Frank - Interview 03

Age at interview: 77

Age at diagnosis: 72

Brief Outline: Frank had discomfort in his penis and was finding urination difficult. A lump emerged on Frank's penis. He saw his GP and was given a preliminary diagnosis of cancer, this was confirmed after a biopsy. Weeks later Frank went on to have a partial penectomy.

Background: Frank is a white male in his 70s. Frank is single with a grown up child, aged 46. He is a retired business development manager by trade at a large employer.

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Frank realised he may have a problem when in February 2006 he began having discomfort in his penis, this was followed by a difficulty in urinating. The opening of Frank’s penis began to close up and form a skin over it. At first Frank dismissed this development as a minor problem, something that happens to most men. A few days down the line Frank noticed that a lump had emerged on his penis, but again he felt that this probably wasn’t anything too serious. The lump began to get larger, urinating began to get increasingly difficult and painful and the pressure of the urine made it spurt out to the side of Frank’s penis.

 

Frank spoke to a close friend about his symptoms. His friend encouraged him to see his GP, which he did. Frank’s doctor instantly gave a preliminary diagnosis of penile cancer. His GP referred him to see a consultant at the local hospital and also gave him some strong antibiotics for an infection. At this point Frank did not know anything about penile cancer and was dismayed not to be given any information.

 

Within five days of been given his initial diagnosis Frank attended a meeting with a consultant surgeon. The consultant arranged for Frank to have a biopsy taken, in order to confirm that he had penile cancer. The small operation to take a biopsy involved Frank staying overnight in hospital, Frank found the procedure quite painful. When the results of the biopsy came back, the surgeon was very blunt in confirming that the lump was cancerous and stated that he should have sought help earlier. The surgeon went on to talk about treatment and said it was likely that he would have to have his penis amputated. No other treatment options were offered. Frank was shell shocked.

 

After receiving his diagnosis Frank decided to discuss his condition with a set of his closest friends. He didn’t want to broadcast it around, but equally he felt that keeping it bottled up was not healthy. Like Frank, his friends did not know anything about penile cancer, but they were grateful that Frank had told them and Frank was grateful for the moral support.

 

Within a period of two weeks Frank was given an operation date at another regional hospital which had expertise in the area of penile cancer. On the day of the operation Frank chose to go to the hospital alone. He was nervous and was thinking in a quite fatalistic way, although he was trying to keep positive. The journey to the hospital was hard for Frank, however once he walked into the hospital reception he told himself ‘I’m in good hands now’ and he became much calmer.

 

Frank went on to have a partial penectomy and was discharged from the hospital after eight days. Frank was very sore for several weeks after the operation but was relieved that it was not as severe as he had feared. On leaving the hospital, Frank was given a range of pills including some painkillers. Frank was told that he may have trouble urinating after the operation, but managed this very well.

 

Frank cannot use urinals in public toilets and generally has to sit down to pee, whilst this can be awkward when he is somewhere that doesn’t have suitable facilities he is able to manage his life to try and avoid this occurring.

 

  

Frank's first symptom was difficulty peeing, which worsened and became painful as the growth covered the hole at the end of his penis.

When I first realised something was wrong the main symptom, the first symptom was difficulty in urinating and then... gradually the – if I describe the penis, the opening of the penis started to close and it started to form a skin over it and within three or four weeks I was in tremendous pain... and the pressure of the urine when I needed to urinate was starting to force its way through the side of the member. Then it was at that point as I mentioned previously, that I realised something was quite serious. First of all the discomfort, secondly the difficulty in urinating and thirdly... the terrible pain.

Frank was told that he must have a biopsy to confirm it was cancer. The biopsy was quite painful and he had to stay overnight in hospital.

The next thing he said was that, “You must have a biopsy.” And that was arranged and again within a very short space of time I went back into hospital and had a biopsy in order to confirm that there was an infection and very probably that it was a cancer. The biopsy was quite painful actually and it meant that I had to stop in hospital overnight. It was almost a mini operation. I came out and within two days the results came through and yes, I had been confirmed as having penile cancer.

Frank was given the blunt truth in his first consultation; he was glad the consultant was open and clear, but a few weeks later felt bereft of an explanation.

No I think in a way when I had the first consultation and… was given the blunt truth, I suppose in a way I was glad that he was open and plain and clear about it. I would not have wanted anything to be hidden. That didn’t upset me at all. Of course, in the end his prognosis was fortunately not as – far more severe than what I did have to have done to me. No. I suppose I was being a bit fatalist and I was told I’d got cancer, I was told I had to have everything taken away, I came out of the hospital and I thought ‘well, there we are. It’s been a good life.’ [Chuckles]. It was only a few weeks later that I began to realise how bereft he had left me of any explanation as to how it – why did it occur? I still don’t know. What caused it to happen? I don’t know. Nobody tried to explain anything to me.

When I had the interview with the consultant surgeon – I mentioned just now that he was quite brutal about it – because he said that [hesitation] in all probability I would have to have a total removal of the penis, the scrotum and all the testicles and the urinary tube should be redirected. That took me a while to take in. I suppose eventually I had gone into a sort of stasis [chuckles].
 

Frank confided in a few close friends. He thinks the worst thing that you can do, if you have something wrong, is bottle it up.

Once I had been diagnosed with cancer, yes I did and I know that a lot of people might not agree with my viewpoint on this but I have several friends. Three or four are very close friends and they are elderly people like me, in their seventies and they always confide in each other and I think that once you know about a person’s difficulty and you know that you can confide in each other then you understand a person better. Therefore I told err two or three very close friends err that I was in trouble and I explained to them exactly what the circumstances were and they all said, as I expected ‘thank you for letting us know. Do keep us in touch,’ as they would do for me. I think the worst possible thing in a case like this and again I might advise other people, if you’ve got something wrong don’t bottle it up. Don’t go round broadcasting it to the world err but release your tensions and when you think you can talk about it to a few other people then it’s a good idea to do so.

Frank was discharged eight days after his partial penectomy; he was very sore afterwards but things gradually settled down.

I went into hospital, I had the operation and I was discharged after eight days. The operation was not as severe as I had been  warned. I had a partial penectomy. The consultant said to me afterwards “we had to dig deep but I think we’ve saved it.” So I had a partial penectomy and I was looked after wonderfully well and I came out of hospital – I was discharged as I say after eight days, I was very sore for several weeks afterwards and gradually things settled down.

Frank talks about the importance of accepting the positive diagnosis and sharing doubts and fears.

I think all I would say to somebody who has already been diagnosed with penile cancer... accept the fact that it is a positive diagnosis, take a positive outlook on life, you can’t turn the clock back, you have it, you’ve been diagnosed with it, take it on board, be positive, share your doubts and fears if you feel you are able to with other people especially with your wife or your partner and your friends as I have mentioned previously. But each of us reacts differently when we are faced with a severe problem... and it would be quite wrong for me to... tell somebody... how they should react themselves, but I think that’s all I can say really.