Men who are not circumcised are at greater risk for Penile Cancer:

What is Penile Cancer? 

Much more common in Haiti, cancer of the penis is rare in the United States. But, if you are uncircumcised, infected by the HPV virus, and practice poor penile hygiene you are at risk. Therefore, diagnosing penile cancer early is critical. The information here should help you diagnose this tumor long before it becomes life-threatening. Penile cancer is very rare in Jewish males, for whom circumcision at birth is the accepted ritual.

What are Symptoms of Penile Cancer? 

The earlier penile cancer is found, the easier it is to treat . If it’s found early, there is a good chance for successful treatment and a cure. If diagnosis is delayed, the disease can get worse. Treatment for more advanced cancer may be less successful and more disfiguring.

Since you see and touch your penis when you urinate, you can help spot the disease early. Men who are not circumcised are at greater risk for penile cancer.

You should see your health care provider if you notice any of these on the foreskin, or the shaft or head of your penis:

o An area of skin becoming thicker and/or changing color o A lump on the penis o An ulcer (sore) that might bleed o A reddish, velvety rash o Small, crusty bumps o Flat, bluish-brown growths o Smelly discharge (fluid) under the foreskin o Swelling

Most of these signs may be from a bacterial or fungal infection, or even an allergic reaction. All of these will respond to antibacterial or antifungal ointments and creams. But growths that return or sores that don’t heal must be thought of as cancer until it’s proven they’re not.

Penile cancer is often, unfortunately, ignored until it is advanced. Patients are reluctant or embarrassed to talk about their genitals. Or, they may be afraid of treatment or surgery on the penis. If you notice any of these signs, it’s important to have them checked by a health care provider as soon as you can.

What are Causes of Penile Cancer? 

Penile tumors are thought to be caused by body fluids that get trapped in the foreskin. If they aren’t washed away on a routine basis, they can have cancer-causing effects. Older men and smokers are more likely to get penile cancer. Conditions like AIDS can lead to penile cancer.

Another possible cause may be the human papilloma virus (HPV). HPV is a virus passed through sex. Antibodies to HPV-16 have been found in many patients with penile cancer. HPV is known to play a role in cervical cancer as well. Men who keep clean with good genital hygiene and who are circumcised are much less likely to get penile cancer.

How is Penile Cancer Diagnosed? 

Penile cancer is diagnosed with a biopsy of the penile mass or lesion. This is when a small sample of tissue is removed from the penis and examined under a microscope. If the cells look like cancer cells, they will be “staged.” The cells are also given a “grade”. This is a measure of how abnormal the cells look. The grade is often a number, from 1 to 4. The higher the number, the more abnormal the cells look. Higher-grade cancers tend to grow and spread more quickly than lower-grade cancers. The TNM system is used to stage the penile cancer. A Tis is the most superficial cancer and the T4 is the deepest and highest staged tumor. The higher the T number the most likely the cancer will present with metastasis ( see Figure ) . Penile cancer can be very deadly.

If your doctor believes that cancer has spread to nearby lymph nodes, other tests will be done. A lymph node biopsy will help determine the cancer’s stage and grade. If cancer is thought to spread to other parts of the body, imaging tests such as CT, MRI or PET scans . If tests suggest cancer spread , prompt care and regular follow-up will be very important.

How is Penile Cancer Treated? 

If penile cancer is found early, it can be treated with success and low risk. If the tumor is on top of the skin, it may be treated with a skin cream. This cream has few side effects. External beam radiation is also a therapy for small superficial lesions.

If the lesion is larger, but still about the size of a pea, a small local excision or “Moh’s surgery” may be done. This is a type of surgery where layers of abnormal tissue are “shaved off “until normal tissue is reached. With both of these methods, the penis should still look normal and work as usual. But careful follow-up is vital to check for early recurrence. With small lesions, it’s not likely that cancer has spread to the lymph nodes. For this reason, it’s often not necessary to remove the lymph nodes.

With larger lesions, more tissue needs to be removed. Your surgeon will also consider taking out or draining lymph nodes in the groin. A mix of surgery, radiation, and chemotherapy may be needed. In cases where the cancer is more advanced, the entire penis may need to be removed. This procedure is called a total penectomy.

Early detection is very important. Men should frequently self examine their penis for new lesions. It not only ensures better results and survival but also allows less debilitating surgeries.

Frequently Asked Questions

Is penile cancer contagious? Can I pass it on to others? 

Until recently, penile cancer was mostly thought to be caused by chemical irritation. For this reason, there was no worry about transmitting it. But recent data have linked the HPV to both penile and cervical cancers. There seem to be more cases of these cancers in the spouses of people with this sexually transmitted disease. Thus, while penile cancer isn’t transmissible, if you or your partner has HPV, you should wear a condom during sex. You should also be aware of any lesions. Women should have cervical examinations often. It’s important to eliminate or minimize the infection. It’s also important to talk with your urologist about HPV’s link to penile cancer.

Does an operation on the penis mean that I won’t be able to stand to empty my bladder? 

If your cancer is found early, the surgery needed shouldn’t affect your ability to stand when you urinate. The surgeries needed for more advanced cancer may cause you to have to sit when you urinate.

Will the treatment affect my ability to have sex? 

Early detection and minimal surgeries shouldn’t interfere with normal sex. More extensive procedures might lead to partial or complete penile amputation. These aggressive operatives might lead to difficulty voiding per penis and sexual activity.

Sources :1- www./urologyhealth.org,

2- Campbells Urology

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