Michael and Ann - Interview 10

Age at interview: 79
Age at diagnosis: 77
Brief Outline: Michael found a small lump on his penis, after delaying action a friend encouraged Michael to seek help. Michael's GP referred him onto a local hospital. Tests revealed the lump was cancerous. Michael went on to have a total penectomy.
Background: Michael is a white male in his late 70s. He is a widower with two grown up children aged 56 and 45. Michael previously worked as a full time traffic warden, but is now retired.

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Michael had noticed a small lump on the end of his penis, after several weeks it was still there and was getting worse. Michael began to worry about it, but was embarrassed to seek help. He spoke to a good friend about the problem, telling her he had a sweat rash, but not mentioning the lump. When later the problem had not cleared up, Michael’s friend encouraged him seek help. Michael went to see his GP late one afternoon, the Doctor felt that the lump was ‘quite serious’ and immediately referred Michael onto a specialist at the local hospital.

At the hospital, Michael saw a surgeon who explained what tests he would be performing that night. A few days later the test results came back. The consultant was to the point with his diagnosis, telling Michael he had cancer and he would need to have his penis removed. In that moment, Michael just wanted to make sure things would be okay, and didn’t care what was done. Only when he got home did he think about possible alternatives.

Michael told his family and close friends about his diagnosis. Whilst some members of his family were upset and asked a number of questions, they were supportive. Michael’s close friend did some research about penile cancer on the internet and found lots of disturbing information. She selectively relayed some of the information back to Michael. At this stage Michael was feeling very low and being more active in this way made him feel a little better.

Michael was booked in to have a penectomy (removal of the penis) approximately a week after receiving his diagnosis. Leading up to the operation Michael was a little anxious and wanted it over and done with. Michael had the operation under general anaesthetic and therefore was unconscious through the whole procedure. When he woke he had no pain but his lap was full of blood, the surgeon assured him that this would clear up. He was relieved it was over.

After having his first operation, further tests revealed more cancerous cells in Michael’s lymph nodes, he went on to have an operation to have the nodes removed on both sides of his groin, followed by a six week course of radiotherapy. Michael was then diagnosed with a second cancer in his stomach approximately three months after his radiotherapy. The cancer was also operated on and Michael received skin grafts to repair the wound. After these operations Michael was given painkillers and antibiotics to tackle any infection.

Michael feels like he has been able to cope with the impact of penile cancer very well psychologically. He has had to adapt the way he uses the toilet by sitting down rather than standing up. He also struggles to walk as much as he used to, largely due to the reconstructive surgery. Michael continues to receive much appreciated support from his close friend Ann, who helps Michael manage his condition.


 

Michael had never been to the doctors for a urological problem before; he delayed seeking help because of embarrassment, but the embarrassment quickly wore off.

Michael had never been to the doctors for a urological problem before; he delayed seeking help because of embarrassment, but the embarrassment quickly wore off.

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Why do you think you did delay?

I don’t, embarrassment, I’ve never been to a doctor’s for that sort of thing before and it was going to be embarrassing I thought. It wasn’t but I thought at the time it would have been embarrassing. The doctor was - my own GP was very good, very caring and he did everything he could and I was quite satisfied with what he did.

Did you have any fears?

Not any fears but once they told me it was cancer I was more embarrassed than fear I think that wear off quite quickly the fears all the embarrassment wear off.
 

Michael didn't have any fear but he felt a little anxious about the operation. He wanted to get it over and done with.

Michael didn't have any fear but he felt a little anxious about the operation. He wanted to get it over and done with.

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Leading up to the surgery, did you have any fears or anxieties?

Michael' No, I don’t think so. No fears because I wanted it done didn’t I? But perhaps I was a little bit anxious.

Ann' Well, you’d be anxiousness but I think...

Michael' Not that much to worry about was there? I was so worried about I want to get it over and done with so I, you know, I wasn’t anxious about the operation or anything. It’s something you want done and get it over and done with like.
 

During his check-ups, Michael strips off so that the consultant can check his groin.

During his check-ups, Michael strips off so that the consultant can check his groin.

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Michael' Well they last about fifteen minutes I suppose, twenty minutes don’t they?
 
Ann' It all depends. Sometimes you’re quite quickly in and out, they just they make sure they check every time.
 
Michael' It all depends how busy they are. I have to strip off every time and they do make, I mean, the urologist he really do fumble in my groins and poke and push and pull,
 
Ann' See if he can find any lumps.
 
Michael' Yeh, but the other one is just a quick look and see if everything’s alright.
 
Ann' Make sure the plastic surgery’s alright, which they’re very happy with.
 
Michael' They’re both very happy so. We went this week and were there about I suppose twenty minutes this time.

 

Michael says he's not been walking well and that's causing him backache since the reconstructive surgery.

Michael says he's not been walking well and that's causing him backache since the reconstructive surgery.

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Michael' Well as- I’m not walking very well and I’m getting a lot of backaches but I think that’s the way I’m walking that’s causing my backaches. I’m leaning forward all the time. Yeh I can’t walk – well we do try and walk don’t we, we go round the lake but we try and walk two bridges which is about all we can do, we kind of half an hour of it, that’s as much as I can do, but...
 
Ann' But they’re really not sure whether that’s as a result of the penile surgery or the – because of the plastic surgery.
 
Michael' Yeh, most of it’s the plastic surgery because it took a lot of muscle from my leg and put in my stomach you see so…
 
Ann' So it’s difficult to say how much of the actual penile – the cancer surgery has affected his walking as opposed to the results of plastic surgery which of course was as consequence, but not the actual condition.

 

Michael worried about using the toilet after his penectomy. At first he urinated through an opening in his abdomen but this was later moved to his groin, which meant less mess when urinating.

Michael worried about using the toilet after his penectomy. At first he urinated through an opening in his abdomen but this was later moved to his groin, which meant less mess when urinating.

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I was, I was just glad to get rid of it and I think that was the, strong part of it, I just wanted to get rid of it so that didn’t really affect me whatsoever. Worrying about going to the toilet probably was one of the things I was, uptight about but that worked out alright anyhow so…

I can go – well they gave me – they started off one in the middle of the stomach, which is a bit messy at the time and then when I had the next operation they put it right underneath so I’ve got a little hole right underneath, in my groin which is perfectly alright, yeh. It’s good.