A man who lost his penis to a rare cancer is sharing his ordeal in the hope it encourages men with similar symptoms to act sooner rather than later.
Shaun Evans, a 55-year-old former police staffer from England's West Midlands, had his penis amputated just months after first noticing a nagging pain in his pelvic region.
He initially dismissed the pain, but as his discomfort worsened, he began to notice other symptoms, such as blood in the shower and a small spot at the base of his penis that resembled a cold sore.
Concerned, Evans sought medical attention - and in September 2022, months after his first symptoms began, the 55-year-old was diagnosed with penile cancer.
Now, Evans is urging other men to seek help as soon as symptoms arise - before it could be too late.
"I wish I'd gone to the doctors when I had a vague feeling of discomfort and I wish I'd made more of a fuss," he told The Sun Health. "I'm one of the lucky ones, though. I'm still here."
Although survival rates are high, the treatment for penile cancer can be devastating for patients. According to Urology Waikato, a private urology practice in Hamilton, surgery to remove the cancer is the most common treatment, although a cream can be used in some cases. When surgery is required, the doctors try and preserve as much of the penis as possible, the practice said, depending on the size and depth of the cancer.
For Evans, the initial pain soon became more prevalent and uncomfortable. In June 2022, the discomfort became noticeable while sitting as well as bathing, and it didn't take long for it to start interfering with his day-to-day life.
After suffering a heart attack that April, Evans was tasked with cardiac rehabilitation - but the pain in his penis began impacting his ability to do the exercises.
"I went from being able to do all the exercises like the rower and bike, to feeling like my penis was affecting how much I could do physically," he told the outlet.
It was soon after that Evans realised he was bleeding from his foreskin while in the shower, which led to the discovery of the spot at the base.
Evans explained the situation to his physiotherapist, who suggested he go to an STI clinic. Despite having not been sexually active for years, Evans heeded the advice, knowing his symptoms could be similar to a sexually transmitted infection such as herpes or syphilis.
"[The nurse] explained to me that STIs can be dormant for years and then be activated but it just didn't ring true to me," he said.
He was referred to see a specialist urologist, but by August, the pain began to even affect his walking - with Evans admitting he only found comfort when lying down.
"I was starting to get a burning sensation when I urinated and the whole area was becoming inflamed.
"At this point, my penis looked like a Doctor Who special effect. It was mahogany in colour and if I pressed it, the skin just remained indented for ages."
After his urologist appointment in September that year, Evans was referred to another specialist - but before his second consultation could take place, he began noticing an unusual discharge in conjunction with his other symptoms.
"Meanwhile, the cold sore was getting more angry and expanding and the discharge was getting nastier."
That month, Evans finally received an answer - it was penile cancer.
He was initially told that doctors would circumcise him, but before he could undergo the procedure, his symptoms had already escalated - leaving Evans bed-bound and in agony.
That October, Evans called himself an ambulance and was told by paramedics that he could be suffering from sepsis due to his cancerous sore. He was later discharged and told to return for a scan the following day, he recounted to The Sun.
However, in the car en-route to his scan, Evans suddenly felt wet - his abscess had burst. He was admitted to hospital for 10 days, but doctors couldn't yet tell him the fate of his penis.
"I knew it needed to be amputated - I just had a strong feeling and it looked so bad I couldn't imagine how it could be fixed," he said. "It felt like it would be a blessed relief."
On December 23, 2022, Evans had his penis surgically removed, although the surgeon promised she would save as much as she could. The procedure was successful, he said, with the operation able to remove all the cancerous tissue.
In the following months, Evans experienced several strange side effects, including "phantom sensations" of an erection, despite no longer having a penis. However, he said he is grateful for the life-altering procedure - knowing the alternative would have likely been fatal.
If Evans remains cancer-free for five years, he will be given the opportunity to undergo reconstructive surgery - but he still has a while to go before this is possible.
"I'd implore anyone, man or woman, who has any type of pain that might be embarrassing, please go and speak to someone. Your life could depend on it," he told The Sun.
"Men tend to be rubbish at taking care of their health in general, especially if it's anything to do with plumbing or sexual things, but it's so important."
What is penile cancer?
Penile cancer is a rare but aggressive disease, with HPV infection (human papillomavirus) considered the primary risk factor. HPV is the most common sexually transmitted infection - many people don't develop symptoms but can still infect others through sexual contact.
According to the New Zealand HPV Project, HPV-related penile cancers most often affect the head of the penis. It is reported that penile cancer is about 10 times less common than cervical cancer. Penile cancer is generally diagnosed in men over the age of 30 years, and most commonly among those over 70 years.
Risk factors for HPV-related penile cancer include smoking, not being circumcised, having a previous diagnosis of genital warts, or having a previous diagnosis of a sexually transmitted infection (STI).
