Penile Cancer

written by Dr George Lee Eng Geap on 28 December 2011

 

Penile Cancer
 
What causes penile cancer?
 
Penile tumours are caused by secretions that become trapped within the foreskin if they are not washed away on a regular basis. This malignancy is more common in South and Central America, and Third World countries. This cancer is also more common in men who are not circumcised. Penile canceris also related to human papilloma virus (HPV), which already has strong links to cervical cancer.
 
How is penile cancer diagnosed?
 
Patients are often reluctant or embarrassed to call attention to their genitalia and may be afraid of surgical procedures or treatment of the penis. Therefore, when the malignancy is diagnosed, it may be too late. The earlier the diagnosis, the more effective the therapy and the better the chance for cure. The delay in the diagnosis may result in the tumour progression and resulting in the therapy to be less successful and more disfiguring. The penile cancer may present as skin erosion, ulcer, sore, irritation, discoloration that is noticed on the foreskin, the skin of the shaft of the penis or the surface of the head of the penis.Although there is a possibility that the abnormality may result from an infection, the appropriate evaluation includes biopsy where the tissue is removed for examination under a microscope, may be necessary to determine the diagnosis.
 
How is penile cancer treated?
 
The treatment of penile cancer depends on the size, location, grade and the stage of the cancer. Early detection and identification of penile cancer are very valuable because the treatments that can provide successful outcome. If the tumor appears on the skin surface, your urologist may be able to treat the problem with a topical cream that has minimal side effects. If the lesion is larger, surgery that remove the abnormal tissue may be performed. This may result in the loss of function and the structure of the penis. Careful long term follow up is also critical to identify early recurrence. The cancer may also have spread to lymph nodes and, therefore, removal of the lymph nodes may be in the groin may be necessary to achieve cure. In these circumstances, a combination of surgery, radiation and chemotherapy may also be necessary.
 
What can be expected after treatment for penile cancer?
 
Your post-treatment experience will be dependent on the stage of your cancer when it is diagnosed. Cure is almost certainly ensured when lesions are detected early. When the tumour is more progressive, the treatment may become increasingly more debilitating.
 
Frequently asked questions:
 
Is penile cancer contagious? Can I pass it onto others?
 
Until recently, the general consensus was that penile cancer was caused by chemical irritation and there was no concern about transmitting it. But recent data have implicated the HPV in both penile and cervical cancers. There appears to be increased incidence of these cancers in the spouses of people with this sexually transmitted disease. Thus, while penile cancer is not directly transmissible, if you or your partner has HPV, you need to use protection during intercourse, be aware of any lesions, and, if you are the woman, have frequent cervical examinations. Not only are efforts to eliminate or minimize the infection important but so are discussions with a urologist or other specialist about its link to penile cancer.
 
Does an operation on the penis mean that I will be unable to stand to empty my bladder?
 
If your cancer is detected early, the surgical procedures should not impact your ability to stand when you urinate. When the cancer is more advanced, the required surgical procedures may require you to urinate in the sitting position.
 
Will treatments interfere with my ability to have sex?
 
Early detection and minimal surgical procedures should not interfere with normal sexual function. More extensive procedures might, however.
 
Should all male children be circumcised soon after birth to prevent penile tumors?
 
This question creates much debate. Some experts believe that sexual sensation is diminished after circumcision, even though evidence points to a lower incidence of urinary tract infections and penile cancer in men who have had the procedure. Parents should discuss the risks and benefits of circumcision with the child\'s doctor.
 
If a male has not been circumcised soon after birth, will later circumcision as a teenager or young adult protect him from penile cancer?
 
There is now evidence that circumcision soon after birth is the most reliable protection from subsequent penile malignancies. A procedure performed in young adults does not have nearly the protective effect as when it is done in infants. Penile cancer is extraordinarily rare in Jewish males where circumcision at birth is an accepted ritual, but more common in the Muslim population where circumcision at puberty is the established ritual. But it is not as common as in those individuals who have never been circumcised.