Penis Cancer Protocol

[moi621 (imported)]

http://news.yahoo.com/doctors-disagree- ... 31347.html

HELBYVILLE, Ky. (AP) — Doctors called to testify in the civil trial of a Kentucky urologist who amputated part of a man's penis without consulting him differed Tuesday on whether it was necessary to remove the cancerous portion immediately upon making the discovery on the operating table.

"I couldn't identify any emergency situation that dictated an amputation," Dr. David Benson, a 25-year urologist called as a witness for the plaintiffs, said on the second day of the trial in Shelby County Circuit Court.

Phillip and Deborah Seaton of Waddy are seeking undisclosed damages from Dr. John Patterson of Frankfort for not consulting them before the 2007 amputation.

Benson said that when Patterson found a cancerous lesion on Seaton's penis during routine circumcision surgery, he should have taken a biopsy and discussed options with the family before taking further action.

He said removing a man's penis is the "most psychologically debilitating" procedure and patients need to be evaluated to see if they can cope.

But Dr. David Paulson, the former head of Duke Medical Center's urology program, testified for the defense that Patterson had followed the proper standard of care in a life-threatening situation.

Paulson said it would have been medically risky for Patterson to interrupt the surgery to consult Seaton's wife, citing Phillip Seaton's sleep apnea as a concern.

On Monday, Patterson testified the cancer prevented him from inserting a catheter into Seaton's urethra, heightening the possibility of kidney damage from urinary retention.

Paulson said the cancer found during surgery had likely been there for 18 to 24 months.

"It's just so characteristic you can't miss it," said Paulson.

Patterson said he removed less than an inch of Seaton's penis. The rest of the penis was amputated by another doctor later, said Patterson's lawyer, Clay Robinson.

Patterson, called to the stand Tuesday by his attorney, said there had been no indication before surgery that Seaton was afflicted with deadly penile cancer.

Effectively repeating his testimony from Monday, the doctor said what began as routine surgery to relieve inflammation changed dramatically when he cut away the foreskin and found a diseased organ that wasn't recognizable as a penis.

Seaton, 64, and his wife, Deborah, are seeking unspecified damages for "loss of service, love and affection."

Reminds me of the ladies who were to be awakened from anesthesia to "approve" the mastectomy, then go back under. Waking up later and denying the approval.

On the other side of the coin I do know two hospital captives who refusing surgery, were given "cocktails" as to make them agree to anything.

As a result of the anti circumcision movement of some decades, " gone it" we men deserve a solid cancer/penectomy protocol. I doubt lumpectomy would be an option.

Moi

With the movement away from cosmetic prosthesis, I would want a glow in the dark one.

[Mac (imported)]

I would want to be consulted. A partial penectomy would be totally unacceptable to me.

If mine ever has to be removed I would want nothing less than total removal of the penis, testicles and scrotum.

[Richard_Less (imported)]

I recall reading in one article on this story that the doctor claims he had the authority/permission/consent/whatever to perform any procedure he deemed necessary. That kind of blanket power should not supersede "common sense", human dignity, and informed consent.

If doctors can take such liberties without considering the context of such authority then a general protocol (if it's not already in place) should be established and enforced for all procedures, rather than just for penectomies. Imagine going under to have a bunion removed and wakeup without a foot (set aside the fact you wouldn't likely have a bunion removed under general anesthesia).

Once the prognosis changed (i.e. cancer discovered) the operation should have ended, except for perhaps doing a biopsy, if that could have been done safely. Removing anything that wasn't planned to be, whether it's a penis, uterus, breast, or pinky toe, would be traumatic to anyone, some parts more so than others.

Granted there are legitimate emergency circumstances that can truly justify a surgeon's decision, some things aren't. A patient deserves to be informed, if for no other reason than to prepare themself for the loss.

My understanding of a surgeon having carte blanche is more in the context that while performing a biopsy they discover that the cancer is malignant or fatally advanced that removing it then and there is necessary without hesitation. In such cases though, the patient would be aware that such a problem and treatment are possible and at least partially prepared for such an extreme outcome. Another example might be that during the course of some abdominal surgery appendicitis is discovered and the surgeons perform an appendectomy at the same time.

Anyway, my 2 bits, and hopefully my thoughts/opinions are coherent enough or you all.

[DeaconBlues (imported)]

It is hard to say one way or the other, all WE know is what we get in the news report.

If this had happened to me, I am not certain just how I would react to it. But my first thoughts were that the surgeon quite probably DID have good reason to do what he did, or at least it appeared to him that he had reason to immediately remove the cancer. I am just guessing, but I think he would have been quite correctly alarmed that the initial operation and surgery was going to agitate the tumor and antagonize the condition, and would in great likelyhood cause the cancer to become malignant if it had not already. Additionally, the fact that the INITIAL emergency surgery only removed about one inch and was followed up with a complete penectomy later by another surgeon, leads me to believe that complete removal was needed.

Finally, I consider the AGE of the patient, now let's be honest, at age 64, most men can still have some pleasure from sexual activity, but that pleasure is SEVERELY diminished from the levels of pleasure enjoyed by a twenty year old man. I think the plantiff in this case is being very unrealistic about the levels of damage and "loss of service, love and affection" in this case.

So, IF this had happened to me, I believe that after the initial shock, I would have probably reasoned that the decision of the surgeon was probably correct. I would have LIKED to have been consuted before hand, and I do believe that many "medical professionals" behave with contemptable arrogance in their automatic assumtion that they know better than anyone what is "best" for everyone. Still, in this case, I think the immediate removal was justified.

[YourPhriendlyAuthor (imported)]

Unfortunately, the jury sided with the doctor.

Ultimately, with the cancer the way it was, the penis would have *had* to have been amputated. The problem, though, is that there's a *serious* emotional trauma that's going to occur, and the couple should have been given the chance to *prepare* for that loss!

Even though the cancer seemed to be advanced, it didn't sound like the amputation had to be performed *immediately*. If it was a case of, say, gangrene, where a lethal situation would be almost *certain* to occur if the doctor waited, I could see going ahead with it, but in this case, I wouldn't see a problem with waiting a day or two, so that the patient and his wife would have been *ready* for what had to happen!

It'll be interesting to see what happens with the appeal...

-YPA

http://www.washingtonpost.com/national/ ... story.html

Ky. jury rules against patient who sued urologist over penis amputation after cancer found

SHELBYVILLE, Ky. — A jury on Wednesday ruled against a Kentucky truck driver who sued his urologist claiming the doctor amputated part of his penis without his consent.

The six-man, six-woman jury deliberated briefly before coming back with the verdict in the lawsuit filed by 64-year-old Phillip Seaton, and his wife, Deborah,

in Shelby County Circuit Court.

The jury ruled unanimously against the claim that

Dr. John Patterson of Frankfort

had failed to exercise proper care. It ruled 10-2 against the claim that Seaton hadn’t consented to the amputation.

Jurors were told that Seaton had gone to Patterson seeking a circumcision in 2007, but the doctor decided to amputate part of the organ after he found potentially deadly cancer during surgery.

All jurors, including the forewoman, declined to comment as they filed out of the courthouse aft

er the trial.

Seaton, who with his

wife of 35 years had been seeking more than $16 million in damages for “loss of service, love and affection,” also declined to comment after the verdict.

The Seatons’ attorney, Kevin George, said in closing arguments, “Phillip has changed. He was mutilated. His manhood was taken.”

George said he planned to appeal the decision on the grounds that a doctor is allowed to change a consent for surgery only if there is a danger of imminent death.

“There was no emergency, no reason to do it,” George said of the amputation.

Patterson said after the verdict, “I think we’re feeling pretty good.” He declined to say more about the highly publicized case, calling one reporter who tried to question him “a member of the tabloid press.”

“We feel like justice was done,” the doctor’s attorney, Clay Robinson, said.

“No doctor ever wins a malpractice action,” Robinson said. “It’s just a matter of how much you lose by.”

The key question of the case revolved around whether Patterson should have halted the surgery when he made the surprise discovery of penile cancer, then consulted the Seatons before taking further action.

Seaton, a heavyset former truck driver from Waddy sporting a long, gray ponytail and gray beard, receives Social Security disability payments because of arthritis and bad eyesight, according to court testimony. Clad in a button-down shirt, he showed little reaction through most of the three days of testimony but said on the witness stand that he was “bad case” emotionally after hearing the news of the partial amputation and had wanted to run from the hospital.

“I didn’t have no say in it,” Seaton said. “I wasn’t told what had to be done. It was just done.”

According to court testimony, Seaton had told his general practitioner during a routine examination that he was experiencing burning when he urinated and was prescribed a cream. When symptoms persisted, the doctor later referred Seaton to Patterson, who recommended a simple circumcision, according to court testimony.

Seaton had testified that he had not been told prior to the surgery that it would be anything but a circumcision, and had even joked with his doctor about the procedure.

But Patterson testified Monday that when he cut the foreskin, the tip of the penis had the appearance of rotten cauliflower, indicating cancer. A pathologist later testified that tests confirmed the diagnosis.

“What I saw was not a penis. What I saw was cancer,” Patterson had testified.

Patterson said he removed less than an inch of Seaton’s penis. The rest of the penis was amputated by another doctor later,

Patterson’s lawyer said.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

[A-1 (imported)]

What the article probably DIDN'T say was that in all probability the part that was removed was gangrenous, and leaving the gangrenous part risked systemic sepsis which can likely be fatal.

If NOT fatal, serious complications, including major organ shutdown and heart valve infections are likely.

No, I would agree, somebody who would live with a penile cancer for TWO years until the growth is so large that it obstructs the urethra is bizarre to the extreme.

In addition, loss of services? Are YOU kidding me. Not only can you NOT beat a sore penis YOU CANNOT FUCK WITH IT, EITHER... and speaking of not fucking with something, cancer is near the top of the list, just under professional snipers...

:shakemitk

[SplitDik (imported)]

What I don't understand though, and what I think is malpractice, is that this urologist was involved in treating this "inflammation" and hadn't noticed the possibility of cancer or discussed it beforehand? I mean what kind of cursory care is that? If it "looked like cauliflower" then I think it would have been obvious before the guy went under.

Also, a person has the right to choose to die or whatever. Or to shop around for a doctor that is known for the best cosmetic result. Or to try some new therapy. It was life threatening but not an emergency.

The other issue is the pyschological one. Anyone who needs an amputation needs to get psychologically prepared for it. Just doing surgery is not sufficient to treat such a patient, and he obviously actually did harm.

However, I agree (and mentioned this in my thread on pictures of diseased penises which I recently posted) that it is weird that someone could let their penis get in such bad shape before seeing a doctor. The only disease I understand is Fouriers gangrene which progresses really fast (even 24 hours). But how can you have a penis that has cauliflower-like cancer.

[baldwin92 (imported)]

One of the items mentioned here in Kentucky news reports that was not noted in reference reports here was that Mr. and Mrs. Seaton were separated and had not lived together for several years. While not officially divorced, they were not a couple either. So while the questions of surgery were of primary concern the damages for loss of "service, love, and affection" towards Mrs Seaton could be taken as mute since they were not active as a couple anyway. It also may help answer the question of why Mr. Seaton didn't notice the cancer earlier, he wasn't using his penis for sex. As a juror I would have questioned her involvement in the lawsuit.