Patients with incurable cancer have a clear preference for oral CT, but are generally not willing to sacrifice efficacy for their preference. Almost 40% of patients did not want to make final treatment decisions themselves.

The Supportive Care Framework for Cancer Care was originally formulated in 1994 (Fitch, 1994). The framework was designed as a tool for cancer care professionals and program managers to conceptualize what type of help cancer patients might require and how planning for service delivery might be approached. The framework has been presented in various arenas and the number of requests has been growing for a wider distribution of a full description of the framework. The purpose of this article is to share the Supportive Care Framework for Cancer Care with the cancer nursing community. As a conceptual framework, it may be a useful tool for service or program planning, a basis to organize educational approaches in cancer care, or as a model underpinning research projects.

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This study explored the experiences of men living with sexual dysfunction as a consequence of having been treated for prostate cancer. An ethnoculturally diverse sample of 18 men (14 heterosexual, and four homosexual) participated in a series of four to five in-depth interviews. These one-on-one interviews were designed to elicit information pertaining to their beliefs, values and performances regarding masculinity vis-a-vis prostate cancer and its treatment. Interview transcripts were analyzed using the grounded theory method. The core category of 'Preserving Manhood' incorporated five major themes: enhancing the odds; disrupting a core performance; baring an invisible stigma; effortful-mechanical sex; and working around the loss. We conclude that men's performances of sexuality and masculinity were highly interwoven; that loss of sexual functioning constituted a focal disruption for participants; and in some instances, posed a significant threat to their masculine identities.

This qualitative study explored issues of support and coping for couples where the man had been diagnosed with prostate cancer. Thirty-four men with prostate cancer and their spouses were interviewed separately at three points in time: prior to surgery; 8 to 10 weeks post-surgery; and 11 to 13 months post-surgery. The core category for the couples' experience with diagnosis and treatment for prostate cancer was Managing the Impact of Illness. Five major domains emerged, including: dealing with the practicalities; stopping illness from interfering with everyday life; keeping relationships working; managing feelings; and making sense of it all. While it was clearly important for couples to manage illness and to reduce its potential intrusion into everyday life, this strategy had psychological costs as well as benefits. Men struggled to stay in control of their emotions and their lives, typically vacillating between the pulls of fierce self-reliance and fearful neediness. Women were constrained from employing their usual strategies of coping and were distressed by the complicated requirements of being supportive while also honoring their partners' need for self-reliance.

These results suggest the financial burden is problematic for 20% of this sample. The caregivers' lost time from work influence this burden, and for 36% of this sample, it amounts to one third of their working days in any given month. Policies and programs to address these gaps are needed.

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