Facts and figures about penile cancer
Penile cancer is very rare, only around 550 new cases are diagnosed each year in the UK, but this is increasing, thought possibly to be linked to increase in sexually transmitted disease.
It is rare in those under 40 years of age and most cases are in men over 60years. Over 95% of tumours are squamous cell carcinomas. Risk factors include exposure to HPV, multiple partners before the age of 20, poor hygiene and possibly smoking or a depressed immune system.
Penile cancer symptoms
- Change in colour and /or thickening of skin.
- Non-healing growth or sore on the penis.
- Bleeding from the penis or foreskin.
- Foul smelling discharge.
- Difficulty in drawing back the foreskin (phimosis).
Diagnosis of penile cancer
Investigations may include:
- Physical examination
- Biopsy- tissue samples will be taken for analysis CT scan MRI scan Ultrasound scan reviewing lymph nodes in the groin Fine needle aspiration (FNA) may be performed if abnormal lymph nodes are suspected- a thin needle may be used to collect cells from the lymph nodes for analysis.
Penile cancer treatment
Depends on several factors:
- The type of tumour.
- The size and position of the tumour.
- The stage of the cancer.
- Age and general health.
Very early stage carcinoma in situ may be treated with a chemotherapy cream (usually fluorouracil 5FU) or imiquimod which uses the immune system to treat the cancer.
Surgery is the main treatment for penile cancer where the tumours are very small this may be laser surgery or cryosurgery.
In other cases it may conventional surgery such as circumcision if only the foreskin is involved or it may involve a wide local excision to remove the affected tissue with a clear margin and possibly lymph nodes.
Total or partial removal (penectomy) is only performed if the disease is deep into the penis or at the base, usually followed by reconstruction.
Radiotherapy may be used if the patient is not fit for surgery or declines surgery. Also, it will be treatment of choice if the disease has spread to the lymph nodes in the groin or into the pelvis.
Post-operative radiotherapy might be suggested to reduce risk or spread/recurrence.
Chemotherapy cream can be used for carcinoma in situ. Intravenous chemotherapy may be used if the disease has spread to other parts of the body.