Penile cancer is a cancer that has been diagnosed more and more frequently in recent years. Everything incl. by altering the sexual behavior of men, which increases the risk of contracting carcinogenic HPV. What are the other causes and symptoms of penile cancer? What is the treatment? What's the prognosis?

Penile canceris a malignant neoplasm that is rarely diagnosed. In Europe and North America, it accounts for 0.3 to 0.6 percent. malignant neoplasms in men, but in some countries in Asia, Africa and South America, the proportion can be as high as 10%. In Poland, the incidence is 0.8 / 100,000. In the last 30 years, the number of penile cancer cases has increased by 20%. This is due to a change in male sexual behavior, which increases the risk of HPV infection, and a decrease in childhood circumcisions. In addition, penile cancer, which usually appears around the age of 60, is diagnosed in younger and younger men (even in 45-year-olds), which is also associated with HPV infections.

Penile cancer - causes and risk factors

A risk factor for developing penile cancer is phimosis, which occurs in approximately 50% of patients. In the development of this cancer, an important role is also played by infection with the human papillomavirus (HPV), specifically HPV types 16 and 18, which increases the risk of penile cancer up to six times. HPV infection is present in 31-63 percent.GOOD TO KNOW>>HPV in men: symptoms and treatment

Penile cancer can also occur in men who do not care enough about their personal hygiene. Its maintenance is facilitated by circumcision performed in childhood. Therefore, in countries where male circumcision is performed for religious or cultural reasons (e.g. Israel), penile cancer is rare. Other risk factors include chronic inflammation of the glans and foreskin, penile injuries, PUVA chemophototherapy in patients with psoriasis and smoking. (increases the likelihood of penile cancer up to four times). In addition, this cancer appears more often in patients with AIDS and leukemia.

According to an expertAndrzej Łęcki, MD, PhD, specialist urologist

How can a lack of personal hygiene lead to penile cancer?

Mastka (smegma) is the secretion of the prepuce (sebaceous) glands, exfoliatedforeskin cells and abundant bacterial flora. If it is not removed regularly from under the foreskin, it causes chronic inflammation of the foreskin, including the glans. Over time, this leads to inflammatory phimosis. Both of these conditions are risk factors for penile cancer.

Pre-cancerous states of penile cancer

Pre-cancerous conditions of penile cancer are changes on the surface of the penis, on the basis of which a malignant tumor may develop. They include:

  • genital warts (genital warts), caused by HPV types 6 and 11)
  • lichen sclerosus and atrophic
  • Queyrata erythroplasia (red keratosis, only on the glans). HPV types 16 and 18 are responsible for the disease)
  • Bowen's disease (skin of the penile shaft)
  • bowenoid papulosis. HPV type 16 is responsible for the disease
  • skin horn
  • leucoplakia (white keratosis)
  • Buschke-Lowenstein tumor (giant condylomas), caused by HPV type 6 and 11

Penile cancer - symptoms

Initially, penile cancer shows no symptoms. Only a little later in the area of ​​the glans, foreskin (80% of cases) or (less often) the shaft of the penis, a painless change in the form of a flat lump, induration, wart or ulcer with shaft-like edges appears. The accompanying symptom is purulent exudate. In addition, the inguinal lymph nodes are enlarged.

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Penile cancer often metastasizes to nearby lymph nodes

Penile cancer - especially in the early stages of development - may metastasize to the surrounding lymph nodes - to the groin, within the pelvis. Distant metastases are rare (about 10% of cases) and concern, among others, lungs, liver, bones, skin and brain.

Penile cancer - diagnosis

The doctor takes a sample of the tumor for histopathological examination. A lymph node biopsy is also performed.

Penile cancer treatment

1) Surgical

  • sparing treatments

- circumcision - if the neoplastic lesion is limited to the foreskin only. - glansectomy - if the neoplastic lesion is limited to the glans only - laser therapy (it is used in pre-invasive cancer, which includes, among others, Queyrat erythroplasia or Bowen's disease) - cryotherapy (it is used in papillary penile cancer)

  • penectomy (total or partial), i.e. penile amputation

2) Chemotherapy - local or systemic (plays a palliative role) 3) Radiotherapy: teleradiotherapy and brachytherapy

Penile cancer - prognosis

Five-year survival depends on the number and location of metastases. In patients without metastases, it is approx. 90-100%. If there are ≤ 2 metastases to inguinal nodes, the chance of five-year survival is approx. 80%, and if more than 2 - approx. 30%. On the other hand, in patients with metastases to pelvic nodes, the prognosis is the worst (0-15%). Most untreated men die within 2 years.

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Penile cancer - how can it be prevented?

In order to prevent the development of penile cancer, you should take care of personal hygiene (it is much easier to maintain for men after circumcision). In addition, avoid HPV infection - use condoms and performvaccination against human papillomavirus- HPV types 16 and 18, which are the most oncogenic types of the virus. You should also limit the number of sexual partners (because the fewer partners, the lower the risk of HPV infection, and more). Preventive circumcision is also a solution. In addition, you should report to the doctor early on any changes noticed on the penis (eruptions, inflammations, phimosis).

Category:

Oncology