Gendered and Cultured Relations: Exploring African Nova Scotians' Perceptions and Experiences of Breast and Prostate Cancer

Although breast and prostate cancer are those most frequently diagnosed in Canada, information about the ways in which gender, class, race, culture, and other social determinants impact the experience of African Canadians living with cancer is lacking. This study began to address this gap by exploring cultured and gendered dimensions of African Nova Scotians' experiences of these two cancers. Using a participatory action research approach, data were collected in two phases of focus group discussions in five African Nova Scotian communities from a total of 57 people, including those with breast or prostate cancer and their families and associates. Findings provide insight into how gender and meanings of masculinity and femininity in the African Nova Scotian community unavoidably interact with other social structures such as race and class to affect women and men's perceptions and experiences of these two cancers. These insights point to the need for culturally appropriate and meaningful health interventions. As a prerequisite, health care professionals need to have an understanding of the overlapping and contextualized nature of gender, class, and race and be willing and able to work in partnership with African Nova Scotian communities to identify and develop strategies that reflect the realities of peoples' lives. Keywords: health; race; gender; class Breast and prostate cancer continue to be two of the most common forms of cancer in North America. In Canada, breast cancer and prostate cancer are the most frequently diagnosed cancers in women and men (National Cancer Institute of Canada, Canadian Cancer Statistics 2004). One in nine women is expected to develop breast cancer in her lifetime and one in eight men is expected to develop prostate cancer (National Cancer Institute of Canada, Canadian Cancer Statistics, 2004). Statistics indicate that in the United States these cancers are the second leading cause of death among women and men (Wingo et al., 1996). Despite the high incidence of breast and prostate cancer in the United States, Long (1993) reports that African Americans are grossly underrepresented in cancer data. This is also the case in Canada where no statistics regarding the incidence and mortality rates of African Canadians diagnosed with breast or prostate cancer are available. In the absence of such information, statistics regarding cancer in the African American population may provide some indication of the health issues faced by African Canadians. Studies to date indicate that African American women with a diagnosis of breast cancer have significantly higher mortality rates than Caucasian women (Rahman, Mohamed, & Dignan, 2003; Wilson, Baker, Brown-Syed, & Gollop, 2000), and the highest mortality rate among 11 different ethnic groups of women (Barroso et al., 2000). African American men have a 32% higher incidence of prostate cancer than White men (Weinrich et al., 1998) and the highest incidence of prostate cancer in the world (Robinson, Kimmel, & Yasko, 1995). The impact of cancer and its treatment remains elusive from a cultural perspective. Because ethnicity is not a cancer specific variable, the cancer experience of African Canadians tends to be either extrapolated from White findings or ignored. While significant advances are being made to study culture, translating results into interventions that demonstrate real cultural sensitivity lags. The high incidence and mortality rates for breast and prostate cancer among people of African decent in North America suggest that much more research which is attentive to the dimensions of gender and culture is needed. The purpose of this study was to explore the cultured and gendered dimensions of African Nova Scotian men and women's experiences of breast and prostate cancer. The research responded to a growing acknowledgment by the National Cancer Institute of Canada (NCIC) of the importance of multiple determinants of health. …