Our bodies are composed of many types of cells. Normal, healthy cells carry out their specific tasks in an orderly fashion. They respond to signals from other cells and do not grow beyond what the body needs for healthy function. When they become old or damaged, they die and new cells are formed. Cancer cells are cells that have gone haywire. They continue to grow and divide and can result in clusters of cells called tumors. While cancer of the penis is not as common as bladder or breast cancer, the American Cancer Society estimates that about 2,320 new cases of penile cancer are diagnosed each year. Read on for 12 facts you may not know about penile cancer.
12. Benign Conditions Affecting the Penis
Not all growths on the penis are cancerous. Genital warts (condylomas) are caused by the human papilloma virus (HPV) and look like tiny cauliflowers on the skin. Another condition caused by HPV is called Bowenoid papulosis, which appears as many small, raised, brown, red, or skin-colored growths on the shaft of the penis. While Bowenoid papulosis is not cancer, if left untreated it can progress to form cancer. The HPV vaccine protects against genital warts and cancers caused by HPV. The use of condoms during sex also prevents transmission of this virus.
11. Penile Cancer Prevalence and Risk Factors
Penile cancer is rare in North America and Europe. It accounts for less than 1% of cancers in men in the United States. Higher rates of penile cancer are seen in some parts of Asia, Africa, and South America. Some risk factors for contracting penile cancer are non-circumcision, becoming infected with HPV, smoking, and age greater than 55 years. Uncircumcised men with a buildup of secretions under the foreskin, called smegma, may be prone to cancer from irritation and inflammation of the penis. Men with weakened immune systems caused by HIV infection may also be more likely to develop penile cancer.
10. Squamous Cell Carcinoma
Squamous cells are the thin, flat cells that make up the outer layer of the skin. The majority of penile cancers start in these cells in the epidermis of the penis. Many of them begin on the foreskin of uncircumcised men. They may also develop on the glans, or head, of the penis. Verrucous carcinoma, also known as Buschke-Lowenstein tumor, is a squamous cell tumor that resembles genital warts. Carcinoma in situ (CIS) is the earliest stage of squamous cell penile cancer. CIS of the shaft of the penis is called Bowen disease.
Melanocytes are the skin cells that produce the melanin that darkens your skin to protect it from the sun. When the DNA of the melanocytes is damaged, usually by the sun’s ultraviolet rays, mutations occur causing the skin cells to rapidly divide and form cancerous tumors. While melanoma most frequently occurs in skin that is exposed to the sun, it can form in other areas, such as the penis. This type of penile cancer is very rare.
8. Basal Cell Carcinoma
Another form of cancer that can, very rarely, affect the penis is basal cell carcinoma. This cancer forms in the very deepest layer of the skin’s epidermis, in the basal cells. Basal cell carcinoma appears as open sores, shiny red bumps or patches, or pink growths. This type of cancer does not tend to spread from one region of the body to another.
Adenocarcinoma very rarely develops from the sweat glands in the penis. Adenocarcinoma is most commonly found in lung, prostate, pancreatic, esophageal, and colorectal cancers. Penile adenocarcinoma may look like carcinoma in situ.
Soft tissue sarcoma encompasses tissues that develop in soft tissues such as muscle, tendons, fat, lymph nodes, blood vessels, and nerves. Soft tissue sarcomas are mainly found in the arms, legs, and torso. On rare occasions, they can develop from the blood vessels or connective tissues of the penis.
5. Symptoms of Penile Cancer
Changes in the skin of the penis are often the first indication that something is awry. Penile cancer lesions may appear on the head (glans) of the penis, on the shaft of the penis, or on the foreskin of uncircumcised men. One warning sign is when an area of skin becomes thicker than the surrounding areas or changes in color. You may notice a tumor, a lump, or an open sore. Skin growths can appear as crusty bumps or flat brown nodules. A rash, foul-smelling discharge, or bleeding under the foreskin of uncircumcised men is also a signal to seek medical attention.
4. Prevention of Penile Cancer
Circumcision seems to be a strong factor in the prevention of penile cancer. However, uncircumcised men can decrease their likelihood of developing cancer of the penis by using good hygiene. It is recommended that uncircumcised men pull back the foreskin to clean the entire penis. This prevents the development of painful smegma, the irritating secretions that can be trapped under the foreskin. Since human papilloma virus is linked to the development of penile cancer, taking precautions against HPV will also be protective against cancer. Use of condoms during sexual activity and vaccination against HPV can help prevent cancer.
3. Diagnosis of Penile Cancer
If you detect warning signs of penile cancer, your doctor will conduct an exam and take a thorough medical history. Biopsies may be taken of the nodules or bumps, and biopsies of your lymph nodes may be taken as well. Your physician may order a computed tomography (CT) scan to see if the cancer has spread to other areas of your body. A CT-guided needle biopsy may be employed to remove a sample of enlarged lymph nodes. MRI, ultrasound, and chest x-rays are other diagnostic tools that may be used to determine the extent of cancer in your body.
2. Treatment of Penile Cancer
Surgery is the most common treatment for penile cancer. If the cancer is limited to the foreskin, circumcision may be all that is required to remove the cancer. In other cases, more of the tissue of the penis may need to be removed. If the cancer is caught early enough, some of the penis may be spared, called a partial penectomy. If the cancer has advanced to later stages, the entire penis may be removed in a penectomy. If the cancer has spread to lymph nodes, they may need to be surgically removed as well. Radiation may be used to treat penile cancer if the lesions are very small or if surgery is not an option. If caught very early, some low-grade penile cancers may respond to laser treatment or cryotherapy.
1. Prognosis of Penile Cancer
When caught early, the prognosis for penile cancer is optimistic. According to the American Cancer Society, the 5-year survival rate for cancers that were confined to the penis is around 85%. If cancers have spread to nearby tissues or nodes, the 5-year survival rate is around 59%. Good genital hygiene, understanding of risk factors, and safe sexual practices all aid in prevention, early detection, and intervention of penile cancer.