The following is a summary of “Clinical considerations for sexual and gender minorities with prostate cancer,” published in the July 2024 issue of Urology by Dickstein et al.

Managing prostate cancer in sexual and gender minorities necessitates a nuanced and inclusive approach across all stages of care. Among sexual minority men, particularly gay and bisexual individuals, the practice of receptive anal intercourse can influence prostate-specific antigen (PSA) levels, potentially leading to unnecessary biopsies or treatments due to elevated PSA readings. This highlights the need for healthcare providers to understand and contextualize the sexual behaviors specific to this population, which often differ from heterosexual norms centered around vaginal intercourse. Effective communication about sexual practices is essential to avoid overdiagnosis and overtreatment, ensuring that clinical decisions are based on accurate diagnostic information and aligned with individual patient needs and preferences.

Gender minorities, including transgender women and individuals assigned male at birth with feminine gender identities, present additional complexities in prostate cancer management. Many of these individuals undergo gender-affirming hormone therapy and/or pelvic surgeries as part of their transition process. These interventions can significantly impact prostate health by altering PSA levels and potentially masking the detection of prostate cancer. Moreover, residual prostate tissue from surgeries or anatomical changes may complicate diagnostic imaging and treatment planning, requiring careful consideration and specialized expertise from healthcare providers.

Recognizing the diversity within gender minority communities is crucial; not all individuals will pursue or have access to gender-affirming treatments, and their medical histories can vary widely. Personalized approaches are essential to address these unique factors and ensure equitable access to quality prostate cancer care. By shedding light on these issues, this seminar article aims to promote awareness, foster sensitivity, and advocate for tailored healthcare strategies that enhance outcomes and patient satisfaction among sexual and gender minorities affected by prostate cancer.

Source: sciencedirect.com/science/article/abs/pii/S1078143924005076