Clinical Condition

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Penile cancer

what is penile cancer?

As with any malignancy, penile cancer is an abnormal growth from the penis. It can arise from glans, prepuce (skin covering the glans) or from the shaft of the penis. Frequently penile cancer starts as a benign looking lesion.

who can be affected by penile cancer?

Unlike in western countries, in Indian subcontinent penile cancer is more common. It is more common in age group.

what are the risk factors for cancer penis?

Genital warts

Multiple sexual partners

Smoking

Poor hygine-possibly a risk factor but not conclusively proven

Herpes simplex infection-commonly transmitted sexually

can penile cancer be prevented?

Circumcision at birth decreases the risk of penile cancer. To certaint extent risk is reduced by circumcision in pre-pubecent individuals. however risk is not reduced by doing circumcision in adults.

Avoiding above mentioned risk factors.

what are the symptoms of penile cancer?

Penile cancers usually begin as a small painless discoloration or bump not unlike a wart on the glans or prepuce. Some tumors may appear as a sore that refuses to heal. They gradually expand around the surface until eventually covering the entire glans. As they grow along the surface the also grow into the surface slowly invading the shaft of the penis.

How is penile cancer diagnosed?

Primary mode of diagnosis is biopsy. During biopsy, a small piece of tissue from the growth or the ulcer is taken and sent for pathological examination.

Once the diagnosis of penile cancer is made, other tests are done to detect spread of tumour to other organs like lung, liver, bones etc. It includes

blood tests like liver function tests, complete blood count

Chest X-ray

Computerised tomography of abdomen and pelvis

What is the treatment for cancer penis?
Surgery

The goal of surgery is to remove the cancer and the threat it poses. In the instance of small, well-defined tumors that are confined to the prepuce, only the tumor and a little extra tissue are removed. A technique called microsurgery in which the surgeon uses a microscope to distinguish normal cells from malignant cells at the edge of the incision can minimize the amount of tissue being removed adjacent to the tumor. Laser surgery has also been used in these cases.

More adjacent tissue is removed when the tumors are larger than 1.5 cm, a little over half an inch. Studies have shown that when only the tumors and minimal amounts of adjacent tissue are removed, up to half of the cancers recur. When the cancer involves a substantial portion of the head of the penis and has started down the shaft, a partial amputation is recommended.

Removal of any less substantially raises the risk of recurrence and a second operation. Penectomy (amputation) and radical penectomy (amputation plus removal of lymph nodes in the groin) are the preferred surgeries when the cancer has spread substantially.

Topical treatment

When the cancer is diagnosed at its earliest stage while it is still confined to the skin surface, it may be treated with a topical anti-cancer agent such as 5-fluorouracil.

Radiation

Radiation treatment is also reserved for selected patients whose cancers are small and have yet to penetrate deeper than the surface of the skin. Two radiation treatment approaches are available. External beam radiation aims the radiation like a tightly focused flashlight beam on the tumor. Several treatments are usually required. Brachytherapy involves creating a radioactive mold which is placed over the penis and worn for 12 hours a day for a week. These treatments are also applied to men who refuse surgical interventions and as a palliative therapy for those whose cancer has metastasized.

Chemotherapy

There are a variety of drugs that are administered intravenously in patients whose cancers have metastasized beyond local lymph nodes and the pelvic area. Some chemotherapies are combined with radiation treatments.

Can penile cancer be prevented?

The sooner penile cancer is detected, the greater the chances of beneficial therapeutic outcomes. Any suspicious discoloration, bump or ulcer on the penis should be called to the attention of a doctor.