The signs and symptoms of penile cancer can be difficult to identify because they can be similar to other conditions (see ‘
Signs and symptoms of penile cancer‘). This means that it can take health professionals some time to come to a diagnosis (see ‘
Seeking help for symptoms of penile cancer‘). Most of the men we spoke to had been referred to a specialist in the urinary tract (urologist) by another health professional, often a GP, who was either unaware that it could have been penile cancer, or hadn’t wanted to mention this possibility to the man in case it wasn’t. Men with penile cancer will usually be given the diagnosis in a hospital after an assessment by a senior (consultant) urologist. A nurse will often be present, and some men had their wife or partner there too. Benjamin said he had learned of his diagnosis when reading a letter from the hospital specialist to his GP.
Some health professionals may have mentioned that cancer was a possible diagnosis. During the process of investigation, some of the men came to suspect that they either needed to have something done to their penis, such as a circumcision, or that they had cancer. Others weren’t suspecting anything serious and were shocked to learn the diagnosis.
Several of the men talked about their diagnosis being revealed to them in a direct manner. Whilst honesty and openness was valued by many of the men we interviewed, some were left feeling frightened. In some cases, these men felt as if they hadn’t been given an explanation of what could be done to treat their cancer and weren’t aware that it wasn’t immediately life threatening.
A health professional with experience of penile cancer can often make a diagnosis from a visual examination of the penis. Rather than give a firm diagnosis, a GP is more likely to say that they suspect cancer and refer the man onto a specialist. In a hospital urology department, urologists will be able to draw on colleagues for second opinions (as in John Z above).
In some rare cases, the cancer will be so severe that it requires an operation immediately and before it is possible to make a diagnosis of cancer. During the operation, the surgeons will probably remove some of the penis and take samples that will be checked for cancer. The men we interviewed who had been in this situation received their diagnosis when they were still recovering from the operation and found it extremely difficult to take in.
Before learning about their specific diagnosis, just hearing the word ‘cancer’ can leave people feeling frightened because they associated cancer with death. Some of the men we interviewed were confident that medical knowledge will be able to provide a cure, particularly if the cancer is caught early enough. Others thought that, because their cancer was visible on their penis, on the outside of their body, that it was less serious than a cancer of an internal organ, such as the liver or kidney. More and more people are surviving cancer nowadays thanks to earlier diagnosis and effective treatments, and treatment for penile cancer can be very successful.
Many people will have known friends and family who’ve had cancer, which will affect how they respond to the news that they have penile cancer.
At the same time as receiving their diagnosis, most were told about the way in which the cancer could be treated, which usually meant removing part or all of the penis. Consequently, how they responded to their diagnosis depended on what they thought about treatment and how it would affect them (see
‘
Information on penile cancer‘).
Some of the men we interviewed wanted to get on with treatment and didn’t want to find out any more than they were told at their specialist centre. Indeed, Ian found some reassurance in the ability of treatment to provide a cure. In some of these cases, a friend, family member or partner would seek out information about their cancer.
Asking a friend, relative or significant other to come to appointments or to phone you afterwards means that they can provide support (see ‘
The support of others‘). Emotional support is particularly important when receiving the diagnosis although there may also be practical concerns such as assistance in returning home.