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Cancer of the Penis


Penile cancer is a rare condition in which malignant cells develop on the external skin and in the deeper tissues of the penis. There are several types of penile cancer, the form of which depends on the tissues which the malignant cells have invaded. Some of these cancers are more serious than others. 

The first thing to keep in mind is that penile cancer is very rare, and it only occurs as one percent of all male cancers. Naturally, though, as with all cancers, there are some lifestyle factors which will increase the risk. As you might expect, one of these is sexual promiscuity - according to one report, men who have had thirty or more sexual partners in his lifetime, and those who are infected with the human papilloma virus (HPV) seem to have a greater risk of developing penile cancer. Other factors which have been associated with penile cancer include cigarette smoking, not washing under the foreskin on a regular basis, and some kinds of penile rashes or injuries - though this may be considered an association and not a correlation. 

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Most penile cancers originate in the squamous cells of the skin. If they are non-melanoma cancers, skin cell tumors grow slowly and there is usually a warning of their development in the form of precancerous changes - some of which can last for several years. These tumors can usually be cured if they are detected and treated while they are still in their early stages. Although cancers of the squamous cells may develop anywhere on the penis, they seem to be most common on the foreskin in men who have not been circumcised, and on the glans.

There is another even rarer form of penile cancer named adenocarcinoma which may grow in the sweat glands found in the skin of the penis; the rarest form of penile cancer has its origins in melanomas. These are more dangerous because they will grow faster and they can spread more quickly. Although melanomas usually develop on parts of the body which have been exposed to the sun, they can sometimes develop on other areas which are less likely to be sunburnt, such as the penis. And the final group of penile cancers develop from tumors of the cells of the blood vessels, connective tissue or muscle fibres of the penis.

I should emphasize that this is hardly something you need to worry about: penile cancer is extremely rare. But just so you know, the most common symptom takes the form of a tender spot on the glans or an open sore located on the end of the penis, on the glans. If this is not treated, it may - like all cancers - grow slowly over a wider area of skin and invade much deeper layers of tissue. And if this happens, then you may feel some pain and experience some bleeding as the cancer invades deeper tissue. And - again, like all cancers - penile cancer can migrate into the nodes of the lymphatic system, from where it may spread into the groin and other parts of the body. It can then grow more widely and invade other tissues.

If penile cancer is suspected, a urologist will wish to examine a man's penis to check for lumps, open sores or anything else which may be out of the ordinary, anything he may think is a potential problem: a biopsy will distinguish between malignant cancer, syphilis chancres and penile warts. When analysed as cancer, a further biopsy will determine if the cancer has migrated into other parts of the body. In the first stage of penile cancer (stage 1), malignant cells are located on the surface of the glans. In stage II, the deeper tissues located beneath the surface and under the skin of the shaft of the penis will be infected. In stage III, the cancer cells will have migrated into the lymph nodes located in the groin, which will swell. In the final stage of the disease, stage IV, cancer cells will have spread through the penis, into the lymph nodes and throughout the groin area, or it will have migrated to other parts of the body.

Treatment of penile cancer

Penile cancer can be attacked with a combination of excision surgery and radiation therapy. Unfortunately, some or all of the penis may have to be removed, and the lymph nodes and adjacent tissue may also have to be excised to some extent. The key to success in treatment is early diagnosis: men may then be left with enough of the penis to be able to urinate and enjoy penetrative sex. Advances in microsurgery allow doctors to remove the cancer cells and only a minimal amount of normal tissue; and laser surgery, which involves the use of a highly focused bean of microwave light can be employed to dissolve or cauterise cancer cells. Radiation therapy is an effective way of backing up the effects of surgery and preventing recurrence. It may also be used as an alternative to surgery.

There are some skin-deep penile cancers which are treated with medication applied directly to the penile skin. But the further a cancer has developed, the more it will need systemic treatment with chemotherapy, using powerful chemical agents which flow round the bloodstream and kill cancer cells that have migrated to other parts of the body.

The key thing to remember is that the cure rate for penile cancer is high when the treatment is applied early. As far as self-care is concerned, look for any abnormal growths, anything that looks like a wart, or any irritated areas of skin, any rashes, especially on the glans or foreskin. Usually such growths are benign (which means they are not cancerous), but they can sometimes develop into a form of penile cancer if they are not treated.