Penile cancer is uncommon and tends to be a disease of older men, in the 60- to 80-year age group. However, the tumor is not unusual in younger men. Penile cancer is a slow-growing cancer in its early stages, and because it seldom interferes with voiding or erectile function, patients often do not seek medical help until they experience itching or burning under the foreskin, pain, or notice a discharge from a lesion that does not heal. Penile cancer may exhibit other symptoms such as a subtle hardening of the skin, a small warty growth, or a reddened area on the glans. Because treatment is most effective when the cancer is diagnosed in the first stages of development, early medical detection is of the utmost importance.
Causes: While the exact cause of most penile cancer is unknown, the following have been considered as risk factors: human papillomarvirus (HPV) infection, because the virus can cause warts that are spread through sexual contact; unprotected sexual relations with multiple partners, leading to an increased risk of contracting HPV; smoking and chewing tobacco; psoriasis treatment combining a drug called psoralen and exposure to ultraviolet light; and poor hygiene.
Ongoing research has not offered conclusive evidence regarding the role of circumcision in the prevention of penile cancer; however, data collected from most large studies has demonstrated that penile cancer is very rare in individuals who are circumcised shortly after birth.
Evaluation: Biopsy is the most widely approved method of determining if an abnormality on the penis is cancer, and there are a number of tests that Capital Region Urology physicians can perform to determine the presence and extent of the cancer. These methods include fine needle aspiration, to extracts cells from the affected tissue; ultrasound, to determine the depth of the affected tissue; CT Scan or MRI, to examine the lymph nodes; and a dissection or biopsy of the lymph node itself.
Treatment: Surgery has been the traditional therapy for penile cancer, often effective with local resection, or with just a circumcision. Capital Region Urology physicians can offer the patient a number of methods of surgical treatment. Cryosurgery, using liquid nitrogen to freeze and destroy abnormal cells, and laser surgery, to vaporize cancer cells, are two such alternatives. Mohs surgery is another option; this is a procedure in which a microscopic dissection can remove the cancer with minimal cosmetic damage. In advanced stages, the disease may be treated by removal of part of or the entire penis.
Other methods of treatment that may be used in conjunction with or as an alternative to surgery include radiotherapy, local chemotherapy, or systemic chemotherapy.