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Alastair Munro, a 49-year-old construction engineer from Inverness, noticed a small lump on his penis that began to grow, alerting him that something might be seriously wrong. Although he delayed seeking medical advice for about six weeks, once he consulted his GP, he was told there was a strong possibility it was cancer. “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 this suspicion, after which Alastair underwent a biopsy.
After three months from when the lump first appeared, Alastair received a diagnosis of penile cancer, a rare illness affecting only 80 to 90 men annually in Scotland and about 700 across the UK. The news was unfamiliar to him, and he expressed surprise at the rapid progression of events. A CT scan later revealed the cancer had begun spreading. His surgery, captured by a BBC crew for the documentary series *Surgeons: At The Edge of Life*, involved a complex seven-hour operation. During this procedure, the tumour and 30% of his penis were removed. Because the cancer had spread to lymph nodes in his groin, these were excised and his penis was reconstructed using a skin graft from his thigh.
Following the first operation, additional surgery was necessary when tests showed residual tumour remained. This subsequent procedure lasted three and a half hours. Alastair described how surgeons removed nodes until they were certain all cancerous tissue was eliminated, explaining, “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.” After surgery, he underwent a month of radiotherapy and was declared cancer-free in February. Despite this success, Alastair is currently dealing with lymphedema, a swelling of the skin caused by the treatment, which affects his ability to urinate and have sex. He is expected to have reconstructive surgery within a year and has been informed there is a significant risk the cancer could return within two years.
Sharing his diagnosis with family was difficult for Alastair, not only because penile cancer is so rare and little-known but also because his surgery was being filmed for a BBC documentary. His goal in participating was to raise awareness about this men’s cancer. “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,” he said. He emphasized how subtle the symptoms can be and urged men experiencing lumps, erection problems, or bleeding to seek medical advice promptly.
The surgery was performed by Consultant Urological Surgeon CJ Shukla at Edinburgh’s Western General Hospital, one of only two centres in Scotland equipped to treat these rare male cancers. Alastair was struck by the graphic nature of the filmed operation. “I must admit, I thought it
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