Saskatchewan

Penile implant helps Sask. man find a new normal after cancer

A Saskatchewan man says a penile implant changed his life after his recovery from prostate cancer. But the procedure isn't funded in the province.

Doctor calling on province to fund the procedure

Pictured is one version of a penile implant that is inserted into the body through surgery. The device includes a water reservoir, which allows men to pump it up to achieve an erection. (Kendall Latimer/CBC)

Stan Hanoski never imagined a penile implant would be his dream come true, but in the aftermath of prostate cancer it became just that.

The Regina man's journey began with a routine checkup in February 2015. Then 59 years old, Hanoski had gone for a checkup every year since he was 50.

This time the doctor's office called with the news no one wants to hear. Cancer.

For Hanoski, the cancer and what followed was a very personal attack on his body. 

"It was an aggressive cancer," he said, adding it had potentially escaped the envelope of the prostate.
When Stan Hanoski, 63, considered getting a penile implant he had many questions: what if it doesn't work? What if there are complications? But after trying everything else, the cancer survivor felt he had nothing to lose. (Trent Peppler/CBC)

Surgery was the only option. Six weeks later he went underwent a non-nerve sparing laparoscopic radical prostatectomy, which saw his prostate and some of the surrounding tissue removed.

You never know if your partner is thinking behind the scenes, 'Well gee, you know, maybe I need to trade them in for a better model.'- Stan Hanoski

The surgery was successful, but brought incontinence and erectile dysfunction.

The incontinence eventually subsided, but the ED did not.

Hanoski said he was initiallly prescribed pills like Viagra and Cialis. After a frustrating stretch of no results, his oncologist told him the pills would never work.

He said his wife of 44 years was understanding and supportive throughout the process. They married at 18. 

"You just sort of learn to get along differently, but you still are sort of searching for the magic pill," he said.

Hanoski invested in a penis pump — vacuum technology that stimulates an erection — and used it for about eight months. Unfortunately it had to be re-pumped often.

"It's very unromantic. It's very emotionally draining," he said. 

"You never know if your partner is thinking behind the scenes, 'Well gee you know maybe I need to trade them in for a better model.' "

Injections into the penis were another possibility, but that wasn't a good fit for Hanoski. 

He became emotionally withdrawn and began to feel depressed. He decided to approach Dr. Francisco Garcia, who practices in Swift Current, about a penile implant.

It certainly has not made me normal, but it has given me normalcy in my life.- Stan Hanoski

A penile implant is a device that's surgically inserted into the body to allow impotent men get an erection.

It can be inflated and deflated with an internal pump that sits inside the body but can be squeezed from the outside of the body.

For Hanoski, the surgery was life changing and in some ways, lifesaving.

"It was like a fulfilment of a dream. Prior to having cancer I would have never had that dream," Hanoski said. 

"It certainly has not made me normal, but it has given me normalcy in my life." 
Pictured is another version of a deflated penile implant and the take-home key chain practice pump that comes with it. (Kendall Latimer/CBC)

Surgery should be funded: doctor 

For some men, the surgery can be hard to access.

It hasn't been covered in Saskatchewan since 1993.

"It absolutely should be funded," said Garcia, the urologist at the Lonely Tree Medical Wellness Clinic in Swift Current.

Garcia said a patient will pay about $15,000 to $16,000 all-in for the procedure. It's about $7,500 to $9,000 for the device with the other half for hospital fees.

He said it should at least be funded for men who have lost potency because of diseases like prostate, rectal, colon or bladder cancer — which could damage nerves beyond repair.

"We have the same logic that we follow when we're looking at woman who undergo breast cancer surgery," he said.
Dr. Francisco Garcia wants penile implants funded by the provincial government. (Trent Peppler/CBC)

Garcia said penile implants can restore confidence and a sense of normalcy. Also, other options work for many men, meaning coverage wouldn't be a huge burden on the health care system, he said. 

"At best, probably somewhere between one and three per cent of men who have undergone pelvic surgery are going to even need an implant," he said.

Garcia suggested nobody would bat an eye if someone wanted to get their hip or knee replaced to improve their quality of life.
Pictured is a basic version of a penile implant. The rod surgically placed inside the penis and allows people to bend it up or tuck it down. (Kendall Latimer/CBC)

Formal request made in 2015

The Saskatchewan Medical Association (SMA) and the ministry of health are currently reviewing a request to insure the procedure, according to a ministry spokesperson.

A physician put forward the request to the SMA in 2015

"In reviewing the request, the SMA and the Ministry will consider factors such as medical necessity and standard of care. A recommendation will be made by early next year," they said in a statement.

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