Supportive Care in Cancer

, Volume 26, Issue 10, pp 3379–3388 | Cite as

Perceptions of masculinity and body image in men with prostate cancer: the role of exercise

  • David Michael Langelier
  • Prue Cormie
  • William Bridel
  • Christopher Grant
  • Natalia Albinati
  • Jena Shank
  • Julia Teresa Daun
  • Tak S. Fung
  • Colin Davey
  • S. Nicole Culos-ReedEmail author
Original Article



The goal of this study was to explore the association between levels of exercise and patterns of masculinity, body image, and quality of life in men undergoing diverse treatment protocols for prostate cancer.


Fifty men with prostate cancer (aged 42–86) completed self-report measures. Self-reported measures included the following: the Godin Leisure Time Exercise Questionnaire (GLTEQ), Masculine Self-esteem Scale (MSES), Personal Attributes Questionnaire (PAQ), Body Image Scale (BIS), and the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Masculinity, body image, and quality of life scores were compared between men obtaining recommended levels of exercise (aerobic or resistance) and those not obtaining recommended level of exercise. Secondary outcomes included the association between masculinity, body image, and quality of life scores as they relate to exercise levels.


There were significantly higher scores of masculinity (p < 0.01), physical well-being (p < 0.05), prostate cancer specific well-being (p < 0.05), and overall quality of life (p < 0.05) in those obtaining at least 150 min of moderate to vigorous aerobic exercise. In the 48% of men who had never received androgen deprivation therapy, significantly higher levels of masculinity, body image, and quality of life were observed in those meeting aerobic guidelines.


Whether treatment includes androgen deprivation or not, men who participate in higher levels of aerobic exercises report higher levels of masculinity, improved body image, and quality of life than those who are inactive. Future longitudinal research is required evaluating exercise level and its effect on masculinity and body image.


Body image Masculinity Movement Prostatic neoplasms Oncology Self-concept 


Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of The University of Calgary Health Research Ethics Board of Alberta (HREBA)–Cancer Committee (HREBA.CC-16-0625_REN1), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Burns SM, Mahalik JR (2007) Understanding how masculine gender scripts may contribute to men's adjustment following treatment for prostate cancer. Am J Mens Health 1(4):250–261. CrossRefPubMedGoogle Scholar
  2. 2.
    Gardner JR, Livingston PM, Fraser SF (2014) Effects of exercise on treatment-related adverse effects for patients with prostate cancer receiving androgen-deprivation therapy: a systematic review. J Clin Oncol 32(4):335–346. CrossRefPubMedGoogle Scholar
  3. 3.
    Statistics Canada (2017) Population and demography. Government of Canada. Retrieved 20 September 2017 from
  4. 4.
    Moyad MA (2005) Promoting general health during androgen deprivation therapy (ADT): a rapid 10-step review for your patients. Urol Oncol 23(1):56–64. CrossRefPubMedGoogle Scholar
  5. 5.
    Carter N, Bryant-Lukosius D, DiCenso A, Blythe J, Neville AJ (2011) The supportive care needs of men with advanced prostate cancer. Oncol Nurs Forum 38(2):189–198. CrossRefPubMedGoogle Scholar
  6. 6.
    MacDonald R, Fink HA, Huckabay C, Monga M, Wilt TJ (2007) Pelvic floor muscle training to improve urinary incontinence after radical prostatectomy: a systematic review of effectiveness. BJU Int 100(1):76–81. CrossRefPubMedGoogle Scholar
  7. 7.
    McGinty HL, Phillips KM, Jim HS, Cessna JM, Asvat Y, Cases MG, Small BJ, Jacobsen PB (2014) Cognitive functioning in men receiving androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis. Support Care Cancer 22(8):2271–2280. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Baumann FT, Zopf EM, Bloch W (2012) Clinical exercise interventions in prostate cancer patients--a systematic review of randomized controlled trials. Support Care Cancer 20(2):221–233. CrossRefPubMedGoogle Scholar
  9. 9.
    Cushman MA, Phillips JL, Wassersug RJ (2010) The language of emasculation: implications for Cancer patients. Int J Men’s Health 9(1):3–25. CrossRefGoogle Scholar
  10. 10.
    Cecil R, McCaughan E, Parahoo K (2010) It's hard to take because I am a man's man': an ethnographic exploration of cancer and masculinity. Eur J Cancer Care (Engl) 19(4):501–509. CrossRefGoogle Scholar
  11. 11.
    Fergus KD, Gray RE, Fitch MI (2002) Sexual dysfunction and the preservation of manhood: experiences of men with prostate cancer. J Health Psychol 7(3):303–316. CrossRefPubMedGoogle Scholar
  12. 12.
    Cormie P, Chambers SK, Newton RU, Gardiner RA, Spry N, Taaffe DR, Joseph D, Hamid MA, Chong P, Hughes D, Hamilton K, Galvao DA (2014) Improving sexual health in men with prostate cancer: randomised controlled trial of exercise and psychosexual therapies. BMC Cancer 14(199):1–9. CrossRefGoogle Scholar
  13. 13.
    Cormie P, Newton RU, Taaffe DR, Spry N, Galvao DA (2013) Exercise therapy for sexual dysfunction after prostate cancer. Nat Rev Urol 10(12):731–736. CrossRefPubMedGoogle Scholar
  14. 14.
    Cormie P, Oliffe JL, Wootten AC, Galvao DA, Newton RU, Chambers SK (2016) Improving psychosocial health in men with prostate cancer through an intervention that reinforces masculine values - exercise. Psychooncology 25(2):232–235. CrossRefPubMedGoogle Scholar
  15. 15.
    Culos-Reed SN, Robinson JW, Lau H, Stephenson L, Keats M, Norris S, Kline G, Faris P (2010) Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention. Support Care Cancer 18(5):591–599. CrossRefPubMedGoogle Scholar
  16. 16.
    Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU (2010) Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 28(2):340–347. CrossRefPubMedGoogle Scholar
  17. 17.
    Keogh JW, MacLeod RD (2012) Body composition, physical fitness, functional performance, quality of life, and fatigue benefits of exercise for prostate cancer patients: a systematic review. J Pain Symptom Manag 43(1):96–110. CrossRefGoogle Scholar
  18. 18.
    Cormie P, Galvao DA, Spry N, Joseph D, Chee R, Taaffe DR, Chambers SK, Newton RU (2015) Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int 115(2):256–266. CrossRefPubMedGoogle Scholar
  19. 19.
    Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Akhlil Hamid M, Galvao DA (2013) Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis 16(2):170–175. CrossRefPubMedGoogle Scholar
  20. 20.
    Galvao DA, Taaffe DR, Spry N, Newton RU (2007) Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis 10(4):340–346CrossRefPubMedGoogle Scholar
  21. 21.
    Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME (2009) Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 27(3):344–351. CrossRefPubMedGoogle Scholar
  22. 22.
    Cash TF, Jakatdar TA, Williams EF (2004) The body image quality of life inventory: further validation with college men and women. Body Image 1(3):279–287. CrossRefPubMedGoogle Scholar
  23. 23.
    Levy A, Cartwright T (2015) Men's strategies for preserving emotional well-being in advanced prostate cancer: an interpretative phenomenological analysis. Psychol Health 30(10):1164–1182. CrossRefPubMedGoogle Scholar
  24. 24.
    Burns SM, Mahalik JR (2008) Treatment type and emotional control as predictors of Men’s self-assessed physical well-being following treatment for prostate Cancer. Psychol Men Masculinity 9(2):55–66. CrossRefGoogle Scholar
  25. 25.
    Chapple A, Ziebland S (2002) Prostate cancer: embodied experience and perceptions of masculinity. Sociol Health Illn 24(6):820–841. CrossRefGoogle Scholar
  26. 26.
    Gray RE, Fitch MI, Fergus KD, Mykhalovskiy E, Church K (2002) Hegemonic masculinity and the experience of prostate Cancer: a narrative approach. J Aging Identity 7(1):43–62. CrossRefGoogle Scholar
  27. 27.
    Oliffe J (2005) Constructions of masculinity following prostatectomy-induced impotence. Soc Sci Med 60(10):2249–2259. CrossRefPubMedGoogle Scholar
  28. 28.
    Oliffe J (2006) Embodied masculinity and androgen deprivation therapy. Sociol Health Illn 28(4):410–432. CrossRefPubMedGoogle Scholar
  29. 29.
    Wall D, Kristjanson L (2005) Men, culture and hegemonic masculinity: understanding the experience of prostate cancer. Nurs Inq 12(2):87–97CrossRefPubMedGoogle Scholar
  30. 30.
    Bruun DM, Krustrup P, Hornstrup T, Uth J, Brasso K, Rorth M, Christensen JF, Midtgaard J (2014) "all boys and men can play football": a qualitative investigation of recreational football in prostate cancer patients. Scand J Med Sci Sports 24(Suppl 1):113–121. CrossRefPubMedGoogle Scholar
  31. 31.
    Cormie P, Turner B, Kaczmarek E, Drake D, Chambers SK (2015) A qualitative exploration of the experience of men with prostate cancer involved in supervised exercise programs. Oncol Nurs Forum 42(1):24–32. CrossRefPubMedGoogle Scholar
  32. 32.
    Hamilton K, Chambers SK, Legg M, Oliffe JL, Cormie P (2015) Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer. Support Care Cancer 23(1):133–142. CrossRefPubMedGoogle Scholar
  33. 33.
    Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146PubMedGoogle Scholar
  34. 34.
    Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426. CrossRefPubMedGoogle Scholar
  35. 35.
    Clark JA, Bokhour BG, Inui TS, Silliman RA, Talcott JA (2003) Measuring patients' perceptions of the outcomes of treatment for early prostate cancer. Med Care 41(8):923–936CrossRefPubMedGoogle Scholar
  36. 36.
    Helmreich RL, Spence JT, Wilhelm JA (1981) A psychometric analysis of the personal attributes questionnaire. Sex Roles 7(11):1097–1108. CrossRefGoogle Scholar
  37. 37.
    Hopwood P, Fletcher I, Lee A, Al Ghazal S (2001) A body image scale for use with cancer patients. Eur J Cancer 37(2):189–197CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J, Eckberg K, Lloyd S, Purl S, Blendowski C, Goodman M, Barnicle M, Stewart I, McHale M, Bonomi P, Kaplan E, Taylor S, Thomas C, Harris J (1993) The functional assessment of Cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579. CrossRefPubMedGoogle Scholar
  39. 39.
    Cella D, Nichol MB, Eton D, Nelson JB, Mulani P (2009) Estimating clinically meaningful changes for the functional assessment of Cancer therapy--prostate: results from a clinical trial of patients with metastatic hormone-refractory prostate cancer. Value Health 12(1):124–129. CrossRefPubMedGoogle Scholar
  40. 40.
    Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ (1997) Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument. Urology 50(6):920–928. CrossRefPubMedGoogle Scholar
  41. 41.
    Gannon K, Guerro-Blanco M, Patel A, Abel P (2010) Re-constructing masculinity following radical prostatectomy for prostate cancer. Aging Male 13(4):258–264. CrossRefPubMedGoogle Scholar
  42. 42.
    Keilani M, Hasenoehrl T, Baumann L, Ristl R, Schwarz M, Marhold M, Sedghi Komandj T, Crevenna R (2017) Effects of resistance exercise in prostate cancer patients: a meta-analysis. Support Care Cancer 25(9):2953–2968. CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Keogh JW, Patel A, MacLeod RD, Masters J (2013) Perceptions of physically active men with prostate cancer on the role of physical activity in maintaining their quality of life: possible influence of androgen deprivation therapy. Psychooncology 22(12):2869–2875. CrossRefPubMedGoogle Scholar
  44. 44.
    Harrington JM, Jones EG, Badger T (2009) Body image perceptions in men with prostate cancer. Oncol Nurs Forum 36(2):167–172. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • David Michael Langelier
    • 1
    • 2
  • Prue Cormie
    • 3
  • William Bridel
    • 2
  • Christopher Grant
    • 1
    • 4
  • Natalia Albinati
    • 2
  • Jena Shank
    • 2
  • Julia Teresa Daun
    • 2
  • Tak S. Fung
    • 5
  • Colin Davey
    • 2
  • S. Nicole Culos-Reed
    • 2
    Email author
  1. 1.Department of Clinical Neurosciences, Division of Physical Medicine and RehabilitationUniversity of CalgaryCalgaryCanada
  2. 2.Faculty of KinesiologyUniversity of CalgaryCalgaryCanada
  3. 3.Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneAustralia
  4. 4.O’Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada
  5. 5.Information TechnologiesUniversity of CalgaryCalgaryCanada

Personalised recommendations