Meu estoma em sociedade: experiências de homens com câncer intestinal

Abstract

Introduction: Cancer diagnosis rates are rising exponentially each year across Brazil. In the southern region, colorectal cancer represents the second highest incidence among the male population, and the detachment of this group from healthcare services exacerbates the difficulty in early disease detection. Consequently, a common outcome in these cases is the need for an intestinal stoma. In this context, social relationships are affected as alterations in body image disrupt the existential foundation, leading these individuals to conceal their stomas in order to conform to socially established masculine norms. Objective: To analyze the sociability of men with stomas undergoing oncology treatment from the perspective of Transition Theory. Method: This qualitative study employed focused ethnography as its method, conducted with patients undergoing treatment for intestinal cancer at a reference hospital for cancer care in southern Brazil. The study involved 20 men, from September 2023 to June 2024, who were interviewed using a semi-structured data collection instrument. Data analysis was performed through inductive thematic analysis and interpreted using Afaf Meleis's Transition Theory, Raewyn Connell's concepts of Masculinities, and Georg Simmel's Sociability. Results: Several factors inhibiting sociability were identified, such as inadequate public infrastructure and the weight of social judgment. The loss of autonomy and role reversal are recurring experiences that impact the participants' identity and self-esteem. Men seek new ways to engage socially and employ strategies such as prolonged fasting, stoma concealment techniques, and complete social reclusiveness. On the other hand, resilience and adaptation emerge as facilitators of sociability, with men developing strategies to cope with their new reality. The central theme, "Transitions in Masculine Sociability After Stoma Creation", encapsulates these experiences and unfolds into subthemes that capture the challenges faced. Conclusion: The experience of men following stoma creation coexists with the struggle to maintain masculinity amidst physical and emotional challenges, highlighting the need for sensitive and interdisciplinary support. The narratives indicate that stoma creation presents physical challenges that affect the perception and maintenance of masculine sociability. The adaptation process to this new reality involves a constant negotiation with cultural norms of masculinity and social normality. This study enriches the field of interdisciplinarity by integrating theories and concepts from various areas of knowledge to understand the experiences of men with ostomies undergoing cancer treatment. Additionally, it provides support for the development of more sensitive and holistic approaches that consider the complex interactions between health, male identity, and sociability.