Cancer-related masculine threat, emotional approach coping, and physical functioning following treatment for prostate cancer.

OBJECTIVE Aspects of masculinity and gender role, particularly those that are traditional and restrictive, are related to poorer physical and psychological outcomes in men with cancer. This longitudinal study uses a cancer-specific assessment to determine whether cancer-related masculine threat (CMT) predicts prostate-related (i.e., urinary, bowel, sexual) functioning over time, and whether cancer-related emotional approach coping (EAC) processes explain these relationships. Whether coping self-efficacy and emotional suppression explain effects of CMT on EAC also is tested. METHODS Sixty-six men (M age = 65.76; SD = 9.04) who underwent radical prostatectomy and/or radiation therapy for localized prostate cancer within two years were assessed on physical and psychological variables at study entry (T1), and two (T2) and four (T3) months later. RESULTS Analyses controlling for baseline functioning and age revealed that CMT predicted declines in (T1 to T3) urinary (B = -.21, p < .05), bowel (B = -.24, p < .05), and sexual (B = -.17, p < .05) function. CMT also predicted decreased emotional processing (T1 to T2), but not emotional expression. Decreased emotional processing predicted declining prostate-related functioning and helps explain the effect of CMT on bowel and sexual (but not urinary) functioning. Low coping self-efficacy (p < .05), but not emotional suppression, was a mechanism by which CMT predicted emotional processing. CONCLUSIONS The extent to which men believe that cancer is inconsistent with their masculinity exacerbates declines in prostate-related functioning following cancer treatment. CMT likely shapes coping responses and negatively affects the efficacy of emotion-directed coping. Emotion-regulating coping processes, particularly the ability to process cancer-related emotions, appears to be one pathway through which gender role affects recovery from prostate cancer.