Odour, discharge and painless sores – this is the most taboo cancer of all. One man shares the story of how his penis almost cost him his life… and changed his sex life and marriage forever

Mention HPV and most of us immediately think of women, and more specifically cervical cancer. 

Years of campaigning, screening and vaccination have transformed our understanding of the role the human papillomavirus can play in the disease.

What is much less widely understood is that HPV affects men too. 

It is associated with several cancers affecting men, including head and neck, anal and penile cancers, yet awareness remains comparatively low.

And in the case of penile cancer, embarrassment and stigma about symptoms can make an already uncommon disease particularly difficult to talk about.

Cormac France knows only too well what that silence can mean. When the married father–of–four was diagnosed with penile cancer at 52, in late 2019, he had never even heard of the disease.

Looking back, there had been warning signs. A keen runner who was training for a marathon, Cormac had lost weight rapidly, but put that down to exercise. 

He was unusually tired and constantly cold, even during the summer, but again found perfectly ordinary explanations for both.

Then he began noticing physical changes which, because they were painless, were easier to dismiss. 

As the symptoms persisted, including lumps, discharge and an unusual smell, Cormac initially wondered whether exercise, sweating or an infection might be responsible.

‘I was putting two and two together and getting 175,’ he says now.

His wife Sharon repeatedly encouraged him to have the symptoms checked, but Cormac was busy working and training and continued to put it off — plus he says, crucially, nothing hurt.

‘I had zero pain,’ he says. ‘And when I say zero pain I really mean it. I thought the other symptoms were down to sweating from all the running I was doing.’

It was only after completing the marathon he had been training for that Cormac finally contacted his GP. He recalls her being alarmed at his condition and fast–tracking him to hospital. 

Very quickly it was established that he had cancer — and that the disease had spread. 

At a subsequent consultation, with Sharon by his side, they were told it was very serious and that life was unlikely ever to be quite the same again.

For Sharon, the medical terminology suddenly mattered far less than the word neither of them wanted to hear.

‘When Cormac was diagnosed, it was cancer. It didn’t matter what type it was,’ she says. ‘We were told it was very severe, and there were so many emotions. 

‘I felt I had to be strong and hold everything together for Cormac and the family.”

Their children responded with a positivity that Sharon still remembers. ‘They never said, “Dad is going to die.” It was always, “Dad is getting well. Dad is going to fight this.” We are a very close family, and their positivity really helped.’

Cormac underwent major penile surgery, including lymph–node removal, followed by further topical chemotherapy treatment which he found extremely painful and difficult to tolerate. 

During his final course, he reached the point where he simply could not complete the last few days.

Today, at 59, he remains under specialist care and continues to have regular scans. He has not been given what he calls a formal ‘all–clear’, although he is in a much better place and no longer undergoing active cancer treatment. 

There have been lasting consequences: he has required hospital treatment for lymphoedema and still experiences occasional panic attacks, for which he receives treatment.

There are other changes too which are less obvious. Cancer treatment can affect how a person feels about their body and alter a couple’s physical and emotional relationship. 

Cormac speaks carefully about that part of his recovery, conscious that the diagnosis did not happen to him in isolation.

‘It’s tough for other people too. It’s not just yourself,’ he says. 

His consultant had warned him that life would be very different afterwards and, Cormac says, he was right.

‘When something happens to somebody, it doesn’t just happen to that one person. It happens to a group around them. It’s a ripple effect. 

‘For some people it can make them stronger, others it can break them apart, and it has a different effect on different relationships.’

For Sharon, being grateful that her husband survived has existed alongside accepting that cancer inevitably changed something in both their lives.

‘The hardest part is that you lose a part of what you had before,’ she says. ‘We are of course still very close and we talk, but it’s always there. It can feel like an invisible wall.’

It is perhaps one of the less discussed realities of surviving a serious cancer, Sharon says – the treatment may finish, but fear does not necessarily disappear with it.

‘Even when someone has survived cancer, you are still dealing with your own mortality,’ Sharon reflects. ‘If something new appears, the worry is always there in the background.’

Dr Diarmuid Sugrue, Specialist Registrar in Urology at St James’s Hospital and a member of the National Penile Cancer Centre team at Beaumont Hospital, says that men’s reluctance to talk about their symptoms matters because it can delay seeking help for symptoms which may appear relatively innocuous.

Penile cancer is rare, with Dr Sugrue estimating that there are around 60 to 70 cases annually in Ireland, but he says rates are ‘slowly increasing and we’re not 100 per cent sure why’. 

For the people affected, the consequences can be profound, particularly when diagnosis comes at a later stage.

‘Men very commonly put it off, put it off, put it off,’ he says. ‘I won’t say until it’s too late, but certainly until it’s at an advanced stage.’

Part of the difficulty is that the warning signs may not initially seem alarming. Persistent redness or itching, minor bleeding, a lump or a sore can all warrant investigation, but the symptoms are frequently painless.

A man may therefore assume the problem will clear up by itself, while embarrassment can provide another reason for postponing a conversation with a partner or doctor.

‘We’re just not very good at talking about our genitals. Even when it comes to for example foreskin hygiene in Ireland — a country where men are mostly uncircumcised,’ says Dr Sugrue, who believes HPV related male cancer awareness has not received the attention it deserves.

‘The HPV story is very well known, I think, in cervical cancer,’ says Dr Sugrue. ‘It’s very well described and it’s very well advocated for. The HPV story in men is very much glossed over I feel.’

And while not every penile cancer is HPV–related, Dr Sugrue says HPV is implicated in around half of cases, while chronic inflammation is an important factor in many of the remainder.

Other recognised risk factors include smoking, immune suppression, increasing age and phimosis, a condition in which the foreskin becomes difficult to retract.

There is no national screening programme for penile cancer —the numbers are too small to justify one — but Dr Sugrue points out that investigating a worrying symptom can be relatively straightforward. 

A GP can perform an examination and, if there is cause for concern, refer a patient to a urologist or the specialist national service for further investigation.

His advice is simply that a persistent change should not be ignored.

‘If you have any persistent symptom, lump, itch, ulcer, and you think something’s not quite right, it hasn’t gone away, just go see your doctor,’ he says.

Early presentation matters not simply for survival, but because modern treatment increasingly aims to minimise the physical consequences of the disease. 

Penile cancer care in Ireland was centralised at Beaumont Hospital in 2021, creating a specialist national service. 

Dr Sugrue says around 80 per cent of first operations performed there are now organ–preserving, with the team aiming wherever possible to maintain normal urinary and sexual function. More extensive treatment can still be necessary in advanced disease.

For Cormac and Sharon, however, increasing awareness also means challenging the uncomfortable assumptions which can surround a cancer affecting an intimate part of the body.

‘There is still a taboo around cancers involving sexual organs,’ says Sharon. ‘But cancer can happen anywhere in the body, and people need to be aware of that.’

The association with HPV can add another layer of misunderstanding. HPV is an extraordinarily common virus and, as Dr Sugrue explains, most infections are self–limiting: people can acquire the virus without knowing about it and their immune system clears it.

Dr Sugrue is a member of HPV Network Ireland, a coalition of health, clinical, research and advocacy organisations which was launched earlier this year to improve public understanding of HPV and the six cancers it can cause, as well as strengthening confidence in prevention.

Vaccination is a crucial part of that prevention. The HPV vaccine is offered to both boys and girls, and Dr Sugrue describes vaccination as one of the most effective cancer–prevention tools available.

The message, says Dr Sugrue, is that vaccination benefits boys as well as girls, and is most effective when given before a young person becomes sexually active, which is why it is offered through the school programme. 

Catch–up vaccination can also be appropriate in some circumstances for people who missed it when younger.

Cormac now wants the same openness around penile cancer that exists around better–known male cancers. 

He is particularly frustrated that men’s health campaigns routinely discuss prostate and testicular cancer while the disease which nearly cost him his life remains largely invisible.

‘Penile cancer or other male HPV–related cancers rarely get mentioned,’ he says.

Since his illness, Cormac has fundraised, supported awareness initiatives and spoken publicly about his experience. 

On one occasion, he learned that a man had read an article about him, recognised that something wasn’t right and sought medical help. The man subsequently required surgery.

For Cormac, hearing that was extraordinary. It was evidence that talking about an uncomfortable cancer could have a very tangible effect. 

It is also why Sharon supports her husband’s decision to make what was once an intensely private family experience a very public one.

‘It is a very personal journey, but it has also become a public one,’ she says. ‘Cormac wants to raise awareness and help as many people as he can. 

He wants people to recognise the symptoms and make sure nobody else has to go through what he went through.’

Nearly seven years after his diagnosis, Cormac is still doing marathons, although these days he walks rather than runs them. 

There are four children to enjoy, two grandchildren, and an approaching 60th birthday that, after being told at 52 that his future was uncertain, feels particularly precious.

He thinks often now of his own father, who died in his 60s, and of how differently he views getting older.

‘I’d give anything to see my dad’s age now,’ he says. ‘The way I treat things now is: this is my life plus one,’ Cormac says.