Penile Cancer

How common is Penile Cancer?   

Penile cancer is a rare malignant disease, with an incidence of 0,1-0,9 cases/ 100.000 men in Western societies. On the contrary, there are countries in Africa, Asia and South Africa where penile cancer covers 20% of all male cancer cases. This difference is due to very poor genital hygiene in these countries. 

What are the causes of Penile Cancer?

Today it is believed that a significant etiological factor for penile cancer is chronic irritation due to the sebor (smegma) produced normally in the region. The risk increases when there coexists phimosis that does not allow for the removal of sebor or when there is lack of genital hygiene. HPV virus (Human PapilloVirus) has also been related to the development of penile cancer and particularly subtypes 16 and 18, which induce cervical cancer of the uterus. Lastly, smoking is another aggravating factor related to penile cancer.

How is Penile Cancer diagnosed?

The patient usually observes some painless change on penile skin -looking like a sore (ulceration) or cauliflower- which does not heal. In neglected cases (e.g. elderly patients) the lesion may be particularly extensive. It may occur at any spot of the penis but in the majority of cases it is formed in the glans and foreskin (the end part of the penis). The patient may also experience pruritus (itching), burning sensation or hemorrhage in the area of the lesion. In the early stages there is no pain; as a result, many patients do not ask for medical help because they feel embarrased. The patient will be clinically examined by the physician and, if the lesion is suspicious, a small specimen has to be obtained under topical anesthesia and sent for biopsy in order to have the final diagnosis. 

Is there need for further screening tests?

Penile cancer may metastasize to lymphnodes of the groin and pelvis, as well as to other organs (liver, bones, lungs and brain). If necessary, your physician will ask for futher imaging tests (UltraSound, CTscan, MRI, Bone Scintigram), in order to identify the stage of the disease. 

How is Penile Cancer treated?

Timely diagnosis is highly significant for the treatment of penile cancer. When the lesion is small, the problem can be treated with Laser or Cryopexy with very few side-effects. In larger lesions, there will be need for topical surgical resection, which does not affect though penile functionality. Close follow-up on a regular basis is necessary for there is high risk for recurrence either topically or at remote areas. In larger lesions, there may be need to remove part of the penis (partial penectomy) and at the same time remove lymphnodes from the groin and pelvis. The surgical procedure can be combined with radiotherapy and chemotherapy for higher efficacy. In some cases, external radiation may be applied, instead of undergoing partial penectomy.  Whatever the treatment,  though,  follow-up has to be very close so that, in case of cancer recurrence, this can be treated on time. 

What is the prognosis of Penile Cancer?

Survival depends on the presence or absence of  metastases to lymphnodes. When diagnosis is set early and lymphnodes have not been afflicted, 5-year survival rate ranges from 65-95%. When lymphnodes have been invaded,  the 5-year survival rate drops significantly. 

Is it possible to prevent Penile Cancer?

Read carefully about main prevention measures, by clicking  here.