Penile cancer

Researchers have identified certain risk factors that make a man more likely to develop penile cancer.

They include:

• Human papillomavirus (HPV): An HPV infection may increase the risk of penile cancer. HPV comprises more than 150 related viruses, according to the ACS, and is found in about 50 percent of penile cancer cases.
• No circumcision: Men who were circumcised when they were young have a lower risk of penile cancer. While it’s not completely understood why, it’s thought to be related to conditions known as phimosis and smegma. Uncircumcised men may develop phimosis, which happens when the skin becomes tight, preventing it from easily retracting. This may result from inflammation or from smegma, a thick secretion that builds up under the foreskin if not cleaned well. Uncircumcised men should watch out for both phimosis and smegma and always keep their penis and foreskin clean.
• Smoking: Smoking and using tobacco products increases the risk of penile cancer. Those who smoke and have an HPV infection face an even higher risk.
• Age: As men age, their risk of penile cancer increases. Men older than 55 represent about four out of five penile cancer diagnoses in the United States, according to the ACS.
• AIDS: Men with AIDS are thought to be at higher risk of penile cancer, likely due to their weakened immune system.
• Ultraviolet (UV) light for treating psoriasis: Men with psoriasis sometimes receive a treatment using a UV light source (called PUVA). A higher rate of penile cancer has been seen among men who’ve undergone PUVA. As a result, psoriasis patients have their genitals covered when receiving treatment.

Penile cancer doesn’t always present with symptoms. Still, symptoms are possible, so men who suspect any changes are urged to seek medical help. Some of the most common symptoms include:

• Changes in color of the penis
• Unexplained growths or sores
• Discharge from the penis, including blood from the tip or under the foreskin
• Unexplained pains
• Lesions or rashes
• Small, crusty bumps
• Swelling of the penis or of the lymph nodes in the groin area

There are several types of treatment available for penile cancer, based on the type of cancer and its staging.

• Surgery is the most common treatment for all stages of penile cancer. Surgeries include the following types:
  • Mohs microsurgery. A surgeon cuts the tumor from the skin in thin layers. Then, using a microscope, they examine each layer of skin, looking for cancer cells. The surgeon continues to remove layers of tissue until no additional cancer cells are found.
  • Laser surgery. Using a laser beam, a surgeon makes cuts into skin tissue to remove a tumor or surface skin lesion.
  • Cryosurgery. The surgeon uses a special instrument to freeze and destroy cancer cells.
  • Circumcision. This is a surgery that removes the foreskin from the penis, either partially or completely.
  • Wide local excision. This type of surgery cuts the cancer from the skin.\
  • Amputation of the penis. This is the surgical removal of all or part of the penis.
• Radiation therapy uses high-energy radiation, such as X-rays, to target and destroy cancer cells. Radiation may be delivered either internally or externally.
  • With internal radiation, controlled radioactive materials—such as seeds or catheters—are placed in or near the cancer in order to kill the cancer cells.
  • With external radiation, a machine sends rays of radiation specifically to the parts of the body that need treatment.
• Chemotherapy: With chemotherapy, doctors prescribe drugs, either injected or taken orally, to kill cancer cells. This is known as systemic chemotherapy and allows drugs to enter the bloodstream and reach the cancer cells.
  • For some types of penile cancer, chemotherapy drugs may be applied directly to the skin (known as topical chemotherapy).
• Biologic therapy uses the body’s immune system to fight off cancer and is also referred to as immunotherapy.