Penile Cancer

John - Interview 05

Age at interview: 58
Age at diagnosis: 44

Brief outline: When taking a bath John found a hard lump in his groin. A biopsy revealed the lump to be cancerous however, the specialists believed that this lump was not the primary source of the cancer. A partial circumcision revealed a patch of redness on the penis. John was given chemotherapy and radiotherapy.

Background: John is a white male in his late 50s. John is an acclaimed artist who works in a variety of mediums. John is currently single.

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It was December 1996 and John, an artist living in London was feeling a bit under the weather. When taking a bath John found a hard lump in his groin, he immediately thought that something wasn’t right. As Christmas was close his first thoughts were to postpone any check up till after the holidays, however he quickly realised he needed to seek help immediately. 
John went to see his GP who on examining the lump recommended that he see a consultant for tests. Over the Christmas period John was extremely worried about what the consultant would find. After the holiday period John had an appointment with the consultant who stated that the lump ‘could be a tumour’ and said John would need to have a biopsy to find out. 
Several weeks past, and over this time John’s paintings were becoming increasingly dark, possibly reflecting his anxieties around this time. On the day of the biopsy John attended a pre-operation meeting with the nurse specialist. John and the nurse discussed the possible outcomes of the biopsy in the meeting, one of these outcomes was cancer. After the meeting John underwent a few routine pre-operation procedures including weight checks and anaesthesia choices. 
The biopsy went smoothly and a few weeks later the consultant revealed in a meeting that the results of tests revealed that the lump was cancerous. The tests did not however reveal whether the lump was the primary source of the cancer or whether the primary cancer was elsewhere. A series of exploratory tests were conducted over the course of two weeks to attempt to find the primary source of the cancer “I had cameras in every orifice” says John. After these tests the consultants had still not found the primary source. By this point John was realising how serious the situation was, one consultant stated ‘don’t make any plans for Christmas’. 
One consultant suggested looking at John’s penis. His foreskin had always been tight and it was awkward to draw it back, so it was suggested that he have a circumcision. John had a partial circumcision. On the head of his penis the consultants found a patch of redness, John looked at it and thought ‘that doesn’t look good’. The consultants said, ‘that’s it’.
After a wait on the ward John went on to have a consultation about the discovery. The consultant told John that there were a number of treatment choices, chemotherapy, radiotherapy and surgery. John questioned the term surgery, ‘well, amputation or partial amputation of the penis’ said the consultant. Whilst John was aware of the seriousness of his situation he was not keen on the idea of surgery. Back on the ward, John had a chance encounter with a consultant who had been working in France. After a quick examination the consultant said, ‘In France we would try radiotherapy’. 
By now it was summer 1997, six months after his initial consultation. Over this period John had had an operation in his groin to remove the lump and had experienced several infections from the operations he’d experienced. To John’s surprise, none of the consultants seemed to be in a rush to treat the penile cancer. One consultant recommended the use of Interferon, a strong form of chemotherapy. John was asked to inject himself with the drug, as John was squeamish this was something which he didn’t find easy. Over the two months he was taking Interferon John felt really low, within two days of taking the drug his nails began falling out. Throughout this period of treatment John’s life view began to change, he began to look after himself better, eating healthier, not using too much energy and living more in the moment. 
One weekend, after two or three months of being on Interferon John felt really bad. He had ‘an explosion’ in his groin where he had the operation. He went to the GP that weekend who advised him to go straight to Accident and Emergency. On arrival at A&E John had a large eruption of fluid from his groin. Luckily a Macmillan nurse who had been assigned to John was in the hospital and was able to inform A&E staff about what they were dealing with, therefore John was given treatment to stabilise his symptoms.
The next day consultants discussed surgery options with John. John was told that they would have to remove the Lymph nodes in his left groin, and also have to do ‘something’ about his penis, either amputating it or partially amputating it. John said that he was happy for an operation to be performed but asked if the surgeons could leave the penis for now. 
During the operation the surgeons found a large amount of cancer in the groin. After the operation John felt incredibly deflated and despite surgeons emphasising the seriousness of his condition, John could not face further surgery. At this point John remembered the conversation he’d had with the consultant working in France and suggested radiotherapy as an alternative to surgery. Reluctantly the consultant accepted John’s request and referred him to the radiotherapy department. 
John had to attend a meeting to make a mould of his penis, which would direct the radiotherapy treatment to the required area of the penis. The actual radiotherapy only took three days, two sessions of six minutes each day. The treatment made John’s penis very sore duringthe treatment and this was at first awkward for John’s girlfriend at the time, who was a bit squeamish. The penis however healed up quickly.
After the initial phase of radiotherapy the consultants were happy with the results, but still had concern over the cancer found in John’s lymphatic system. They wanted to given him twentyfour hour cycles of continual chemotherapy for a week and radiotherapy  to the whole of hisbody, John was told he would be given as much treatment as is possible without killing him. John accepted and underwent this treatment over Christmas 1997. 
Today John is healthy, however has recurring health problems related to the treatments he has had. These include Lymphodema and cellulitis. His penis although sensitive is fully functional.


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