Tuesday, October 03, 2006

Gentlemen, look away now


Last week I found myself at a Urology seminar in a central Fife hospital. No glittering award dinners or swanky foreign conferences for yours truly - although I do get my £7.20 train ticket back as expenses, I think. I don't usually talk about what I do for a living on here - not because I'm modest or ashamed or anything, I just don't want to get into trouble. But recently I've slightly changed paths in the cancer field and need some more background in specific forms of the disease, to help with what I've been asked to do. So that's why I made the trip over to the Kingdom to attend a series of lectures on the ins and outs of Urological cancer. And as you'll shortly be aware, ins and outs feature heavily. If you're reading this whilst eating, probably best to put down the sandwich and continue, or maybe visit someother site this lunchbreak.

Urological cancer covers everything to do with your 'waterworks' - kidneys, bladder, prostate (for some of us), and all associated tubes and piping. Euphamisms seem to be relied upon quite a lot - 'plumbing', and 'south of the equator' were both mentioned during the day. It was all very interesting, and started off with a talk from a Urology nurse about her role at a busy hospital - she was refreshingly frank about subjects like DRE - digital rectal examination. And this was the first speaker. Next up was a kidney surgeon talking about what he gets up to during the course of a typical day. His elbows, apparently (surgical joke for you there). He was a classic 'Old Chap' doctor, cheerfully mumbling about enormous tumours, people conking out on his table, etc. His take-home message was that Kidney cancer is extremely difficult to diagnose. "For example, you could have it, and not even realise!" he said lightheartedly whilst pointing at a woman in the audience, who went extremely pale.

The day wasn't ghoulish at all, these diseases are very very rare - for example the cancer we discussed immediately after lunch affects fewer than 1 in 200,000 people. Unfortunately for us chaps in the audience, it was a real leg-crosser. I asked a colleague over a plateful of free sarnies (it's not all bad) what was up next, and mis-heard her. "Renal cancer?" I said. "I thought we'd just done that?". "No, not Renal. PENILE", she said in that slightly-too-loud voice that comes out at all the wrong moments. So I sat back down wondering exactly what could be in store, and within thirty seconds of the 'Knob Doctor' starting his talk, he flashed up a photograph the likes of which I've never seen before so soon after eating. Thankfully I've got a strong stomach - I've cut open all kinds of animals in the name of science, regularly see photos of the after-effects of smoking, and pathology photos of colonic tumours (they look like chops) - but this...well. It looked like what happens when you buy a punnet of strawberries and leave one in the fridge too long until it goes squishy.

There was more to come of course. Only three men in the audience of almost forty, but we were shrinking into our seats as the powerpoint presentation of pain continued, punctuated by a staccato voiceover from the (extremely pleasant) willy man. I took notes, of course - if anything to avoid looking at the screen - and here are some of the phrases I recorded. 'mutilating surgery'...'left with a useful stump'...'fluid leakage'...'this patient had to sit down to void'. And so it continued. I've never before seen a photograph entitled 'stump regressed into the pubic fat', and I think never was enough. I was briefly left wondering why the surgeons referred to any salvageable remains as a 'stump'.

Well, it's because they use this as a starting point for surgically recreating the penis, of course. That's something I never thought I'd see, let alone type - but I have to confess it was all strangely fascinating. In a nutshell (no pun intended), they mould a new one out of skin from near the navel. "As you can see - it looks like a penis, albeit slightly smaller" he said - something no man should have to hear. So after that the next speaker - a specialist in erectile dysfunction - was a walk in the park by comparison. It was like listening to stories about stroking kittens, and indeed that wasn't far from the truth. I was listening to what was being said, but watching the woman translating into sign language for a deaf doctor in the front row - funny how the hand gestures for certain things aren't what you'd expect...