Cancer of the Penis

1) Why does cancer of the penis occur?

2) What are the symptoms of penile cancer?

• Most patients with penile cancer present with an ulcer over the penis which does not heal.
• Larger ulcers which bleed are more likely to be cancerous
• A few patients present with spread to the groin lymph nodes
• A few cancers can be hidden because of tight foreskin

3) How is penis cancer diagnosed?

The diagnosis is usually by a biopsy which is taken under local anesthesia The staging is done usually by a PET scan.

4) How is penile cancer treated?

The main treatment of penile cancer is surgery. If the size and location of the cancer are large then the doctor will decide to perform the surgery.

Very early cancers can be treated by non-surgical means like cryotherapy. Radiation is considered an inferior option to surgery but is used sometimes when it is not possible to remove the tumour surgically.

Chemotherapy is usually used in advanced metastatic cases usually with palliative intent.

5) Surgical treatment of penile cancer elaborated

The doctor will decide the type of surgery depending on the size and location of the cancer

• In very early cases where the cancer is limited to the foreskin a circumcision may suffice Small cancers on the tip of the penis can be excised locally with a margin.
• Larger cancers which have involved the glans of the penis may need removal of part of the penis a procedure known as partial penectomy.

Cancers which have involved the shaft of the penis may need a procedure known as total penectomy. Here the urinary diversion is done to the perineal area. Apart from the penis it is important to address the lymph nodes in the inguinal region or groin.

When lymph nodes are metastatic removal of entire lymph nodal group may be required, a procedure known as ilioinguinal node dissection When the lymph nodes are not involved a lesser extent of lymph nodal removal known as sampling may be done.