Removing 30% of my penis saved my life – this is why I let the surgery be filmed

Removing 30 of my penis saved – Alastair Munro, a 49-year-old construction engineer from Inverness, has shared his harrowing experience of battling penile cancer, a rare condition that led to a seven-hour surgical procedure filmed by a BBC camera crew. His story, set to air on Wednesday’s episode of Surgeons: At The Edge of Life, highlights the importance of early detection and the emotional toll of a diagnosis that many men hesitate to discuss.

The Diagnosis

Alastair first noticed a small lump on his penis, which gradually enlarged over six weeks. Initially dismissing it as a minor issue, he eventually sought medical attention after his general practitioner raised concerns. The doctor’s assessment was startling: “It was quite a bold thing to say,” Alastair recalled. “I was shocked. He couldn’t say 100% but he thought it was cancer.” A week later, a urologist at Raigmore Hospital confirmed the suspicion, leading to a biopsy that confirmed the grim diagnosis three months later.

“I was pretty shocked but had been confident it was cancer,” he told BBC Scotland News. “I’d never, ever heard of this kind of cancer before.”

The cancer had already spread to lymph nodes in Alastair’s groin, necessitating urgent intervention. His surgery, performed at Edinburgh’s Western General Hospital, became the centerpiece of a documentary aimed at shedding light on men’s cancers. The hospital is one of only two in Scotland equipped to handle such rare conditions, making the procedure both critical and unique.

The Surgical Journey

During the operation, surgeons removed the tumour along with 30% of Alastair’s penis. The procedure, which lasted seven hours, also required the excision of affected lymph nodes. A skin graft from his thigh was used to reconstruct the penis, a complex process that left him with a significant recovery period. Despite the physical toll, Alastair emphasized the speed of the treatment: “Things moved pretty quickly once the diagnosis was confirmed.”

Two months after the initial surgery, Alastair underwent a second operation lasting three-and-a-half hours. The decision was prompted by residual cancer cells detected in the first procedure, which posed a 50% risk of spreading to his pelvic region. “They can’t actually tell if it’s cancerous until they get inside you,” he explained. “What they do is cut away the nodes and check them straight away. They’re basically just digging through you.”

“They keep going until they find the end of the cancer. It sounds pretty primitive but that’s what they’re doing. It’s quite amazing really.”

The surgery’s graphic nature was not lost on Alastair, who had watched a preview of the documentary. “I must admit, I thought it was pretty gruesome to be perfectly honest,” he said. “You see in the programme that I had a major bleed. When I watched it, I said, ‘well nobody told me about that.’” Yet his surgeon reassured him that such complications are routine. “But my surgeon just said it was nothing, that it happens all the time,” Alastair added.

Recovery and Complications

Following the surgeries, Alastair embarked on a month of radiotherapy, which eventually led to his clearance in February. However, the treatment came with lasting side effects. He now struggles with lymphedema, a condition causing skin swelling, which has made it difficult for him to urinate properly and engage in sexual activity. Reconstructive plastic surgery is expected to address these issues within a year.

Alastair’s recovery has also been a test of resilience. After being diagnosed, he faced the emotional challenge of informing his family about his condition, particularly as they were unfamiliar with penile cancer. The added layer of having his surgery filmed only compounded the anxiety. “The whole purpose of it is to raise awareness of men’s cancer,” he said. “If there’s one person out there who’s got something wrong with their penis but is too embarrassed to go to the doctor and he watches this programme and says, ‘I’d better go to the doctor,’ that’s basically the whole purpose of it.”

A Rare but Serious Threat

Penile cancer is uncommon in the UK, affecting between 700 and 800 men annually. In Scotland, only 80 to 90 cases are reported each year, making Alastair’s experience a rare but vital case study. Consultant Urological Surgeon CJ Shukla, who performed the operation, noted the condition’s increasing prevalence. “The projection is that by 2030 to 2040, it’s just going to go higher and higher,” Shukla said. “We need to be prepared to look after these patients well.”

Alastair’s personal journey underscores the importance of vigilance. His lump, located on the head of his penis, was painless but grew rapidly. At one point, he noticed blood, a symptom that often goes unnoticed until it becomes severe. “It’s so difficult to spot. There are very few symptoms. It could just be a wee spot on your penis,” he said. “If anyone finds a lump or is having problems with erection or blood, just get checked out.”

Advocacy and Gratitude

Despite the challenges, Alastair remains deeply grateful for the NHS’s support. “I want to thank the surgeons and all the staff at the Western General in Edinburgh and the district nurses,” he said. “The treatment I got was unbelievable. I can’t fault it at all. I can’t thank the NHS enough. Dr Shukla basically saved my life.”

Shukla, with 14 years of experience as a consultant, has become a pivotal figure in addressing Scotland’s high incidence of penile cancer. The country has the highest rate of the condition in the UK, a fact Alastair’s case brings to the forefront. His willingness to share the experience not only aids in raising awareness but also serves as a beacon of hope for others facing similar diagnoses.

Alastair’s story is a testament to the power of early intervention and the courage required to confront a condition often shrouded in stigma. By allowing his surgery to be filmed, he transformed a personal ordeal into a public service, encouraging men to seek medical attention without hesitation. His journey, marked by both physical and emotional challenges, highlights the critical role of healthcare professionals in fighting rare cancers and the impact of media in promoting proactive health care.

As he prepares to watch his surgery again on television, Alastair reflects on the journey that changed his life. “I can’t wait to see the final episode,” he said. “It’s a way to share my story and help others understand the importance of not ignoring even the smallest signs.” His experience, while extreme, serves as a powerful reminder that early detection can be the difference between life and death in the fight against penile cancer.