Cancer is when cells grow out of control. They can invade nearby tissue and spread to other parts of the body.
Penile cancer happens when cells in or on the penis start to grow uncontrollably. It’s not clear why this sometimes happens, but there are some risk factors that may make certain guys more likely to develop it. It is most often diagnosed in men over the age of 60 years. It’s rare. But it can be treated, especially if it’s found early on.
There are several types of penile cancer, including:
squamous cell carcinoma, which begins in flat cells called squamous cells. It accounts for about 90% of cancers that start in the penis. It can spread to nearby lymph nodes and other parts of the body.
CAUSES OF PENILE CANCER
The specific aetiology of penile cancer is uncertain. It’s assumed to have something to do with overall cleanliness, and it’s far less prevalent among males who had all or part of their foreskin removed shortly after birth. This is because males who haven’t been circumcised may find it more difficult to draw the foreskin down far enough to clean below completely. Human papillomavirus (HPV), which causes penile warts, also raises the risk of penile cancer.
Men older than 50 have a higher risk than younger men.
Being circumcised as a baby may lower your risk for penile cancer later in life. Talk with your doctor about the benefits and risks of circumcision before you make a decision for your child.
Certain human papillomavirus (HPV)
HPV is a group of viruses that can cause warts on or around your genitals. Some types of HPV can lead to penile cancer if you have them for years without treatment. It’s passed from one person to another during sex or other intimate skin-to-skin contact. There are vaccines for boys and girls that help protect against HPV infections, but they aren’t given after age 26.
Smoking tobacco and marijuana
They may raise your risk if you smoke them regularly or over a long time period. Smoking cigarettes may increase your risk for penile cancer. It can also make your treatment less effective.
Poor hygiene, primases
If left untreated, certain skin disorders that affect the penis might progress to cancer. It is critical to consult your doctor if you observe white spots, red scaly patches, or red wet areas of skin on your penis so that you can receive the necessary treatment.
The cancer of the penis is not contagious and cannot be spread to others. It is not caused by an inherited defective gene; thus it is unlikely that other members of your family would contract it.
PENILE CANCER SIGNS AND SYMPTOMS
a) The initial indicators of penile cancer are usually a change in skin colour and thickness.
b) A growth or sore on the penis, notably on the glans (head of the penis) or foreskin, but sometimes on the shaft of the penis, are later signs.
c) It’s possible that there will be a discharge or bleeding. The vast majority of penile malignancies are painless.
d) Flat, bluish-brown growths, a red rash, or little crusty pimples are all possible symptoms of cancer.
e) When the foreskin is pushed back, the malignancies are often only visible.
f) These symptoms might be caused by something other than cancer. Cancer of the penis, like other malignancies, is simplest to cure if caught early.
HOW IT IS DIAGNOSED FOR PENILE CANCER
Your primary care physician will evaluate you and may refer you to a hospital expert for treatment and guidance.
The doctor will inspect your whole penis as well as your groyne lymph nodes. The lymph nodes may expand if the malignancy has spread to them. The doctor will remove a sample of tissue (a biopsy) from any painful or atypical regions on the penis to get a definitive diagnosis. This is normally done under a local anaesthetic, which numbs the region. A microscope will be used to analyse the biopsies.
FURTHER TESTS OF PENILE CANCER
If the biopsy reveals that you have cancer, your doctor may order further tests to determine whether the disease has outspread. Cancer can have extended throughout the body via the circulation or the lymphatic system. The lymphatic system is an important aspect of the body’s defence mechanism against infection and illness. The lymphatic system consists of a network of lymph glands (also known as lymph nodes) connected by small ducts that carry lymph fluid. The findings of these tests will aid the specialist in determining which treatment option is appropriate for you.
X-ray of the chest: A chest x-ray is routinely taken to see if the cancer has gone to the lungs.
CT scan (computerised tomography): A CT scan is a sort of x-ray that is highly specialised. To create a detailed image of the inside of the body, a succession of photographs are taken and processed into a computer. The scan will reveal if the cancer has expanded to other places of the body or not. It takes few minutes to half and hour and is painless.
Biopsy of lymph nodes If you have any swollen lymph nodes in your groyne, your doctor may take a sample of cells by inserting a needle into the node. This is to see if the enlargement is caused by cancer. Infection, not cancer, is the most common cause of enlarged lymph nodes.
STAGING AND GRADING FOR PENILE CANCER
Staging of Penile Cancer
A cancer’s stage refers to the size of the tumour and whether or not it has migrated beyond its initial location. Knowing the specific kind and stage of cancer aids doctors in determining the best treatment for you.
Stage 1 The cancer narrowly attack the skin which surround the penis, the head of the penis (glans), or the foreskin.
Stage 2 The cancer has progressed into the shaft of the penis or into one of the groyne lymph nodes.
Stage 3 The cancer has spread to multiple lymph nodes in the groyne or deep into the shaft of the penis.
Stage 4 The malignancy has progressed to deep pelvic lymph nodes or other regions of the body.
Recurrent cancer occurs when your cancer returns after initial therapy.
Grading describes how cancer cells appear under a microscope and provides an estimate of how rapidly the disease will progress. Low-grade cancer cells have a similar appearance to normal cells, are sluggish to develop, and are less likely to spread. The cells in high-grade tumours have an aberrant appearance, are more likely to develop fast, and are more possibility to expand.
Treatment of Penile Cancer
The sort of therapy you receive will be determined by several factors, including the location and size of the cancer, whether it has spread, the disease’s grade, and your overall health.
Surgery, radiation, and chemotherapy are all may be used to diagnose penile cancer. Surgical procedures have improved in recent years, and it is typically feasible to maintain the penis or reconstruct it. Men with penile cancer should seek treatment at a specialised cancer centre.
Surgery of penile cancer
Small, non-spreading surface tumours are treated by removing only the afflicted region. Traditional surgery, laser surgery, or freezing can all be used to eliminate the malignancy (cryotherapy). Cryotherapy is a treatment that uses a cold probe to freeze and destroy cancer cells. If the cancer is limited to the foreskin, circumcision may be the sole treatment option.
All of the therapies listed above may normally be done as an outpatient procedure. Depending on the conditions, they may be performed under local or general anaesthesia.
Excision of a large area If the cancer has progressed to a larger region, you’ll require a procedure called a broad local excision. This entails eliminating the malignancy while leaving a healthy tissue boundary around it. This healthy tissue barrier is crucial because it lowers the chances of the cancer returning in the future. The procedure will be performed under general anaesthesia and will need a brief stay in the hospital.
Getting rid of the penis (penectomy) If the is huge and covers a considerable region of the penis, this may be recommended. Amputation can be partial (when only a portion of the penis is removed) or total (where the entire penis is removed) (removal of the whole penis). The best procedure for you is determined by the location of the tumour.
Total amputation may be the sole choice if the tumour is at the base of the penis.
If there is proof or a probability that cancer cells have moved to the lymph nodes in the groyne, the surgeon may remove those as well.
Reconstructive surgery is a type of surgery that helps to rebuild a After amputation, it is frequently feasible to have a penis rebuilt. This necessitates another procedure. Taking skin and muscle from your arm and utilising it to create a new penis is one of the procedures that may be employed. It is sometimes feasible for surgeons to reconnect part of the nerves in order to restore feeling and blood flow to the repaired penis, allowing it to become erect.
This sort of surgery is performed by surgeons with specialised training, and you may be required to go to a specialty hospital for the procedure.
Radiotherapy is a cancer treatment that uses high-energy radiation to eliminate cancer cells while causing as little harm to healthy cells as feasible. It can be used prior to or following surgery. If the disease has progressed to other regions of the body, such as the bones, radiotherapy may be used to address symptoms such as pain.
External radiation is usually administered in the hospital’s radiotherapy department as a series of brief daily sessions. A equipment emits high-energy x-rays that are focused at the cancerous spot. The treatments are normally administered Monday through Friday, with a weekend break. It takes 10–15 minutes for each treatment.
The number of treatments required can vary depending on the kind and size of the disease, but therapy for early cancer might take up to six weeks. Your doctor will talk to you about the therapy and any potential adverse effects.
The radiographer will carefully place you on the sofa before each session of radiation to ensure that you are comfortable. You will be left alone in the room for your treatment, but you will be able to communicate with the radiographer who will be observing you from the next room.
Radiotherapy is not uncomfortable, although it does need you to lie motionless for a few minutes while it is administered. You will not become radioactive as a result of the treatment, and it is totally safe for you to be around other people, including children, thereafter.
Implants containing radioactive materials A radioactive implant can be used to deliver radiotherapy. Brachytherapy is another name for this procedure. Small radioactive wires are carefully positioned in the afflicted part of the penis under a general anaesthesia. The wires are left in situ for 4–5 days before being removed. Smaller tumours on the end of the penis are frequently treated with this procedure (the glans). You must stay in an isolated room in the hospital while the implant is in place so that other people are not exposed to the radiation needlessly.
Side effects of radiotherapy
The penis may have adverse effects as a result of radiation treatment. The skin on your penis may get painful and break down as your therapy progresses. Radiotherapy can cause healthy tissues to thicken and stiffen over time (fibrosis). This might cause constriction of the tube that transports urine through the penis (the urethra) in certain men, making it difficult to pass pee. If the urethra narrows, it may typically be eased by a procedure that stretches (dilates) the region. This is done under general anaesthesia and involves inserting a tube into the urethra.
Chemotherapy of Penile Cancer
Chemotherapy is the treatment of cancer cells with anti-cancer (cytotoxic) medicines. It might be a single medicine or a combination of substances. It is not usually used to treat penile cancer. Chemotherapy cream may be used to treat extremely tiny, early malignancies of the foreskin and penis (glans).
For more advanced cancers, chemotherapy can be administered as pills or as an injection into a vein. It might be used in conjunction with surgery or radiation (or both).
CLINICAL TRIALS OF PENILE CANCER
New treatments for penile cancer are constantly being investigated. Cancer doctors utilise clinical trials to test new medicines. Before a research can begin, an ethical committee must approve it and agree that it is in the best interests of the patients.
There’s a chance you’ll be asked to take part in a clinical experiment. Your doctor should go over the therapy with you so that you understand everything there is to know about the research. After then, you may decide whether or not to take part in the trial at any moment. After that, you’ll receive the best standard treatment available.
You’ll get frequent check-ups and maybe scans or x-rays once your therapy is over. These will most likely last for several years. Between these periods, if you have any issues or notice any new symptoms, contact your doctor as soon as possible.
YOUR FEELINGS AND SUPPORT
The need for physical and emotional assistance will, of course, be unique to you and may be influenced by the therapy you get as well as any potential adverse effects. Some surgeries or radiation, for example, may impair your ability to have an erection and pass urine regularly. Your expert will advise you of any potential adverse effects and how to cope with them before you consent to treatment.
You may be affected by a variety of emotions. Anger, guilt, worry, and fear are just a few of the most prevalent emotions humans experience. You could get emotional, agitated, and unable to sleep. It’s possible that you’re depressed and despairing. These are all natural emotions, but admitting them may be difficult and painful.
You don’t have to deal with these emotions alone; there are individuals who can assist you. Some hospitals have their own emotional-support services, staffed by professionally trained personnel, and some nurses on the ward will have had counselling training. You might feel better at ease speaking with a counsellor or a religious leader outside of the hospital setting.
SEX AFTER PENILE CANCER
You could be concerned that you won’t be able to have sex again. The majority of penile cancer treatments, on the other hand, have no effect on your ability to have sex. However, some men who have had a portion of their penis removed, as well as those who have had their entire penis removed, will notice a difference in their sex life. This can be quite upsetting, and coming to grips with it may take some time.
Talking to your spouse about how you’re feeling and the changes in your relationship might be beneficial. This can be quite challenging, and you may require the assistance of a skilled nurse or therapist. They may be able to assist you and your spouse in dealing with these changes. A counsellor or professional nurse may typically be arranged by your medical practitioner, hospital doctor, or one of our cancer support service nurses.