Cancer of the penis or penile carcinoma is a rare, male cancer that is often seen in individuals over 50 years, however, it can occur at any age. Cancer of the penis surely sounds scary but if diagnosed early it can be completely treated and cure without any complications. Never hesitate to visit the doctor if you see any lesion on the penis, delay in diagnosis of the cancer due to your embarrassment might result in total amputation of the penis. The more the cancer has advanced the less the chance of cure. Cancer of the penis can be seen anywhere, but the most common sites are the foreskin and glans.
Types of Penile Cancer
There are several types of penile cancers depending on their type of cell. The most common one is squamous cell carcinoma accounting for more than 90% of the cases, others are listed as below:
Squamous cell carcinoma: Most common type of cancer, grow slowly and is curable if discovered early.
Adenocarcinoma: Adenocarcinoma of penis accounts for 5% of the total cases. They arise from glandular cells.
Basal cell Carcinomas: They account for 2% of the cases, and are slow growing cancer. They rarely spread to other areas. They arise from basal cells.
Carcinoma in situ: They are squamous cell cancer that has not yet invaded beyond the level of epithelium of the penis. It is also called as penile intraepithelial neoplasia.
Melanoma: Melanoma of penis is very rare cancer that accounts for less than 2% of the cases. They arise from melanocytes and are rapidly spreading so are life-threatening.
Sarcoma: Sarcomas are the type of cancers that arise from blood vessels, smooth muscle and other connective tissues cells. They are very rare rapidly growing type of cancers accounting for less than 1% of the cancer of penis.
Signs and Symptoms of penis cancer
The clinical signs and symptom of penile cancer vary from small bump, pustule, or warty growth to an extensive carcinoma with pain, ulcer and bleeding. Common site for carcinoma of the penis include the glans (80%), followed by the prepuce (15%), the balanopreputial membrane (5%), and less commonly the shaft. The initial symptoms of cancer of the penis may cause itching or burning under the foreskin of the glans or ulceration of the foreskin.
In addition, there may be balanoposthitis or phimosis, dysuria and pain during sex. In some cases there may be foul smelling discharge from the penis. The inguinal lymph node may be swollen. Remember; when there is a sore or growth on the penis that is not healing after continue medications, penile cancer should be suspected.
Causes and Risk Factors for Penile Cancer
Although the exact cause for penis cancer is not known, there are many factors that can increase the risk of penile cancer; some of the risk factors that have been identified are listed below. Lichen sclerosus, genital warts and uncircumcised penis are by far most common risk factors for penile cancer.
Risk Factors for cancer of the penis
Age being 60 or older
Phimosis, Paraphimosis and balanitis
Poor or inadequate personal and sexual hygiene
Repetitive tear, injury and chronic penile inflammation and irritation of the penis
Balanitis xerotica obliterans (lichen sclerosus)
Human papillomavirus (HPV16 and 18) infection (condylomata acuminata)
Multiple sexual partners and early age of first intercourse
Bowen disease of the penis
Erythroplasia of Queyrat
Several other sexually transmitted diseases
Photochemotherapy (sporalene+ UVA) for several skin diseases like psoriasis, vitiligo and cutaneous T-cell lymphoma
Treatment of Penile Cancer
Treatment modality for carcinoma of the penis depends on size, location and tumor spread. In case of carcinoma in situ, topical creams with laser may be sufficient, while for other forms cancers, surgical removal may be the best option. In general cancer treatment includes:
Chemotherapy that uses medications to kill cancer cells
Radiation that uses high powered x-rays to kill cancer cells
Surgery that just cuts out and removes the cancer
The outcome of the treatment depends on how far the cancer has spread. For localized superficial lesions, treatment might totally cure the lesion without any complications. However, for more severe cases and widespread lesion total penectomy may be the option that results in total removal of penis.