Penile cancer is a rare disease with a frequency of 0.3-0.8 cases per 100,000 men. The highest is the frequency in Latin America and part of Africa and the lowest in the countries applying circumcision at an early age.
1. What is the cause of a penile cancer disease?
The cause is related to sexually transmitted diseases, human papillomavirus infection, chronic inflammation, and perhaps smoking.
2. What are the tumors of the penis?
Most tumors are squamous cell with varying degrees of differentiation. Rarely occurs with melanoma, lymphoma and sarcoma. Additional prognostic factors are the depth of invasion, involvement of lymph and blood vessels. Penile cancer is most often a squamous cell carcinoma. The tumor is predominantly located on the surface of the penis or foreskin, rarely on the body of the penis.
3. How is penile cancer diagnosed?
Early diagnosis of the disease when the patients have no complaints. A checkup of the sexual partner and palpation of the inguinal lymph nodes is performed. If a malignant disease is suspected, a histological examination is performed.
For detection of distant metastases, a X-ray examination of the lung and bone system is performed.
Biopsy is taken at enlarged nodes inguinally and a penis tumor. Required before biopsy is to take antibiotic for 4 weeks to respond to inflammatory enlarged inguinal lymph nodes and to detect metastatic disease. Reactive hyperplasia is detected at 50-70% and, after removal of the primary penile tumor, lymphadenomegamy is normalized. Only a histological (cytological) study demonstrates the presence of metastatic lymph nodes and determines the stage of the disease.
4. Where do they metastasize?
The penile cancer metastasizes primarily lymphatically, first affecting the inguinal lymph nodes and then the laryngeal and paraoral lymph nodes. Hematogenic metastases occur late, mainly in the bones and lungs.
5. What is Treatment?
The treatment is based on the extent of carcinoma development. The main treatment is operative. It is expressed by total or partial resection combined with removal of lymph nodes. It can be combined with chemotherapy and radiotherapy. Radiotherapy is an acceptable option for patients who refuse surgery. Brachytherapy (radiotherapy) is suitable for tumors less than 4 cm in diameter. Methotrexate, bleomycin, cisplatin, paclitaxel, ifosfamide are used in chemotherapy.
6. What is the forecast?
The prognosis is good for early diagnosis and timely treatment.
7. What is prophylaxis?
Prevention of penile cancer is extremely important and aims at eliminating predisposing factors. It is necessary to observe very good hygiene, timely surgical treatment of phimosis, treatment of chronic inflammatory diseases of the sexual member, immediate consultation of a doctor in case of complaints.