THE GENDER FACTOR IN CANCER

By LIM WEY WEN

starhealth@thestar.com.my

Understanding the different ways cancer can affect men and women may improve their care.
WHEN cancer looms, do men and women react to it differently? Are the issues they deal with similar, or unique? Does gender really matter when it comes to cancer?
The answers may seem obvious. After all, we are talking about two groups of people who are – to a great extent – unique in biological make-up, thinking pattern, and the way they are socialised to adopt gender-specific behaviour.
The reality is that these differences can be reduced or increased when it comes to the type of cancer, treatment options, and the side effects involved.

“There are some similarities in men’s and women’s issues in cancer, in terms of their reactions to chemotherapy, for example,” said Dr Joanna Lin, a Singapore-based visiting oncologist at the Beacon International Specialist Centre in Kuala Lumpur.
“The main difference probably lies in women’s concerns regarding their physical appearances, eg. hair loss, which is a huge issue with women, especially those younger than 60,” she replied in an email interview.
“Removing a woman’s breast for cancer therapy is also a very obvious physical insult that many women are very concerned about. These physical changes can cause significant psychological and emotional trauma.
“Men are often not too concerned with regards to hair loss, but they are less likely to talk about their issues during treatment,” she elaborated.

Dr Ibrahim ... Communicating treatment alternatives is important, because some patients who are reluctant to undergo a particular treatment may not come back for follow-ups.

She was speaking in general terms. Certainly, all of us have known a woman who is not concerned about her appearance, and a man whose knowledge of skin care products exceeds that of his female peers. But understanding the motivations and priorities of both genders can be an important factor in the way doctors, nurses and caretakers provide treatment and care for people living with cancer.
Much like how a good personal trainer will tailor training programmes according to a client’s motivations, a caregiver who understands the different issues men and women face when they are diagnosed with cancer will be able to effectively work with them to achieve therapeutic goals.
“In most situations however, the patients often do not tell their treating doctor what their real worries and concerns are,” said Dr Lin. “Often, it is because the doctor is too busy and rushed, or is perceived to be too busy by the patient; or the patient does not feel comfortable troubling the doctor with these worries.”
It depends on the site
In an article, Psychology of cancer, published in a US quarterly magazine for cancer patients, writer Leslie Johnston wrote, “How people adjust emotionally to that reality depends on a number of factors, including type of cancer, stage of the cancer, the patient’s age, marital status, ethnicity, culture, profession and – perhaps the most important of all – gender.”
However, Johnston continued, “where the cancer strikes makes a difference”. He then quoted Les Daroff, the director of psychoneuroimmunology and mind-body medicine at the Cancer Treatment Centers of America, to explain.
“If it is stomach cancer, it is perceived as an attack on their stomach, not on their identity,” said Daroff. “However, if it is breast cancer, uterine cancer, prostate cancer or testicular cancer, it attacks their whole psychosocial identity, their way of life and their relationships. Everything they have known is up for grabs.”
Men and women have different risks of developing cancer at different sites. According to the latest Health Ministry national cancer statistics (2006), the top five most common cancers among men are cancers of the colon and rectum, lung, nasopharynx (nose and airways), prostate and liver.
Women, however, suffer most commonly from ca