Men’s (and women’s) lives are complex, involving multiple roles and responsibilities. These responsibilities rarely disappear when a health concern arises, which means that it can often be difficult to find time to go the Doctor (GP). The NHS also offers services, such as walk-in centres, that provide medical help without the need for an appointment. Some GP surgeries now offer extended opening hours, either early in the morning, in the evening, or at weekends. Even if it is difficult finding the time, a man with penile cancer will have to see a GP before they can be referred onto a specialist.
The earlier a man seeks help with symptoms of penile cancer, the earlier a diagnosis can be made, which should mean that treatment can have a better outcome. While some men we spoke to told us they had acted quickly on their symptoms, others delayed seeking help. With the benefit of hindsight several men said they regretted not going to the doctor sooner.
It can be difficult to decide whether a symptom will go away of its own accord and if it requires professional help. A number of the men we spoke to initially thought their symptoms were harmless and weren’t affecting their daily life, and so they delayed any action. One man assumed that the lump that had emerged on the side of his penis was a benign or ‘harmless’ cyst, whilst another thought the lump was a wart.
One man had a patch of discolouration on the head of his penis for many years, and had previously sought help from his GP who assured him it was nothing to worry about. When a lump emerged on his penis, he returned to his GP.
Even if a man has a concern about a symptom, it may not be easy to seek help. Men may put things off, hoping that the symptoms will go away. Others may worry that an examination by a doctor may reveal that they have something serious and so they may hope that their body will fight it off before they have to take action. Many said they only sought help after their symptoms worsened.
When experiencing symptoms, men may feel emotions including fear, anxiety or a sense of embarrassment. For many men, their penis is the most private part of their body. Some men may feel anxious or embarrassed about showing their penis to a doctor. These emotions can often stop people from seeking help.
The first steps to seeking help can be difficult. If a man has regular contact with a health professional for pre-existing health problems, these appointments can provide a prime opportunity for discussing new symptoms. A number of the men we spoke to raised concerns about their symptoms at check-ups for other health conditions. David told us that his irregular heart beat (called atrial fibrillation) required him to have regular check-ups. At one of these appointments he mentioned that he was experiencing pain under his foreskin. Even if the nurse or doctor is too busy to take more time within a routine check-up, they can arrange for a follow-up appointment or recommend another service that may be better suited to checking a particular symptom.
Life events or past experiences can have a powerful impact on our ability or willingness to seek help. Some of the men we interviewed had previous experience of cancer within their family; in some cases this affected their help seeking decisions. Some said they had sought help specifically because they had a history of cancer in the family. Others report that this was a deterrent to acting on their symptoms. John had suffered two bereavements in his immediate family as a result of cancer. He didn’t want his friends and family to suffer in the way that he had. Consequently, he found himself trusting to chance that it wouldn’t happen in his case.
Partners, family and friends can be instrumental in encouraging men to take the first step to receiving help with a health concern (see also ‘
The support of others‘). For instance, Big D told us that his partner strongly encouraged him to seek help.
While considering seeking help for their initial concerns about their penis, there will inevitably be other things going on in the man’s life. Some of the events may be so powerful that they make any concerns about penile cancer seem irrelevant. Jim had recently lost his son and was so devastated by his bereavement that he was not particularly concerned about the symptoms he was experiencing.
Once they had sought help from a professional, many men had to consult their Doctor (GP) two or three times before being referred to an appropriate specialist. This is because the signs and symptoms (see ‘
Signs & symptoms of penile cancer‘) of penile cancer are similar to those for other conditions. Consequently, the Doctor (GP) may think the symptoms the man presents are something that isn’t very serious or can be dealt with without the need or a specialist. Several of the men that we spoke to had a delay to their diagnosis of penile cancer because they were initially misdiagnosed by their GP or another health professional (see also ‘
Diagnosis and tests for penile cancer ‘).
Some GPs initially suspected a prostate problem and tested for that; others dismissed the symptoms at first. Les was initially told that the lump on his penis was a genital wart. Not only was he treated for this condition but his wife was also tested. It was approximately a year before the lump was removed with surgery. Steve was told that he had herpes for several months before being diagnosed with Lichen Sclerosus, a skin condition in the foreskin. Several men were treated by their GP for thrush but for many the cream made their penis sore. Because he was having problems passing urine, James paid to see a private consultant who performed a circumcision. This revealed a sore patch which was misdiagnosed and mistreated for many months before an appropriate referral was made.
Once men had the correct diagnosis, most were extremely happy with the service they received from health professionals (see ‘Professional support‘).