Q:What usually starts with a joke but ends in tears? A:Male cancer.

17 April 2018

“No nurse! I said prick his boil!”

In my work (I deal with clinical negligence and personal injury claims) I come across all sorts of injuries and medical problems, and over the years I have developed a specialisation in male urology cases, particularly those involving testicular and prostate cancer.  Here are a few of the things that I have learned:-

  • We men don’t really like to talk about this sort of stuff, and we don’t like going to the doctors to talk about our meat and two veg/crown jewels/John Thomas and orchestra stalls/pork and beans.
  • If we do have a problem with our unmentionables we are simultaneously really worried about it and in a state of almost complete denial.
  • Eventually, we go to the doctor and say that we’ve got a problem “down below”.  The doctor checks our feet, finds nothing wrong, and we skip out of the surgery feeling like a new man.
  • A week or two later the symptoms haven’t gone away, and so we go back to the doctor and confess to the real problem.  We might even use the correct anatomical terms.
  • For some reason there always seems to be a medical student in the room at this time, and so he or she will also have a go at checking your unmentionables whilst you stand or lie there with your boxer shorts around your ankles.
  • Even after men have been to the doctor, the embarrassment and denial can sometimes continue.  That makes us less likely to telephone to chase up the appointment or the test results.
  • The doctors and nurses who specialise in male urology care know all about the embarrassment factor, and once men get to them things tend to be okay.  There is even a kind of camaraderie. 
  • Those men who have been lucky enough to have routine prostate screening will know that this sometimes involves an exercise where you have to drink about two pints of water, and then pee into a special kind of pot which measures how quickly you empty your bladder.  This is also a great opportunity to make really obvious jokes, but the supervising nurses are so professional that they always laugh as though they have never heard them before. [ And by the way they do leave the room!].
  • As an aside (and I realise this isn’t strictly a male story) when Marilyn Monroe was engaged to the playwright Arthur Miller, she evidently went with him to visit his elderly mother in her small apartment in New York.  The walls were very thin, and when she went to the loo she was worried that Arthur and his mother might be able to hear her peeing.  To hide her embarrassment she turned on the cold water tap, which gushed out at full mains pressure.  Whilst this was happening Arthur asked his mother what she thought of Marilyn and apparently she said “she’s nice, but she pisses like a horse!”.
  • If you are a bloke who used to p*ss like a horse, but now have more of a tinkley dribble, you should have a prostate check.  It probably won’t be cancer, but when you have those symptoms, you should be thinking about your urological wellbeing.
  • Testicular cancer you can check for yourself, and cancer of the penis also has visible signs.  Prostate cancer develops quietly, and almost in secret.  Men can also get breast cancer.

If you have been kind enough to read this far, you will notice how I started off joking but then finally got serious and started using the correct terminology.

And that’s the point.  Men are slow to get serious about this, and so male urological problems tend to be under-reported and ignored.  Compare that to breast cancer screening for women, which we are open and grown-up about, and our healthcare is better as a result.

I mentioned above how the doctors and nurses who specialise in urological care are usually very sensitive to the “embarrassment factor”.  However, good medical care is about so much more than just dedicated clinicians helping to fix you when things go wrong.  Prevention is better than cure, and whilst that might not be possible to achieve, early treatment rather than late treatment is equally important, and it should be our goal.  In an age where Facebook can harvest more of our personal data than we ever knew we had, it should not be beyond our abilities for the NHS to become more proactive in reaching out to men, and to begin an active conversation with them about male health issues.

For that reason I think that male cancer awareness week is a great idea, and I hope that it will be built upon and repeated.

Terrence Donovan is the Head of the Clinical Negligence and Personal Injury Department at Kingsley Napley, and if you would like to contact him his email address is tdonovan@kingsleynapley.co.uk.  Alternatively you can call our Medical Negligence enquiries line on 020 7814 1200.

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