Whatever treatment a man has received, he can expect to stay under the care of his specialist penile cancer centre for a number of years, attending for regular check-ups. These check-ups start at three monthly intervals then every six months and then every year. They are likely to continue for between three and five years after treatment.
Professional monitoring of the patient is an important part of the recovery process. During the regular check-ups, the consultant or nurse will usually want to ask about whether the man can urinate, achieve an erection and ejaculate as any changes show that the penis is either healing or that there may be issues that require following up. Check-ups also provide an opportunity for the man to ask questions, voice concerns and discuss how he can manage the changes since his treatment, such as how he urinates (see ‘
Using the toilet after penile cancer surgery‘) or in his sexual relationships (see ‘
Sex & relationships‘).
Almost all of the men we spoke to were still under the care of their regional specialist centre for penile cancer. Soon after discharge from hospital men may be visited by a district nurse who will change dressings and monitor recovery (see ‘
Professional support‘).
Check-ups can act as a reminder that the man has had penile cancer and can therefore raise a range of emotions. Some of the men we spoke to talked about feeling apprehensive before attending these appointments.
The time between check-ups increases as the men recover from treatment. Most of the men we interviewed went back to their specialist centre soon after treatment. Subsequently, their check-ups started at three monthly intervals, then six months, before becoming annual appointments. If any issues emerge, such as infection of the area treated or further signs of cancer, the time to the next check-up may be shortened. Check-ups will usually end after five years although those who need continuing support, such as with infections in the treated area, will often continue seeing the specialist centre annually.
During the check-up, men can expect to receive a physical examination, blood tests and scans, such as CT or MRI scans, that allow health professionals to see into the body.
After having been well for some months or years after their initial treatment, a few men we spoke to had experienced a recurrence of their cancer. In some cases the recurrence was detected on a scan done as part of routine follow-up, while in other cases a lump or other symptom developed between check-ups.
Some of the men we interviewed told us that they were shocked by the recurrence of their cancer because it was so unexpected. Men whose penile cancer recurs may worry about what might happen next. Recurrences of penile cancer can be successfully treated with further surgery either to the penis or the lymph nodes in the groin. In some cases, the surgery may be followed by radiotherapy. When a routine follow-up scan revealed more cancer on his penis, Benjamin said, ‘I don’t know what he [the consultant] said really apart from the fact that it looks like being a total removal, which was a bit of a shock, but if that’s it, that’s it’. A few months after having the lymph nodes in his groin treated, Michael developed another lump higher in his abdomen, which was then surgically removed.