Penile Cancer

What is penile cancer?

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, mostly in men over 50 years of age, although it can also appear in younger men.

Penile tumor is closely related to exposure to human papillomavirus and therefore varies greatly depending on the geographic area. There are also other risk factors such as phimosis, smoking or preneoplastic lesions. Therefore, any new lesion that does not respond to conventional treatments is susceptible to biopsy. In addition, it is important to explore the presence of lymph nodes in the groin, which could correspond to local metastases.

Most cases are initially detected as a change in the color of the skin of the penis. It is advisable to maintain hygiene and perform self-examination to detect a wart-like lesion, an open sore, a reddish rash or a persistent, odorous discharge under the foreskin.

This type of tumor usually starts in the glans region and, depending on the type of cell showing uncontrolled growth, will be classified into:

• Epidermoid carcinoma
• Adenocarcinoma
• Melanoma
• Basal cell penile cancer
• Sarcoma

Penile cancer is very aggressive, so intense treatment will be necessary from the outset, often including penile surgery. It is important to have multidisciplinary units (urology, plastic surgery, oncology) to optimize both the oncologic and cosmetic and functional outcome.

Depending on the extent of the penile injury, different types of surgery can be performed:

• Excision (removal) of the tumor or suspicious area.
• Partial phalectomy: removal of the penile tumor with a safety margin, preserving the urethra to maintain normal voiding function. This surgery makes it possible to preserve sexual life.
• Total phalectomy: in case it is not possible to keep the penile shaft due to the location of the tumor, the entire penis will be removed.

Depending on whether or not the inguinal lymph nodes are involved, lymphadenectomy (removal of lymph nodes) will be necessary. If we think that there may be metastatic lesions, the treatment of choice is chemotherapy.