A sense of humor can be a good thing to have; you never know what it will get your patients through. Cancer of the penis is a good example. Although there is never anything funny about cancer, a group of researchers in England found that humor helped patients make light of their situation. The researchers were curious about “how men with penile cancer construct humor in relation to their diagnosis and treatment.”1 They also looked at how some of the nursing staff used humor in their interactions with patients with penile cancer.

Treatment for this rare cancer can leave survivors with difficulty voiding and potentially devastating consequences for sexual functioning. The researchers note that humor is especially useful for a male patient who feels vulnerable in a health care setting. Peter Branney, PhD, and his group at Leeds Metropolitan University in Leeds, United Kingdom, wanted to explore the experiences of men as they went through the diagnosis and treatment process for penile cancer.1 The group used this insight when creating the patient-based information resource healthtalkonline.org.

Penile cancer is very rare, and the British group had to work within the limitations of a small sample size. Selection criteria were based on age, disease severity, and type of treatment. Study participants were 10 men age 35 to 84 years, primary treatment ranged from a surgical excision of the glans (5 patients) to a total penectomy (1 patient).

COPING MECHANISMS

The researchers divided the participants into two focus groups, which enabled them to discuss living with penile cancer. The participants gave the researchers a list of key topics to use in interviews about their disease, and the participants used those topics in subsequent interviews with each other. Thus the focus groups delineated the participants’ priorities, while the interviews went into detail about each man’s experience. The researchers recorded the focus groups and interviews.1 Four themes emerged from their analysis: laughing about urination, humor with health professionals, humor discounted, and fear of ridicule.

Laughing about urination Surgical excision of the cancer left the men with a changed anatomy that forced them to change how they performed daily functions. For example, the men could no longer stand up when urinating. Although sitting down to urinate felt abnormal, they were able to make light of the need to sit in a cubicle to urinate. “Because I don’t know which way it’s going to come out…. If I stood up I might shower him at the side of me.”1 Urinary dysfunction was more tolerable when they could relate their experiences to other men facing the same challenges, and laugh about them.

Humor with health professionals Health professionals reported that they used humor to put the patient at ease.1 One man lost his fear of pain during suture removal because the nurse joked with him. Another participant said he joked about having a sex change when he talked with a surgeon prior to his surgery. When the nurses felt comfortable initiating the humor, the patients really enjoyed it. A participant commented, “When you put a bit of a lighter side on it, it just made you feel a little bit better.”1