Background Almost two-thirds of cancer deaths occur in developing countries. In resource-poor countries where there are no well-developed institutional-based palliative care services or where those facilities are in limited supply, family home-based care is a critical element of providing comforting care for patients whose prostate cancer has spread to other parts of the body (advanced). One in 8 men in the UK develops prostate cancer.

Method The study adopted a qualitative repeat in-depth interview approach to explore the complexity of viewpoints. A total of 23 patients with advanced prostate cancer (APC), 23 family caregivers, and 12 health care professional yielded 68 interviews to get a holistic understanding of such care. Patients and their caregiver(s) participated in two interviews either individually or as joints across a period of up to 6 months. The interviews were transcribed and an inductive thematic analysis approach was used to explore relevant content and contexts of commonly recurring themes regarding the experiences stigma and how prostate cancer impacts on men’s masculinity.

Findings Physical changes, impotence, incontinence, and loss of social status impacts on what means to be a real man. APC affects masculinity results in changed identity that affect the masculine role as leaders, breadwinners, and head of households. This together with impotence made the men felt ‘not man enough ‘and ‘living dead’ thereby impacting on their social statuses. APC is stigmatised as a promiscuous disease. The cultural response to prostate cancer should guide any self-management services for men living with prostate cancer.

Conclusion This study has identified the cultural response to prostate cancer and how it influences their quality of life and dignity. This study provides rich experiences about living with prostate cancer issues around cultural responses that may hinder health-seeking and quality of care.