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We left very happy with the doctor-patient relationship
Penile cancer can initially present as skin changes or lesions that sometimes produce few symptoms. Detecting it in its early stages allows for less aggressive treatments and, when possible, preserves penile function and anatomy as much as possible.
Penile cancer is the uncontrolled growth of cells in the penis, the male reproductive organ. It is a rare cancer that affects less than 1% of men, primarily men over 50, although it can also occur in younger men.
Penile tumors are strongly associated with exposure to the human papillomavirus (HPV) and, therefore, vary considerably depending on the geographic area. Other risk factors include phimosis, smoking, and precancerous lesions. For this reason, any newly appearing lesion that does not respond to conventional treatments is a candidate for biopsy. Furthermore, it is important to examine for the presence of lymph nodes in the groin, which could indicate local metastases.
Most cases are initially detected as a change in the skin color of the penis . It is advisable to maintain hygiene and perform self-examination to detect any wart-like lesions, open sores, reddish rashes, or persistent, odorous discharge under the foreskin.
This type of tumor usually starts in the glans region and, depending on the type of cell that shows uncontrolled growth, it will be classified as:
Penile cancer is very aggressive, so intensive initial treatment will be necessary, often including penile surgery.
Depending on the extent of the injury to the penis, different types of surgery can be performed:
Depending on whether or not the inguinal lymph nodes are affected , a lymphadenectomy (lymph node removal) will be necessary. If metastatic lesions are suspected, chemotherapy is the treatment of choice.
Penile cancer usually begins in the glans area and often produces a lesion that is visible and can appear in different forms:
These lesions do not respond to conventional treatments such as antibiotics, antivirals, antifungals, or corticosteroids. Therefore, a biopsy is necessary to rule out the presence of a tumor.
It is important for men to perform regular self-examinations to detect any irregularities. If any abnormality appears on the penis, it should be evaluated by a specialist to rule out penile cancer.
The causes of penile cancer are unknown. However, there are some risk factors that may contribute to its development:
A suspected diagnosis of penile cancer is based on an irregular, sometimes ulcerated and infected, lesion on the penis. The doctor performs a physical examination of the penis to rule out other lesions, abnormalities, or benign conditions that could be mistaken for penile cancer. Following this examination, a biopsy is required to confirm an accurate diagnosis of cancer.
If the signs point to penile cancer, the following tests may be needed:
In this diagnostic test, the doctor takes a small tissue sample to see if it contains cancer cells and to confirm with certainty that it is cancer and determine the nature of the lesion.
If the diagnosis is confirmed after the biopsy, further study will be necessary using imaging tests:
Ninety-five percent of penile tumors are squamous cell carcinomas. However, there are premalignant lesions that must be considered, monitored, and treated very closely. These preneoplastic lesions are:
Once a diagnosis of penile cancer is confirmed, the disease is graded . This helps the doctor predict how quickly the cancer is likely to grow and spread. The grade (1, 2, or 3) is assigned based on how similar the cancer cells are to normal cells. Cancers with a higher grade (3) tend to grow faster.
Early diagnosis is the most important factor for a good prognosis in penile cancer. Therefore, any abnormality in the penis should be evaluated by a urologist for early diagnosis and treatment. Up to 80% of men with penile cancer can be cured, but only in the early stages of the disease.
The choice of treatment will depend on several factors:
Early-stage penile tumors can sometimes be treated topically with 5-fluorouracil or imiquimod, or undergo complete excision of the tumor using a CO2 or Nd:YAG laser. Local treatment of penile cancer is performed on small cancers that have not spread beyond the skin, so the rest of the penis and nearby tissues are not affected.
In this initial phase, the procedure can be performed with local anesthesia, leaving hardly any scar.
In more advanced, localized cases, complete surgical excision of the lesion plus postectomy (circumcision) is necessary, although radical laser treatment can sometimes be performed. In many cases, cosmetic reconstruction will be required after treatment.
Alternatively, radiation therapy is a viable option. Radiation uses high-energy rays, such as X-rays, to destroy cancer cells. This can be directed at the penis and/or lymph nodes from a machine outside the body (external beam radiation). It can also be delivered by placing a radioactive source inside or next to the tumor (brachytherapy).
Conversely, when the disease is more advanced, it is necessary to apply more aggressive treatments: from a glansectomy or a partial penectomy, to a total penectomy.
In a partial penectomy, the tumor is removed along with a margin of normal tissue. In a total penectomy, the entire penis is removed. The surgeon redirects the urethra behind the testicles and creates a urethrostomy (opening) so the patient can urinate.
In cases where lymph node involvement is suspected, lymphadenectomy (removal of the lymph nodes) is crucial, as tumor recurrence in these nodes dramatically affects the prognosis. The extent of the lymphadenectomy depends on the characteristics of the tumor and the findings of the biopsy and other diagnostic tests.
Cosmetic penile reconstruction will then need to be considered. As in the previous situation, radiotherapy is also a viable option.
Chemotherapy is a very useful tool for patients with locally advanced or poor prognosis disease. It is administered intravenously in cycles or rounds and spreads throughout the body. Each course of treatment is followed by a rest period.
Due to the aggressive nature of penile cancer treatment, reconstructive surgical options are essential to minimize the cosmetic and emotional impact of treatment without compromising the chances of a cure. To provide the best possible treatment for penile cancer, not only in terms of cure but also in terms of reconstruction, we have a team of uro-oncologists, oncologists, and urologists specializing in reconstruction. Only a multidisciplinary approach allows us to achieve the best results in such a complex disease that so profoundly affects the men who suffer from it.
We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
Coming soon
We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
Coming soon
We left very happy with the doctor-patient relationship
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