Get used to it.

Cancer treatment means lots of scans, it’s just a fact of life.  I usually get a CT scan every 6 to 9 weeks, but different doctors have different needs.

In the course of treatment, I had ultrasounds, radiotherapy planning scans and even, because I was really lucky? I had some nuclear medicine, and that really is something I don’t ever need to do again.

CT scans with contrast

These are a really important part of cancer treatment, and as far as I can see are used almost universally to see what’s going on inside your body. They can quickly and accurately tell where disease is and where to target treatment.  It’s also a key part of surveillance for the recurrence of cancer once the treatment has finished. Even when I’m in remission, I get a scan every 3 months.

Before any CT scans take place, I have blood tests to check kidney function and general fitness to take the contrast dye. This is usually done the same day in the hour before the scan.

Breath in… and out.

I just put a gown on for the scan and have a small cannula put in my arm where the contrast dye is injected.  Top tip: make sure you’re well hydrated and that your veins are nice and plump.  I’ve got some tricks that work for me which you can read about elsewhere on the site, the key thing is water though.

You lay on the bed and the big doughnut part of the machine scans around you. (that’s donut for our American audience) You breath in, hold it, and breath out a couple of times. When the dye is injected it can feel warm. It makes the whole scrotal area warm and fizzy, and you might even feel like you’ve wet yourself.  You probably haven’t.

It’s a really quick process, and you’re usually done in a couple of hours start to finish.  I always find the most frustrating part to be the waiting for results, as a big team of experts tend to want to look at things case by case.  In the future, we’ll probably do this kind of thing with AI, and the machine will just give you an all clear or a referral to a human.  Until then, we wait.

CT scans are also used to plan radiotherapy treatment. The consultant will put a plan together for the area to be targeted. How wide, how deep and at what angle and I got a couple of tiny tattoos to make sure everything stays where it should.  In my case, my tattoos were re-done every few days anyway!

Ultrasounds, and ultrasound guided aspirations/biopsies

Ultrasounds are lovely.  Cold gel, a small scanner like you beep barcodes with and you get to look at everything on a screen.  If there’s nothing suspicious, you pull your trousers up and go home.

If there is something suspicious or abnormal, then doctors will usually want to take a sample. The ultrasound is then used to guide a needle into the area, which then scrapes around a tiny thing like a lymph node. Tissue samples are taken and sent off to the lab to look for any signs of disease. 

The needle that goes in your groin is long, so I was dosed up with a local anesthetic. Whilst you’re aware of a long needle in your groin, it’s painless.

Nuclear medicine

Wow.  So, this kind of scanning is a completely different animal entirely. It’s used for staging, to look for sentinel lymph nodes, so the surgeons know what they need to take out.

Sentinel nodes are like master lymph nodes. The information gained by removing and testing them gives doctors an idea as to the direction and extent of spread.  It’s a big part of staging cancer.

The process is difficult, as I suspect the penis is just a difficult thing to work with. 

My penis was wrapped in a thick gauze and soaked in anesthetic. I would wait for a while, maybe half an hour and then it’s soaked again.  When everyone’s content that it’s numb, I laid down in the scanning room.

Then, the magic happens. My weary penis was injected 6 times with a radioactive liquid, through the shaft, with a small sharp needle.  Some of the injections don’t hurt at all, sometimes it’s eye wateringly painful. 

More so around the frenulum, the fun zone, where the banjo is played.  But the pain doesn’t last.

Then, the scanning starts and I watched on a screen where the lymphatic fluid flows. Or, in my case where it only half flowed. I already had a block dissection of the inguinal nodes on the other side of my groin. That side was blank on the screen

All the important bits are then marked up, and the radioactive substance stays in your body for 24-48 hours. I stayed overnight in a hotel and had the surgery next day to remove the nodes.

My urine was blue or green for a few days, I just had to drink lots of water to flush it out.