Introduction

Penile Cancer, or cancer of the Penis is a very rare type of cancer, affecting only only one percent of men living in the US each year. Luckily, when this type of cancer is detected early on, it is highly curable; the fact that penile cancer is slow growing can attribute to that. Studies have shown that Cancer of the Penis is more common in countries where circumcision at birth is not common (www.penileplus.com); luckily, in the US and Europe this is a fairly common practice. Additionally, this type of cancer is rare in Jewish and Muslim men that are circumcised at birth, as this is a common practice for both faiths.

Risks

Age

Although rare, research and studies have shown that Penile Cancer tends to affect men in the age range on 45-75. However, there have been cases where this cancer can affect men under the age of 50; nearly a third of reported cases to be exact.

HPV

The Human Papillomavirus (HPV) is a sexually transmitted disease and infection that has more than 40 to 60 sub types. This STD also causes genital warts and Cervical Cancer in women. As relates to Penile Cancer, HPV-16 and HPV-18 sub types are most linked to this type of cancer. Gardasil is a vaccine that protects against HPV, although it only protects against 4 strains of the virus: HPV-6, HPV-11, HPV-16, and HPV-18. In my honest opinion, it is of the utmost importance to to get young adults vaccinated against HPV; there are roughly six million new reported cases of the HPV outbreak every year, in the US alone. Of these reported cases, roughly 75% are found in young adults in the 15-24 age population.

Lack of Circumcision

As stated above, studies and research have shown that Penile Cancer is more likely to affect men who were not circumcised at birth. This is also the case for those who are circumcised later in life, or not at all. As we all know, the act of circumcision is performed in from a hygienic standpoint. That is why men who are not circumcised are at higher risk for this type of cancer. Additionally, failing to circumcise men at birth puts them at a risk for Phimosis. This is a condition that refers to the tightening of the foreskin that will prevent the head of the penis from retracting down past the glands; this can lead to a build of bacteria and germs. Proper cleaning of the uncut penis should be done regularly in order to prevent any type of medical issues from rising up.

Penile Cancer Symptoms

Generally, this type of Cancer will be seen as a tumor on either the glans (the tip, or head of the penis), and the inner lip of the foreskin. Generally painless, and early tumor will look like a lump on the penis; or a dry and scaly area. As with any medical condition, the best way to have a tumor detected early is to seek medical attention if you notice anything that is out of the ordinary for your body. Due to the nature of the area, most men delay getting in to see their Doctor to discuss any changes in their penis and genitals. It can be hard for most men to discuss anything that seems out of the ordinary as relates to their penis.

Penile Cancer symptoms can include, but are not limited to:

A wart-like growth (genital warts), lump, or lesion

A lump that is freely movable

An open sore that won’t seem to heal

Discharge under the foreskin that does not go away with daily cleansing habits

Pain in the penis or bleeding

If you notice any or all of these symptoms you should make every effort to see your health care provider as soon as possible.

Prevention

As with any type of STD or STI, the use of contraceptives such as condoms is vital in order to avoid contracting or spreading HPV. Even during foreplay, or if no penetration is involved, HPV and other STD’s can still be transmitted or contracted. Performing self exams regularly and getting screened on a regular basis by a health care professional can be key in avoiding contracting and/or spreading HPV and other STD’s or STI’s.

Men who are not circumcised should be aware of how to retract their foreskin and clean underneath, and practice good hygiene. Keeping the area clean is vital in order to lower the risk of Penile Cancer in intact men. In addition to daily cleaning, intact men should also examine the area underneath the head of their penis regularly. It is worth mentioning that smegma, or the buildup of bacteria underneath the foreskin can serve as a carcinogenic agent, although this has yet to be proven. Abstinence and limiting the number of sexual partners that you have can be a powerful method of prevention.

Penile Cancer Treatment

As with any type of cancer, treatment for cancer of the Penis will vary by the stage that the cancer is in. Additional factors for treatment include the size, location, and invasiveness of the tumor. Although surgery to remove any tumor from the Penis is the most common treatment currently available, it is always a good idea to get a second opinion beforehand. For smaller superficial lesions, penile cancer may be treated with laser light therapy, radiation therapy, or a cream containing a chemotherapy drug. These types of treatments are considered to be non-invasive, and offer the best chance of removing the cancer while keeping the penis in tact.

Penectomy is a surgery that in extreme cases is used to remove all or part of the penis, and is not commonly done unless it is absolutely necessary. A complete penectomy will remove the entire penis, and is only used in extreme cases. During this type of surgery, the surgeon will move the urethra behind the testes and a hole is created to allow urination. Although a partial Penectomy is more frequently used, this type of surgery removes the tumor as well as a small part of normal penile tissue. This spares as much of the glands and Penis as possible, to ensure sexual function and urinary functions are still retained. In some cases, after a Penectomy is performed, it is possible to undergo Penile reconstructive surgery; using skin from either the buttocks or forearm to create a new penis.

Conclusion

As with any type of Cancer, it is crucial to catch the tumor early. That is why the best practice is to have routine medical check-ups, and get in to see your healthcare provider if you notice anything that looks different or out of the ordinary. Finding a respected urologist that you are comfortable with and trust will help if you have any reservations about someone examining your penis or genitals.