Penile Cancer
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Cancer of the penis, a rare kind of cancer in
the United States, is a disease in which cancer (malignant) cells are found
on the skin and in the tissues of the penis.
Men who are not circumcised at birth may have
a higher risk for getting cancer of the penis. A circumcision is an operation
in which the doctor takes away part or all of the foreskin from the penis.
The foreskin is the skin which covers the tip of the penis. A circumcision
is done on many baby boys before they go home from the hospital.
A doctor should be seen if there are any of the
following problems: growths or sores on the penis, any unusual liquid coming
from the penis (abnormal discharge), or bleeding.
If there are symptoms of cancer, the doctor will
examine the penis and feel for any lumps. If the penis doesnft look normal
or if the doctor feels any lumps, a small sample of tissue (called a biopsy)
will be cut from the penis and looked at under a microscope to see if there
are any cancer cells.
The prognosis (chance of recovery) and choice
of treatment depend on the stage of the cancer (whether it is just in the
penis or has spread to other places), and the patientfs general state of
health.
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Once cancer of the penis is found, more tests
will be done to find out if the cancer has spread from the penis to other
parts of the body (staging). A doctor needs to know the stage of the disease
to plan treatment. The following stages are used for cancer of the penis:
Cancer cells are found only on the surface of
the glans (the head of the penis) and on the foreskin (the loose skin that
covers the head of the penis).
Cancer cells are found in the deeper tissues
of the glans and have spread to the shaft of the penis (the long, slender
cylinders of tissue inside the penis that contain spongy tissue and expand
to produce erections).
Cancer cells are found in the penis and have
spread to nearby lymph nodes in the groin. (Lymph nodes are small bean-shaped
structures that are found throughout the body; they produce and store infection-fighting
cells).
Cancer cells are found throughout the penis
and the lymph nodes in the groin and/or have spread to other parts of the
body.
Recurrent disease means that the cancer has
come back (recurred) after it has been treated. It may come back in the same
area or in another place.
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There are treatments for all patients with cancer
of the penis. Four kinds of treatment are used:
- Surgery (taking out the cancer in an operation)
- Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer
cells and shrink tumors)
- Chemotherapy (using drugs to kill the cancer cells)
- Biological therapy (using the immune system to fight cancer)
Surgery is the most common treatment of all
stages of cancer of the penis. A doctor may take out the cancer using one
of the following operations:
- Wide local excision takes out only the cancer and some normal
tissue on either side.
- Microsurgery is an operation that removes the cancer and as little normal tissue
as possible. During this surgery, the doctor uses a microscope to look
at the cancerous area to make sure all the cancer cells are removed.
- Laser surgery uses a narrow beam of light to remove cancer cells.
- Circumcision is an operation that removes the foreskin.
- Amputation of the penis is an operation that takes out the penis. It is the most
common and most effective treatment of cancer of the penis. In a partial
penectomy, part of the penis is taken out. In a total penectomy, the whole
penis is removed. Lymph nodes in the groin may be taken out during surgery.
Radiation therapy uses x-rays or other high-energy
rays to kill cancer cells and shrink tumors. Radiation may come from a machine
outside the body (external radiation) or from putting materials that contain
radiation through thin plastic tubes into the area where the cancer cells
are (internal radiation). Radiation may be used alone or after surgery.
Chemotherapy uses drugs to kill cancer cells.
Fluorouracil cream (a chemotherapy drug put on the skin of the penis) is
sometimes used for very small surface cancers of the penis. Chemotherapy
may also be given by pill or by a needle in a vein. When chemotherapy is
given in this way, it is called a systemic treatment because the drugs enter
the bloodstream, travel through the body, and can kill cancer cells outside
the penis.
Biological therapy tries to get the body to
fight cancer. It uses materials made by the body or made in a laboratory
to boost, direct, or restore the bodyfs natural defenses against disease.
Biological treatment is sometimes called biological response modifier (BRM)
therapy.
Treatment of cancer of the penis depends on
the stage of the disease, the type of disease, and the patientfs age and
overall condition.
Standard treatment may be considered because
of its effectiveness in patients in past studies, or participation in a clinical
trial may be considered. Not all patients are cured with standard therapy
and some standard treatments may have more side effects than are desired.
For these reasons, clinical trials are designed to find better ways to treat
cancer patients and are based on the most up-to-date information.
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If the cancer is limited to the foreskin, treatment
will probably be wide local excision and circumcision.
- Fluorouracil cream
- Microsurgery
- Amputation of the penis (partial penectomy). Lymph nodes in
the groin may also be removed.
- External radiation therapy
- Microsurgery
Clinical trials of laser therapy for stage I
penile cancer are also being conducted.
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Treatment may be amputation of the penis (partial,
total, or radical penectomy) or radiation therapy followed by amputation
of the penis. Clinical trials of laser therapy for stage II penile cancer
are also being conducted.
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Treatment may be amputation of the penis, followed
by removal of lymph nodes on both sides of the groin or amputation of the
penis followed by radiation therapy. Clinical trials of chemotherapy and
chemotherapy with radiation therapy are also being conducted.
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Treatment will be designed to reduce symptoms
and may include wide local excision, microsurgery, amputation of the penis,
or radiation therapy. Clinical trials of chemotherapy combined with surgery
or radiation therapy are also being conducted.
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If the cancer has come back (recurred), treatment
may include amputation of the penis or radiation therapy. Clinical trials
of chemotherapy or biological therapy are also being conducted.
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Andropause
