Penile Cancer

Penile cancer is a disease in which malignant cancer cells form in the tissues of the penis. Human papillomavirus infection may enhance the risk of developing penile cancer.

Causes:

Some of the risk factors for penile cancer include:

  • Infection with the human papillomavirus (HPV)
  • People who are 60 years or older.
  • A medical condition called Phimosis due to which the foreskin of the penis cannot be pulled back over the glans
  • Poor personal hygiene.
  • Having multiple sexual partners.
  • Consumption of tobacco products

Circumcision will help to prevent the infection caused by the human papillomavirus (HPV). Circumcision is a surgical process which involves part or whole of the foreskin from the penis. Many boys are circumcised soon after their birth. Men who were not circumcised shortly after their birth may be vulnerable to the risk of developing penile cancer.

Signs and Symptoms:

  • Discharge and bleeding.
  • Redness, irritation, or sores on the penis.
  • Lump on the penis.

Diagnosing penile cancer

The following tests and procedures may be used:

  • Physical examination of the patient
  • Checking the medical history of the patient
  • Biopsy

The prognosis and treatment options for the patient mainly depend on the following:

  • The stage of the cancer.
  • The size and location of the tumor.
  • Whether the cancer has chances of recurring

Stages of penile cancer

Following the diagnosis of penile cancer, various tests are performed to determine if cancer cells have spread within the penis or to other regions of the body. It is extremely important to know the stage of the cancer in order to plan the appropriate treatment for the patient.

The following tests and procedures are frequently used in the staging process:

  • CT scan (CAT scan)
  • MRI (Magnetic Resonance Imaging)
  • Ultrasound exam

The following stages are used for penile cancer:

  • Stage 0: In this stage, abnormal or cancerous cells are present on the skin surface of the penis. The stage 0 is also known as carcinoma in situ.
  • Stage I: Cancer has already formed and spread to the connective tissue under the skin of the penis.
  • Stage II: Cancerous cells have spread to connective tissue under the skin of the penis and to one lymph node located in the groin; or may have spread to an erectile tissue and to one lymph node in the groin.
  • Stage III: Cancerous cells have spread to connective tissue or erectile tissue of the penis and to more than one lymph node on one or both sides of the groin; or it may have spread to the urethra or prostate, or to one or more lymph nodes on one or both sides of the groin.
  • Stage IV: Cancer has spread to tissues located near the penis and may have spread to lymph nodes in the groin or pelvis; or it may have spread to any region in or near the penis and to one or more lymph nodes deep in the pelvis or groin; or to remote parts of the body.

Recurrent penile cancer: Recurrent penile cancer is cancer that has recurred or come back after it has been treated.

Treatment

There are various types of treatment for penile cancer such as:

Surgery

Surgery is the most common treatment recommended for all stages of penile cancer. This includes Mohs microsurgery, Laser surgery, Cryosurgery, Circumcision, Wide local excision and Amputation of the penis.

Mohs microsurgery: It is a surgical procedure in which the tumor is removed from the skin in thin layers. This type of surgery is generally used to remove cancer on the skin.
Cryosurgery: Cryosurgery refers to a treatment that makes use of a special instrument to freeze and destroy abnormal tissue.
Wide local excision: This surgery helps to remove only the cancer cells and some normal tissue surrounding it.
Amputation of the penis: This surgery is used to remove part or whole of the penis. If only a part of the penis is removed, it is called Partial Penectomy. If the entire penis is removed, it is called Total Penectomy.

Some other types of treatment recommended for Penile cancer are Radiation therapy, Chemotherapy, Biologic therapy, Radiosensitizers and Sentinel lymph node biopsy followed by surgery

Biologic therapy

Biologic therapy is a treatment that utilizes the immune system of the patient to fight cancer. Substances or certain materials made by the body or created in a laboratory are used to direct or restore the natural defense mechanisms of the body against cancer. This type of cancer treatment is also known as biotherapy or immunotherapy.

Radiosensitizers

Radiosensitizers refer to drugs that make tumor cells much more sensitive to radiation therapy. Combination of radiation therapy with radiosensitizers helps in destroying more tumor cells.

Sentinel lymph node biopsy followed by surgery

Sentinel lymph node biopsy refers to the removal of the sentinel lymph node during the surgical procedure. The sentinel lymph node is the first lymph node that receives lymphatic drainage from a tumor and it is the first lymph node to which the cancer is more likely to spread to, from the tumor. In this process, a radioactive substance or a blue dye is injected in a site near the tumor. The dye passes through the lymph ducts to the lymph nodes. The first lymph node which receives the material or the dye is removed. A pathologist then examines the tissue under a microscope to confirm the presence of cancer cells. Following the sentinel lymph node biopsy, the surgeon removes the cancer.

If cancer cells are absent, it removal of more lymph nodes may not be required.

Follow-up tests or check-ups may be required

Follow-up tests or check-ups have to be performed to find out if the cancer has any chances of recurring. There are certain important tests which have to be performed from time to time even after the treatment has ended.