The mere mention of penile cancer conjures up much fear and uncertainty among public imagination, especially among grown men. It is not a common cancer in Singapore, hence it is not well known to the public. We shall explore more details in this article about this little known cancer.
What exactly is penile cancer?
Penile Cancer happens when the normal cells of the skin and tissue of the penis turns malignant and grows beyond control, forming a tumour. Penile cancer may eventually spread to other parts of the body including other glands, lymph nodes or organs.
Penile cancer is typically a disease of older men, with most patients around the age of 60 when diagnosed. In developed countries like the USA, Europe, Singapore, penile cancer is rare, accounting for less than 1% of all cancers diagnosed. This is in contrast to less developed countries like South America, Parts of Africa and Asia where penile cancer can account for 10 to 20% of all cancers diagnosed.
Signs and Symptoms of penile cancer
The majority of penile cancers arise from the head of the penis or from the foreskin. The most common findings on examination is a painless lump or an ulcer. The symptoms may include bleeding, rash or balanitis. 30 to 60 percent of patients also have swollen lymph nodes in the groin as well.
What is the cause of penile cancer?
The majority of penile cancers are squamous cell carcinoma (SCC) and its many variants. Other cancers which can affect the penis include basal cell carcinoma (BCC), Kaposi Sarcoma (KS), melanomas and other lymphomas.
Who is at risk for penile cancer?
- Patients with previous known medical condition of the penis. This would include warts, infections, previous injury, tears or strictures
- Phimosis. Uncircumcised males sometimes have a thickening and scarring of the foreskin. This is a condition known as phimosis, which is a difficulty in retracting the foreskin over the head of the penis.
- Human Papillomavirus infection (HPV). HPV can be found in 30% to 50% of penile cancers.
- Smoking and Tobacco Exposure
- Human Immunodeficiency Virus (HIV) Infection
- Patients with previous Ultraviolet treatment for psoriasis.
Who to prevent penile cancer?
- Patients who have phimosis can consider getting a circumcision.
- Vaccination against HPV early can also be useful in preventing infection and possible penile/anal cancer. Screening for High Risk HPV through a swab can also be useful in patients who have risk factors.
- Patients who are smokers should definitely stop smoking not only to prevent penile cancers but other forms of cancers as well.
What are the treatments for penile cancer?
Treatment of penile cancer depends on the type and staging of the cancer. If disease is limited, organ preserving treatment options include topical medications, lasers, radiation therapy or micrographic surgery. If the cancer is advanced and locally extensive, a partial or even full amputation of the penis might be required.
What are the complications of penile cancer?
After treatment, patients might be faced with complications depending on the kind of treatment. For organ preservation treatments, issues with cosmesis, erectile dysfunction and reduced sensation are common. For surgical treatments, for example a penile amputation, patients might require an external opening known as a urethrostomy for urination. Patients might also require a surgical reconstruction of the amputated organ for cosmetic issues.