Being treated for penile cancer usually means spending some time in hospital. Working men will need some time away from their job both for the treatment itself and a period of recovery afterwards where their wounds heal and they adjust to the changes in their body. During this period, it may also be difficult to continue with other activities, such as hobbies, family events and voluntary work.
Some of the men we spoke to talked of having lower levels of energy compared to before they had treatment. This lack of energy affected what they could do afterwards.
Many of the men we interviewed were of working age and therefore had to manage their illness alongside work commitments. A supportive employer can make a big difference to how a patient experiences recovery. By providing support and reassurance about job security, an employer can remove a great deal of stress and help provide stability during recovery. In Britain employed people who are too ill to work are entitled to basic statutory sick pay for up to 28 weeks. Some employers have their own sick pay scheme and several people had been paid their full salary during their absence from work, which allowed them to recover without overwhelming money worries. Employed people whose sick leave continues beyond the 28-week limit for statutory sick pay can claim Employment and Support Allowance (formerly Incapacity Benefit). Unemployed and self-employed people who have paid appropriate National Insurance contributions can also claim this. Those whose illness means they cannot look after themselves can claim Personal Independence Payment (if aged under 65) or Attendance Allowance (after age 65); there are different rates depending on the level of disability.
Other men were not so fortunate and didn’t receive all their usual income. Some companies didn’t provide sick pay or those who were self-employed couldn’t afford to continue with their business. The men we interviewed had a number of ways of managing the reduction in their income, including changing from being self-employed to employed, moving to a smaller house, and using holiday allowances for time away from work instead of taking sick leave. Macmillan Cancer Support can offer grants towards everyday living expenses for people on low incomes.
For some men however, the impact of treatment on work and finances was limited. While there are some younger men with penile cancer, most are close to pensionable age so may have reduced their working hours or retired. For example, Paul was retired and able to manage financially on his occupational pension. Retired or working, some of the men we interviewed found that there were other things happening in their life that were of much greater concern, such as the death of someone in the family.
Having a condition such as penile cancer can have other financial implications. As penile cancer is treated in specialist regional centres, many men will need to travel long distances for appointments. Meeting the costs of this travel could be a problem. Michael said that although he had to pay the cost of petrol to get to his daily radiotherapy appointments, he was given free parking. John took advantage of a local volunteer driver service to get to his daily radiotherapy appointments, and only had to pay for the petrol. Some men used hospital transport, which is free. Patients on low incomes can get help with the travel costs associated with NHS treatment by asking at the hospital for refund form HC5.
Additionally, items such as travel and health insurance will increase in price. Macmillan can supply details of insurance companies that will offer insurance to people who have had cancer.