Cancer of the Penis

The penis is a rod-shaped male reproductive organ that passes sperm and urine from the body. It contains two types of erectile tissue (spongy tissue with blood vessels that fill with blood to make an erection):

Corpora cavernosa: The two columns of erectile tissue that form most of the penis.
Corpus spongiosum: The single column of erectile tissue that forms a small portion of the penis. The corpus spongiosum surrounds the urethra (the tube through which urine and sperm pass from the body).

Causes and Risk Factors

Risk factors for penile cancer include the following:

Being age 60 or older
Having phimosis (a condition in which the foreskin of the penis cannot be pulled back over the glands)
Having poor personal hygiene
Having many sexual partners
Using tobacco products

Signs and Symptoms

Possible signs of penile cancer include sores, discharge, and bleeding. These and other symptoms may be caused by penile cancer. A doctor should be consulted if any of the following problems occur:

Redness, irritation, or a sore on the penis
A lump on the penis

Treatment for Penis Cancer

Three types of standard treatment are used:

Surgery

Surgery is the most common treatment for all stages of penile cancer. A doctor may remove the cancer using one of the following operations:

Mohs microsurgery: A procedure in which the tumor is cut from the skin in thin layers. During the surgery, the edges of the tumor and each layer of tumor removed are viewed through a microscope to check for cancer cells. Layers continue to be removed until no more cancer cells are seen. This type of surgery removes as little normal tissue as possible and is often used to remove cancer on the skin. It is also called Mohs surgery.
Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.
Circumcision: Surgery to remove part or the entire foreskin of the penis.
Wide local excision: Surgery to remove only the cancer and some normal tissue around it.
Amputation of the penis (Penectomy): Surgery to remove a part or the entire penis. If part of the penis is removed, it is a partial penectomy. If the entire penis is removed, it is a total penectomy. Lymph nodes in the groin may be taken out during surgery.
Bilateral Inguinal Lymph node dissection: Inguinal Node Dissection (Uniteral/Bilateral) or Inguinal lymphadenectomy is commonly performed for treatment of metastases from penile carcinoma. This involves removal of the lymph nodes in the groin. This operation is used for men with penile cancer who have palpable masses in their groins after taking 6 weeks of antibiotics. Lymph node dissection is the most effective means of eradicating minimal lymphatic disease and of accurately staging the disease.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery to lower the risk of the cancer coming back is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly onto the skin (topical chemotherapy) or into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Topical chemotherapy may be used to treat stage 0 penile cancer.

Authored By : Dr. Mahendra Jain