CHICAGO — Matthew Curtin learned he had prostate cancer after a routine physical examination in October 2019, when test results indicated there was a problem.

Post-treatment symptoms are similar for all prostate cancer patients, including urinary incontinence, erectile dysfunction, diminished libido and loss of ejaculate.

Curtin said he was about three months into treatment when he was struck that “there is a lot going on here — the emotional and psychological effect — that is not being treated.”.

Amarasekera, who has focused his career on urologic care for gay and bisexual men and other sexual minorities, is the program’s first leader.

It is an emerging field of study driven in part by the increasing number of prostate cancer patients who identify as gay or bisexual.

The gay and bisexual men in their 50s and 60s who are now entering the prime demographic for prostate cancer also lived through the worst of the AIDS epidemic.

The problem, experts in the field say, is that the research about gay and bisexual men and prostate cancer is still woefully inadequate.

“Historically, most of the research on gay health was focused on H.I.V., and in young gay men, because that was the biggest killer,” said Simon Rosser, a professor of epidemiology and community health at the University of Minnesota, who led a study in 2017 of gay and bisexual men with prostate cancer.

“It’s only now that as the AIDS generation grew older, and aged into health problems like prostate cancer, that specialists are starting to see gay patients.

Rosser said.

Amarasekera studied urologists’ training and found that many reported receiving less than five hours of instruction on the treatment of gay and bisexual patients.

He also surveyed gay patients, who overall said their sexual satisfaction was not adequately taken under consideration during treatment for prostate cancer.

“It’s important to collect data on how treatment affects sexual function differently for gay and bisexual men, who have different sexual repertoires than straight men,” he said.

One of them is a 59-year-old lawyer in Chicago who is H.I.V.-positive, and who said he was not fully warned about how the removal of his prostate would affect his body.

The health care system, he said, “marginalizes gay men, particularly when it comes to sexual health, and the prostate is so linked to sexual health in gay men.

“A previous urologist simply said, ‘Go forward and enjoy your life, and bye,’” the lawyer said.

Gary Dowsett, emeritus professor at the Australian Research Centre in Sex, Health and Society at La Trobe University in Melbourne, Australia, said such treatment, while not meant to be callous, is not uncommon.

“If they do not understand the role of the prostate in sexual pleasure, it’s rarely a priority discussion,” said Dr.

Dowsett, a prostate cancer survivor himself, said of urologists.

Gene Otto, who is the co-host of a support group in Palm Springs, Calif., for gay and bisexual men with prostate cancer, sees a growing need as well

One gay patient in his group, he said, was given literature geared toward women whose husbands had prostate cancer

“After treatment, many men with prostate cancer focus on the warmth in their relationships rather than the heat,” he said