Effect of sex and gender on psychosocial aspects of prostate and breast cancer

doi:10.1136/bmj.323.7320.1055

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Alexander Kiss, psycho-oncologist (akiss@uhbs.ch)a,
Siegfried Meryn, general internistb

^a Psychosomatic Division, Department of Internal Medicine, University Clinics Basel, Petersgraben 4, CH-4031 Basel, Switzerland
^b Centre for Advanced Medical Education and Health Communication, Medical Faculty of the University of Vienna, Borschkegasse 8B, A-1097 Vienna, Austria

Correspondence to: A Kiss

Being male or female is an important basic human variable that affects health and illness throughout life.1 Men and women differ not only with regard to their reproductive organs and bodies but also in the way they think, feel, and behave. The physical difference is called sex, influenced by genes and biology; the psychological difference is called gender, in which environmental, cultural, and psychosocial factors also have a prominent role. Researchers are just beginning to unravel the complex interactions between sex and gender, and the roles of nature and nuture are still unclear.

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Table 1

Biology and epidemiology

In the case of cancer it is obvious that only men can get prostate cancer and breast cancer occurs predominantly in women. How gender matters is not so obvious. In this article we describe the effect of gender on psychosocial differences in men and women with prostate and breast cancer, respectively.

Summary points

Sex and gender based differences have a profound effect on health and disease

The biology and epidemiology of prostate and breast cancer share many similarities

Differences in psychosocial aspects of prostate and breast cancer are mainly based on gender issues

Gender differences are evident not only in the physical impact but also on sex, quality of life, psychosocial differences, coping, and patients' partners

Differences in doctors' attitude and behaviour in the care of men with prostate cancer and women with breast cancer seem to be based on gender

Methods

We reviewed the recent literature concerning psychosocial aspects of prostate and breast cancer. We also incorporated our experiences as a psycho-oncologist and a general internist practising in sex and gender medicine as well as discussions and scientific exchange with colleagues and nurses in these specialties. There are several limitations—for example, both authors are male, which means there is a gender bias; we may be …