The health and well-being of prostate cancer patients and male-to-female transsexuals on androgen deprivation therapy: A qualitative study with comments on expectations and estrogen

Abstract

Both male-to-female transsexuals and advanced prostate cancer (PCa) patients are treated with androgen-suppressing drugs that have emasculating effects. Additionally, transsexuals take estrogenic compounds to feminize their bodies. We explore the quality of life of these populations, based on interviews with 12 individuals from each group. Overall, the transsexuals had a better psychological response to chemical castration than the PCa patients. The transsexuals showed more enthusiasm about the changes in their life; they viewed their lives as beginning anew, accepted their reduced libido, and were more comfortable with their increased emotionality. Different responses in the two groups are not surprising given that they undergo androgen deprivation under very different medical contexts. However, the fact that the transwomen are able to conceptualize the effects as positive suggests that some androgen-deprived PCa patients may benefit from reconceptualizing their changes within a positive framework. Additionally, difference in the two populations may be attributed, in part, to the fact that the transsexuals take supplemental estrogen. Circumstantial evidence suggests that estrogen in androgen-deprived males may improve sleep quality, help retain sexual interest, and protect cognitive function. This suggests that PCa patients may benefit from using estradiol for androgen suppression.

Keywords:

• quality of life
• health and illness experience
• sexual performance

Acknowledgements

This research was supported through a grant from the Institute of Gender and Health of the Canadian Institutes for Health Research (CIHR). CIHR was not involved in the study design or the collection, analysis or interpretation of data. Christina Sinding was involved in this project from its inception, and helped extensively with data analysis and interpretation. J. Mary Burnet, Mitchell Cushman, Imhokhai Ogah, and Geoffry Smith helped greatly with manuscript production. They along with Gary Dowsett, JoAnne Phillips and Marian Pitts provided critical comments on draft manuscripts.