We need to talk about cancer

Warning: This article addresses some delicate and often socially difficult issues (and, if you think about it, there’d be no point writing it if it didn’t).

“We think you may have cancer.”

That’s one of those sentences you never want to hear but which I heard recently (twice in fact but I’ll come back to the second time later).

Although I’m not being entirely honest because that wasn’t the whole sentence.

But to write the whole truth entails using a word even less socially acceptable than cancer.

What I was actually told was “We think you may have cancer of the penis.”

A sentence which manages to incorporate not just one, but two of those words that people don’t like to say out loud.

“I’ve got the big c down below” or, even worse “I’ve got a bit of a problem but it’s not easy to talk about it”.

I’ve got close to saying both of those.

And how do you deal with that question “How are you?”

Is it acceptable to say, “Not bad except I’ve may have cancer of the penis!” That’s a conversation killer. Of course, you can try “Not bad but I might have penile cancer!” which, at least for a few seconds, might fool the enquirer into thinking that you’ve been given cancer as some form of punishment.

I’m not sure I’d advise either.

Although I can’t help thinking that one of the biggest reasons why cancer is a killer is not that it can rip through your body at quite amazing speeds, not its ability to metastasise, not that it is intractable to so many treatments, but the fact that, at least for certain types of cancer, it isn’t talked about enough.

And the trouble is, if we don’t talk about these things, we don’t get them treated as quickly as we should. I know because I didn’t. And at least in part, that’s because it’s somehow a bit of a “taboo” subject.

Particularly cancers affecting some of the more personal bits of the human body. Fortunately, we are starting to have conversations about prostate and ovarian cancers but what about vaginal cancer? Ever heard anyone talk about it? Me neither, and I’m not competent to do so now but I have got some insight into penile cancer so I can write about that.

So, why didn’t I get mine looked at quicker? I know common sense tells you that if you have developed “lesions” (particularly on your penis) you should go and get them sorted but people have this habit of rationalising their problems and putting off doing what they know they really should do. Oftentimes, we are looking for “permission” to take these problems seriously. External validation of our internal fears. Talking helps.

I certainly didn’t talk. For six months.

I managed to convince myself that these “lesions” were simply a protracted flare up of a herpes attack, something I’ve lived with for decades. Even when I did go to the doctor’s it was for something else and I only mentioned it as an afterthought. And I managed to convince my GP initially that it was definitely herpes, as it was just like previous episodes. It was only after three rounds of increasingly strong Zovirax that we concluded it probably wasn’t and that I needed a more specialised examination.

So off I trot to see the urologist, followed by two dermatologists and then another two urologists.

And along the way, my innate coyness slowly started to evaporate.

Initially, there’s an almost inevitable embarrassment around removing clothing and being examined “down there” but, as the seriousness of the situation starts to become apparent, that coyness disappears at some speed.

Until, by the third (or maybe fourth) appointment when faced, for the first time, with a female dermatologist (and yes, I know it shouldn’t matter but dammit, it often does) I dropped my trousers and underwent the now obligatory inspection without any problem.

Of course it helped enormously that she was a consummate professional and went about her business without a hint (and I’m sorry about this Fiona) of what I would describe as “an archly patronising Fiona Bruce reading the ten o’clock news” (“Children as young as FOUR **raise perfectly manicured eyebrows and adopt a slightly condescending tone** are to receive sex education lessons under new plans published by the government today”).

None of that, thank goodness.

It was more “OK. This doesn’t look right. We need to send you for a biopsy to try and find out what’s going on.”

All delivered in a matter of fact, straightforward manner which, at least to me, is exactly how I want to be dealt with.

From there I was back to the original urologist to authorise the operation and, within the week, I was booked in for day surgery. The plan was to take two tissue samples and send them off to histology to be biopsied.

That was the plan.

Come the day, I pitch up at day surgery and we go through another inspection with a new consultant (by now I don’t really care who takes a gander at my dangler).

“Oh, this looks like Zoon’s Balanitis” he chirps up.

“What, my penis looks like a character from ‘The Hitchhiker’s Guide to the Galaxy’”?

“No, it’s a disorder of unknown origin that tends to affect mainly older men.”

(Thinks: steady with the “older” buster!!)

“Of course, you could have cancer as well.”

Oh, that’s all right then.

“What I propose we do is circumcise you today as that’s the only real cure for Zoon’s Balanitis and send your prepuce off to be biopsied. That way, if you do have cancer, we’d likely want to remove it anyway, and if you don’t, the problem’s sorted in one go.”

Oh, OK then.

Which is how I came to be de-prepuced yesterday, in rather impromptu fashion.

I’ve now got a four to six week wait for the results of the biopsy but that’s OK given everything I’ve already been through.

What’s pretty clear to me though is that I should never have waited so long to go and get checked. Which is what provoked me to write this article. We need to be able to have these conversations and so someone needs to kick them off.

And it might as well be me.

Oh, and the second time? I don’t really know yet because investigations are ongoing (although nowhere near as delicate) but it was one of life’s more unwelcome surprises to have gone to the doctor’s surgery about one quite minor problem with swallowing and an afterthought issue with my penis only to be put on the accelerated cancer investigation process for both.

And I’m optimistic (although not blindly so) that neither will prove to be.

However, it does serve as a timely reminder not to take life too seriously or to put off doing stuff for too long.

Oh, and talk about these things. They’re important.

But preferably not in the style of La Bruce.

Please.