Cancer of the penis
Cancer of the penis
Penis is a male reproductive organ. It consists of a root, body, utrethra, glans and prepuce or foreskin, which is a thin skin covering the glans. Penis also contains erectile bodies of sponge-like structure. The basic function of the penis is erection, during which the erectile bodies are filled with blood, they enlarge and the penis erects. Cancer of the penis is very rare in Europe, however its incidence rises. In most cases we are dealing with a malignant skin tumor (also called squamous-cell carcinoma), which originates from the skin of the penis.
What is cancer?
Cancer is a layman word for all tumors. For the professionals the word cancer has a narrower meaning. Cancer is a carcinoma, therefore a malignant tumor. Tumors in general are divided in malignant and benign. Benign tumors usually grow slowly, do not threaten the surrounding structures and are well curable, because they do not disseminate into secondary foci – metastases. On the contrary the malignant tumors such as the cancer of the penis grow aggressively, invade surrounding tissues and form metastases, which are the most common cause of death in patients with cancer.
Occurrence and causes of penile cancer
It is interesting, that the incidence of the cancer of the penis correlates with the geographic latitude. In Europe and the North America it represents only 0.1-2 % of all tumors, however in Asia, Africa and South America it is 10-20 % of all tumors. The main risk factor of penile cancer is a poor hygiene of the prepuce and the glans. Smegma (a whitish substance) normally cumulates under the foreskin. It consists of shed skin cells under the effect of bacteria. If this substance is not regularly removed, it may irritate the skin and increase the risk of developing a cancer of the penis. Another risk factor is phimosis or a narrowing of the prepuce. It cannot be retracted over the glans and it prevents the basic hygiene. An effect of human papilomaviruses (HPV) is probable. HPV viruses are known as a cause of a cervical cancer in women. HPV virus is widely spread in our population and it is transmitted by a sexual intercourse. A high number of sexual partners increases the risk of penile cancer, just as the cancer of the cervix. Using of any tobacco products also poses a risk.
Symptoms of the cancer of the penis
As for the symptoms of the penile cancer, at first a tumor focus appears on the glans. It looks like reddish mossy spots. Subsequently the cancer begins to spread through the whole penis and into the inguinal (groin) lymph nodes. From there it can disseminate into distant cancer foci. Affected lymph nodes enlarge, they are palpable but not painful. The cancer of the penis itself can appear as a node, ulcer or a red spot. It is important to seek the help of a dermatologist or an urologist, whenever there is an ulcerated, not healing formation on the penis, most commonly on the glans.
Diagnosis and treatment of the cancer of the penis
There is a common problem, that men do not seek a medical help soon enough. One of the reasons is phimosis, which does not allow us to see the surface of the glans. Another reason is a shame, when men are too ashamed to consult a doctor. In the personal history we focus on the duration of the symptoms. The physical examination is based on inspecting the lesion. It is necessary to take a sample for a microscopic examination. This shows if there is a tumor and defines its type. Examination of the lymph nodes is also important. If they are palpable, they can also be examined by ultrasound. For the examination of the affected lymph nodes we can use a computed tomography (CT). It is a method using x-rays and a computer. X-rays irradiate the patient’s body from several angles. The computer then creates the final image so that the doctor can see any layer in the affected area. Magnetic resonance imaging (MRI) may be also used. MRI is a method using magnetic field and is able to image the desired parts of patient’s body with a great accuracy. The patient lies on a bad which then moves into a tunnel and the imaging may begin.
While treating the cancer of the penis we need to be aware of the stage of the penile tumor, the spread of the cancer and the general state of the patient. A radiotherapy (irradiation ), a chemotherapy (administering of aggressive drugs against tumors) and a surgical treatment is usually combined. During the surgical intervention the whole penis or a part of it is removed, depending on the stage of spread. However a surgical removal of the whole penis is rare.
Prevention of the cancer of the penis
Prevention is very important not only in cancer, but also in other diseases of the penis. Sufficient hygiene and washing of the penis under the prepuce is necessary. This has probably something to do with the distribution of the disease in the world. A circumcision is a very reliable method of prevention. If it is done early in life, cancer practically never occurs. This is proven by a minimal incidence in the Jewish population, where the circumcision is a religious obligation. Put it in a nutshell, if you see an ulcer on the penis, a prominent formation or a lesion which does not heal for a long time, do consult your doctor immediately. Do not let the disease spread more than necessary, just because you’re ashamed. The sooner the treatment is started the higher the chance of a complete recovery.