What is penis cancer?
Penis cancer takes birth inside or on the surface of the penis. It does it most often in the skin cells of the penis. The cancerous tumor (malignant) is a group of cancerous cells that can invade and destroy the surrounding tissue. It can also spread (metastasis) to other parts of the body.
Penis cells sometimes undergo changes that make their growth or behaviour abnormal. These changes can lead to non-cancerous (benign) conditions such as genital warts (also called warts).
Changes in the penis cells can also cause precancerous states. This means that the abnormal cells are not yet cancerous, but that they may become so if they are not treated. The precancerous state of the most common penis is penile (pine) intra-epithelial neoplasia.
But in some cases, the changes that affect the penis cells can cause cancer. Most of the time, penis cancer originates in flat and thin cells called squamous cells. These cells are found in the skin and head of the penis (glans). This type of cancer bears the name of squamous carcinoma of the penis. It can appear anywhere on the penis, but it does it most often on the foreskin (in uncircumcised men) or the glans.
Rare types of penis cancer can also occur. Adenocarcinoma, melanoma and basal carcinoma are examples of this.
The penis is part of the reproductive system and the human urinary tract. The main structures of the male reproductive system are the testicles, the epididymis, the seminal vesicles, the prostate and the penis. The internal parts of the male reproductive unit are located in the lower pelvic cavity, between the hip bones (iliac bones). The penis hangs in front of a skin bag called scrotum that contains the testicles.
Pattern of the male reproductive system
Structure
The penis is made up of different types of tissues, including skin, nerves, smooth muscles and blood vessels.
The body is the main part of the penis. The head of the penis is called acorn. The glans is covered with a flaccid and mobile skin fold called foreskin. Sometimes the foreskin is removed by surgery (circumcision). The base of the penis that is attached to the pelvis is called root.
The penis consists of 3 chambers of spongy tissue containing many blood vessels:
The cavernous bodies are the two upper chambers of the body of the penis that form the largest part of this organ.
The spongy body is the lower chamber of the body of the penis that surrounds the urethra.
Inside the penis, there is a thin tube called urethra that extends from the base of the bladder to the tip of the penis. The opening of the urethra is on the glans of the penis and bears the name of Meatus. Urine and sperm circulate through the urethra to the meatus where they are removed from the body.
Function
The penis is part of the urinary tract. It includes the urethra, which circulates urine from the bladder to the outside of the body.
The penis is also a male sexual organ. During an erection, nerves indicate to the blood vessels located inside the cavernous bodies of the penis to fill with blood. When the blood supply increases, the spongy tissue takes up volume and makes stiffen and swell the penis, allowing it to penetrate into the vagina during a sexual relationship. The sperm passes through the urethra and is evacuated by the meatus when the man ejaculates. After ejaculation, the blood is removed from the penis, which becomes soft again.
Risk Factors for penis cancer
A risk factor is something like a behavior, a substance or a condition that increases the risk of developing cancer. Most cancers are due to many risk factors. But it happens that penis cancer develops in men who do not present any of the risk factors described below.
Penis cancer is a rare cancer in Canada. It may appear in people of any age, but the risk of being a day with penis cancer usually increases with age. Penis cancer most often affects men over the age of 60.
The precancerous states of the penis are among other things the intra-epithelial penile neoplasia (pine) and the kraurosis penis (also called lichen sclerosus of the penis). They are not cancerous, but they can sometimes become invasive penis cancer if they are not treated. Many risk factors for penis cancer can also cause these precancerous states. Learn more about the precancerous states of the penis.
The risk factors are usually listed of the largest at least important. But in most cases it is impossible to classify them with absolute certainty.
Known risk factors potential risk factors
Human papilloma Virus (HPV)
Phimosis
Not to be circumcised
Poor genital hygiene
Weakened immune system
PUVA Psoriasis Therapy
Smoking
Penis injury
Known risk factors
Convincing evidence that the following factors increase your risk of penis cancer.
Human papilloma Virus (HPV)
Most sexually active men will have at least one HPV infection in their lives. HPV is easily transmitted during skin-to-skin contact with any infected area of the body. More than 40 types of HPV are propagated through sexual intercourse, genital skin contact and oral sex. Some sexual behaviour may increase the risk of acquiring HPV infection, including:
Become sexually active at a young age
have many sexual partners
Having sex with a partner who has already had many sexual partners
have unprotected sex.
Each type of HPV is considered to be at high risk or at low risk to cause cancer. High-risk HPV is more likely to lead to cancer. HPV 16 and HPV 18 are the most common types of high-risk HPV. They're related to penis cancer. Low-risk HPV, such as HPV-6 and HPV-11, rarely causes cancer, but can form warts on or around the genitals. Men with penis cancer often claim to have already had genital warts. It is not clear yet what role these viruses may have in the onset of penis cancer.
Phimosis
In uncircumcised humans, it is possible that the foreskin becomes thick and narrow, and that it is difficult to lift (retract). We're talking about phimosis. This disorder makes penis cleaning more difficult and could lead to chronic infection or inflammation.
Men with kraurosis penis are often affected by phimosis. They may even present a higher risk of penis cancer than men suffering only from phimosis.
Not to be circumcised
When circumcision is taken, the foreskin is removed. The age of man at the time of his circumcision seems to affect the risk of cancer of the penis. The incidence of this cancer appears to be lower in circumcised men when they were newborns or children. Adult circumcision does not appear to offer protection against penis cancer.
Research suggests that circumcision would promote better hygiene of the penis, cause less irritation or inflammation of the penis and reduce the risk of HPV infection of the penis. Circumcision prevents phimosis, which is also related to penis cancer.
Although some data suggest that circumcision reduces the risk of penis cancer, there is insufficient evidence to recommend circumcision as a preventative method for this type of cancer. The Canadian Paediatric Society does not routinely recommend circumcision of all male newborns. This decision is very personal and often depends more on religion and culture than on medical reasons.
Poor genital hygiene
In uncircumcised humans, a thick substance can accumulate under the foreskin. This substance bears the name of Smegma. It consists of dead skin cells, bacteria and oily secretions.
Accumulation of smegma can increase if the penis is not cleaned properly. Smegma can cause chronic irritation and inflammation of the penis, which increases the risk of being diagnosed with penis cancer. Some studies also suggest that smegma may contain small amounts of cancer-causing substances, but conclusive evidence is not held.
Weakened immune system
Weakening of the immune system (immunosuppression) reduces the body's ability to defend itself against infections, including HPV infection. The immune system can be weakened for many reasons, including the following:
HIV or AIDS
Taking certain medications that inhibit the immune system (immunosuppressants) following an organ transplant
PUVA Psoriasis Therapy
Psoriasis is a skin condition. The treatment may include taking the drug called Psoralen followed by exposure of the area of skin affected to ultraviolet light (PUVA therapy). Men who have received a PUVA therapy are more likely to be diagnosed with penis cancer.
Possible risk factors
There is a link between the following factors and penis cancer, but there is not enough evidence to suggest that they are known risk factors. More research needs to be done to clarify the role of these factors in the onset of penis cancer.
Smoking
Tobacco use or consumption of smoke-free tobacco products (including chewing tobacco and snuff) may increase the risk of penis cancer. This risk seems to be the highest among men who smoke a lot and for many years. The combination of tobacco use with the consumption of smoke-free tobacco products can also increase the risk of penis cancer.
Researchers believe that chemicals present in tobacco and causing cancer could damage the DNA of the penis cells and thus increase the risk of penis cancer. The risk of cancer may also be higher because smoking increases the risk that an HPV infection will not disappear.
Penis injury
We need to do more research to clarify the role that penis injuries may have in the risk of penis cancer.
Unknown Risk Factors
It is not known if there is a link between the following factors and the cancer of the penis. This may be because the researchers are not able to definitively establish this link or that the studies have produced different results. We need to do more research to see if the following are risk factors for penis cancer:
Prolonged and painful erection (priapism)
Obesity
Questions to ask your healthcare team
To make the right decisions for you, ask questions about the risks to your healthcare team.
Symptoms of penis cancer
Penis cancer often causes symptoms at an early stage. Most of the time, the first sign of penis cancer is a change in the skin that may appear on the head of the penis, or gland, or on the foreskin of uncircumcised men. The body of the penis can also be reached. Other medical conditions can cause the same symptoms as penis cancer.
Consult your doctor if you have these signs or symptoms:
Mass or lesion on the penis
Changing the color of the penis – it is possible to raise the foreskin to see the bleached area
Mass or thickening of the skin of the penis
Redness or irritation on the penis
Reddish or velvety rash
Small bumps encrusted
Flat masses bluish brown
Smelly flow or bleeding from the penis or below the foreskin
Swelling at the end of the penis
Mass in the groin
Unexplained pain in the body or tip of the penis
Area or lesion that itches or burns
Diagnosis of penis cancer
Diagnosis is a process to identify the cause of a health problem. The diagnostic process of penis cancer usually starts with a visit to your family doctor. The doctor will ask you about the symptoms you are experiencing and it could give you a physical examination. Based on this information, it is possible that your doctor will direct you to a specialist or that he prescribes exams to verify the presence of cancer of the penis or other health problems.
The diagnostic process may seem long and discouraging. It's normal to worry, but try not to forget that other medical conditions can cause symptoms similar to those of penis cancer. It is important that the care team eliminates any other possible cause of the health problem before making a diagnosis of penis cancer.
The following tests are usually used to eliminate or diagnose penis cancer. Many tests to diagnose cancer are also used to determine the stage, which is how far the disease has progressed. Your doctor may also take other exams to check your health condition and help plan your treatment.
Health History and physical examination
Your health history consists of a review of your symptoms, risk factors and all the medical events and disorders you may have experienced in the past. Your doctor will ask you questions about your personal history:
Symptoms that suggest penis cancer
Human papilloma virus (HPV) infection
Foreskin that does not rise (retraction) completely (phimosis)
Poor genital hygiene
Not to be circumcised
Weakened immune system
Smoking
Psoriasis Treatment
The physical exam allows your doctor to look for any signs of penis cancer. During the physical exam, your doctor may:
Observe and palpate any mass or lesion on the penis and in the genital area;
Raise the foreskin and check the underside if you are not circumcised;
Test the lymph nodes of the groin.
Learn more about the physical exam.
Complete Blood formula
The Complete Blood formula (FSC) is used to evaluate the quantity and quality of white blood cells, red blood cells and platelets. An FSC is made to verify the presence of anemia caused by long-lasting (chronic) bleeding.
Learn more about the complete blood formula.
Blood Biochemical Analyses
In a blood biochemical analysis, the rate of chemical substances in the blood is measured. It allows to evaluate the quality of the functioning of certain organs and also to detect anomalies. The following blood biochemical analyses are used to diagnose penis cancer.
Serum calcium is used to measure calcium levels in the blood. Rates may be high (hypercalcemia) when advanced stage penis cancer has spread to the bone.
alanine aminotransferase (ALT), aspartate transaminase (AST), and alkaline phosphatase are used to assess liver function.
Learn more about biochemical blood tests.
Biopsy
During a biopsy, the doctor collects tissue or cells from the body in order to analyze them in the laboratory. The pathologist's report confirms the presence of cancer cells in the sample. It is possible to remove the foreskin (circumcision) if the abnormal region is on the foreskin. It is also removed to biopsy an abnormal area below.
The excisional biopsy is to remove the entire abnormal region. This type of biopsy may be used if the lesion or abnormal area is small. If the abnormal region only affects the foreskin, a circumcision can be made. If the abnormal region is small or limited to the foreskin, it can often be removed completely by an excisional biopsy.
The incisional biopsy consists of removing only a small part of the tissue from the abnormal region. This type of biopsy may be used if the lesion or the abnormal region is large, if it appears to develop deep in the tissue or if it is ulcerated, i.e. it looks like an open lesion on the skin.
Learn more about the biopsy.
lymph node biopsy
Penis cancer usually spreads to the lymph nodes of the groin that are closest to the penis. Lymph node biopsy is used to remove lymph nodes or to take cells from them during surgery so that they can be examined under a microscope for the purpose of knowing if they are affected by cancer.
The doctor examines the lymph nodes to see if they appear swollen or if they are. If the lymph nodes are not palpable, they are said to be clinically unaffected. If the lymph nodes are large and firm to the touch, they are said to be clinically affected.
If the lymph nodes are not palpable, the doctor can monitor them by conducting imaging tests (CT, MRI or toe) or a sentinel ganglion biopsy (BGS).
If the lymph nodes are large and firm to the touch, the doctor makes a fine needle biopsy (BAF) to find out if they are affected by cancer.
In some cases, lymph nodes are not checked by BGS or BAF but rather by surgery to remove some lymph nodes in an area, so-called ganglionic sampling.
Fine needle biopsy (BAF) can be used to collect a small amount of fluid from a swollen lymph node to determine if it contains cancer cells. We sometimes do a BAF instead of removing lymph nodes when we want to know if they are affected by cancer. If the biopsy reveals that cancer cells are present, surgery is possible to remove all lymph nodes in the area. The doctor may use ultrasound or CT scan to guide the needle in the lymph node if it is too deep to be palpated.
If BAF results are negative, i.e. no cancer cell is present, the biopsy can be redone and the doctor can monitor the lymph nodes using imaging tests.
If BAF's results are positive, that is, cancer cells are present, all lymph nodes in the region can be removed.
Sentinel ganglion biopsy (BGS) may be used to determine whether lymph nodes are being reached and whether lymph node removal is necessary. The Sentinel ganglion is the first lymph node or node cluster that receives lymph from the area surrounding the tumor. The cancer cells will most likely spread to these lymph nodes first. The BGS allows the sentinel node to be removed for examination to determine if it contains cancer cells. There may be more than one sentinel ganglion depending on the drainage pathway of the lymph vessels surrounding the tumor.
If the results of the BGS are negative, i.e. no cancer cell is present, then it is unlikely that other lymph nodes will be reached and no other surgery is necessary.
If the results of the BGS are positive, i.e. cancer cells are present, all lymph nodes in the region can be removed.
Learn more about fine needle biopsy (BAF) and Sentinel ganglion biopsy (BGS).
Ct
In a CT scan, specific X-ray equipment is used to produce 3-dimensional images and cuts of organs, tissues, bones and blood vessels of the body. A computer assembles the pictures in detailed images.
The pool CT is used to see if the cancer has spread to the surrounding lymph nodes, especially in obese men. It can also be used to see if the cancer has spread to the liver, lungs or other organs.
Sometimes a contrast product is given to help you see more specific details. It is usually injected into a vein of the hand or arm.
Learn more about TDM.
Magnetic resonance Imaging
In magnetic resonance imaging (MRI), powerful magnetic forces and radio-electric waves are used to produce cutting images of the body's organs, tissues, bones and blood vessels. A computer assembles images into 3-dimensional snapshots.
The MRI allows to know the size of the tumor and the location of the cancer in the body. It is also used to determine if the cancer has spread to nearby lymph nodes, nearby organs and tissues, or to the brain or spinal cord.
Sometimes a drug is injected into the penis to be erect during the examination. This allows the doctor to see more clearly the inside of this organ. Sometimes a contrast product like the gadolinium is administered to help see more precise details. It is usually injected into a vein of the hand or arm.
Learn more about MRI.
Ultrasound
During an ultrasound, high frequency sound waves are used to produce images of body parts. It helps to know the extent of cancer of the penis. An ultrasound of the pelvis can also be done to determine if the cancer has spread to the surrounding lymph nodes, organs or tissues.
Sometimes a drug is injected into the penis to be erect during the examination. This allows the doctor to see more clearly the inside of this organ.
Learn more about ultrasound.
Radiography
In an X-ray, low-dose radiation is used to produce images of body parts on film. It is used to check whether the cancer has spread to the lungs or bones.
Learn more about the X-ray.
Bone scan
In a bone scan, radioactive material is used that attaches to the bones (radiopharmaceuticals) and a computer to create an image of the bones. It is used to determine if the cancer of the penis has spread (metastasis) to the bones.
Learn more about bone scan.
Positron emission tomography
In a positron emission tomography (PET), radioactive material called radiopharmaceutical is used to detect changes in the metabolic activity of the body tissues. A computer analyzes the distribution patterns of radioactivity and produces 3-dimensional and coloured images of the region examined.
Pet is used to determine if penis cancer has spread to nearby lymph nodes. It can be associated with TDM (PET/TDM).
Learn more about pet.
Questions to ask your healthcare team
Learn more about the diagnosis. To make the right decisions for you, ask questions about the diagnosis to your healthcare team.
Histological Classification of penis cancer
The grade is defined by the appearance of cancer cells compared to normal cells. To establish the rank of penis cancer, the pathologist examines a sample of tissue taken from the penis microscopically. The pathologist assigns a grade of 1 to 4 to penis cancer. The lower the number, the higher the rank.
The term differentiation is used to describe how different cancer cells are.
Low-grade cancer cells are well differentiated. They almost look like normal cells. They tend to grow slowly and are less likely to propagate.
High-grade cancer cells are poorly differentiated or undifferentiated. Their appearance is less normal, or more abnormal. They tend to grow faster and are more likely to spread than low-grade cancer cells.
Knowing the rank gives your care team an idea of how quickly cancer can develop and its likelihood of spreading. This helps him plan your treatment. The rank can also help the care team determine the possible outcome of the disease (prognosis) and predict how cancer might react to treatment.
Stages of penis cancer
The staging describes or classifies cancer according to the amount of cancer present in the body and its location during the initial diagnosis. This is often referred to as the extent of cancer. The information revealed by the examinations is used to determine the size of the tumor, which parts of the organ are affected by cancer, whether the cancer has spread from its place of origin and where it has spread. Your healthcare team uses the stage to plan your treatment and anticipate the outcome (your prognosis).
The most commonly used staging system for penis cancer is the TNM classification. In the case of penis cancer, there are 5 stages, the stage 0 followed by stages 1 to 4. For stages 1 to 4, Roman numerals I, II, III and IV are often used. But in order to make the text clearer, we will use Arabic numerals 1, 2, 3 and 4. In general, the higher the number of the stage, the more the cancer has spread. Talk to your doctor if you have any questions about the staging.
Penis diagram
When doctors describe the stage, they can use local, regional or remote words. Local means that the cancer is found only in the penis and that it has not spread to other parts of the body. Regional means near or around the penis. Distance means in a part of the body farther from the penis.
Some stages of penis cancer also depend on the difference in appearance between cancer cells and normal cells, which is related to the grade of cancer.
Learn more about staging and the histological classification of cancer.
Stage 0 (or carcinoma in situ)
The cancer is found only in the upper layers of the skin of the penis.
Stage One
The cancer has invaded the connective tissue located just under the skin of the penis but not the blood vessels or the lymphatic vessels (flooding lymphovasculaire). The appearance and behavior of cancer cells are very similar to those of normal penis cells.
Stage 2a
The cancer has invaded one of the following parts of the body:
Connective tissue located just under the skin of the penis (also invading blood or lymphatic vessels or appearance and behavior of cancer cells very different from those of normal penis cells)
Spongy body (lower chamber of the body of the penis that surrounds the urethra) and sometimes urethra
Stage 2b
The cancer has invaded the cavernous body (one of the two upper chambers of the body of the penis which form the largest part of this organ) and sometimes also the urethra.
Stage 3a
The cancer spread to 1 lymph node of the groin (inguinal ganglion). This ganglion moves when the doctor palpates him.
Stadium 3b
The cancer has spread to at least 2 lymph nodes of the groin and they move when the doctor palpates them.
Stage 4
At stage 4, one of the following statements applies:
Cancer has invaded a neighboring structure other than the urethra.
The cancer has spread to the lymph nodes of the groin and has formed a mass that does not move (fixed ganglionic mass) when the Doctor palpates it.
The cancer has spread to the lymph nodes of the pelvis (pelvic lymph nodes).
Cancer has spread to other parts of the body (remote metastasis), such as the lungs, liver or bones. We're also talking about metastatic penis cancer.
Recurrence of penis cancer
The recurrence of a cancer of the penis means that the cancer reappears as a result of the treatment. If he reappears at the place where he first started, we are talking about local recidivism. If it reappears in tissues or lymph nodes located near where it first originated, it is referred to as a regional recurrence. It can also reappear in another part of the body: we are talking about relapse or remote metastasis.
Prognosis and survival for penis cancer
If you have a penis cancer, you may be asking questions about your prognosis. A prognosis is the act by which the Doctor best evaluates how the cancer will affect a person and how he or she would react to treatment. Prognosis and survival depend on many factors. Only a doctor who is familiar with your medical history, the type of cancer you are diagnosed with, the stage, grade and other characteristics of the disease, the treatments selected and the treatment response can examine all of these data in conjunction with Survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of cancer (as if it has spread) or a characteristic of the person the doctor considers when making a prognosis. A predictive factor influences how the cancer responds to a certain treatment. Prognostic factors and predictive factors are often approached together and both play a role in the choice of treatment plan and in the prognosis setting.
The following are prognostic or predictive factors of penis cancer.
Stage
The stage of penis cancer established during diagnosis is an important prognostic factor. The lower the stage of penis cancer, the better the outcome. Tumours on the skin surface of the penis produce a more favorable prognosis than those that have passed through the skin to the erectile tissues of the penis (spongy body or cavernous body). When you diagnose it at an early stage, you can usually cure penis cancer.
Spread to lymph nodes
The spread of cancer to the lymph nodes is linked to the stage of the tumor and this is an important prognostic factor. A cancer of the penis that has not spread to the lymph nodes creates a better prognosis than a cancer of the penis that has spread to the lymph nodes. The number of lymph nodes and the group of lymph nodes to which cancer has spread also play a role in the establishment of survival. Men with a single ganglion in the groin (inguinal ganglion) with cancer have better chances of survival than men with more than one inguinal ganglion or a different group of ganglia being reached.
Tumor size
Tumors that measure more than 5 cm and tumors that cover more than 75% of the body surface of the penis are more likely to spread to the lymph nodes and produce a darker prognosis.
Spread to blood or lymphatic vessels
A cancer that has not spread to the blood vessels or to the lymphatic vessels (lymphovasculaire flooding) tends to generate a better prognosis than a cancer that has spread to the blood vessels or lymphatic vessels.
Grade
Low grade penis cancer results in better prognosis than high grade cancer. The tumor that appears on the foreskin or the glans (head of the penis) tends to be low grade. Most tumors that affect the body of the penis tend to be high grade. The higher the grade of the tumor, the greater the likelihood that the cancer has spread (metastasis) to the lymph nodes.
Type of penis cancer
Some types of penis cancer cause a better prognosis. Warty carcinoma and basal carcinoma are usually low grade, they rarely spread to other parts of the body and generate a good prognosis. Penis melanoma tends to develop and spread faster and is often at an advanced stage when diagnosed.
Penis Cancer treatments
If you have a penis cancer, your healthcare team will develop a treatment plan just for you. It will be based on your health and specific information about cancer. When your healthcare team decides what treatments you propose for penis cancer, it takes into consideration the following elements:
The type of cancer
The stage of cancer
The location of cancer on the penis
Your overall health
What you prefer or want
One or more of the following treatments for penis cancer can be offered.
Surgery
Surgery is the main treatment for penis cancer. Depending on the stage and the size of the tumor, one of the following types of surgery can be practiced.
When circumcision is taken, the foreskin of the penis is removed. This is sometimes the only intervention necessary for a very small tumor located only on the foreskin.
During the Mohs surgery, the cancer is removed in layers, gradually, until there is no more. It can be used to treat a small early stage penis cancer.
During laser surgery, an intense and narrow beam of light (laser beam) is used to destroy cancer cells. It can be used to treat a small early stage penis cancer (carcinoma in situ) or a pre-cancerous condition of the penis.
During the cryosurgery, extreme cold is used to freeze and destroy tissue. It can be used to treat early penis cancer (in situ carcinoma or warty carcinoma).
During the large local excision one removes the tumor as well as a normal fabric margin all around. It is used for a small early penis cancer.
When Glandectomie, the head (glans) of the penis is removed. It can be used for a penis cancer that is only on the head of the penis.
In partial or total penectomy, the penis is removed in part or in whole. It can be used for a penis cancer that has spread deep into the tissues of the penis.
A lymph node is sometimes done to remove a cancer that has spread to the lymph nodes.
Radiotherapy
In radiotherapy, radiation is used to destroy cancer cells. It can be administered to men who want to keep their penis:
Before surgery to reduce the size of the tumor
After surgery to destroy the remaining cancer cells and reduce the risk of recurrence (relapse) of cancer;
To relieve the symptoms of advanced cancer.
External radiation therapy and brachytherapy are the two main types of radiation therapy that can be used to treat penis cancer. During the external radiation, a device emits radiation through the skin to the tumor and part of the tissue surrounding it. In the brachytherapy, or internal radiation therapy, the radioactive source is put directly into the tumor or very close.
Drug treatment
Drug treatment for penis cancer is sometimes used. Medications can be administered in different ways.
For topical treatment, a cream or gel is used to apply the medications directly to the penis. It can be used to treat early penis cancer or a precancerous state. Chemotherapeutic agents or immunotherapeutic medications are used for topical treatment. Immunotherapy is a type of biological therapy that uses natural or synthetic substances that alter the way the cells behave.
For systemic chemotherapy, anti-cancer drugs (cytotoxic) are used to destroy cancer cells throughout the body. It is often administered by a needle inserted in a vein (intravenous, or IV). It is usually used to treat advanced stage penis cancer. We can:
Associate or not with radiation therapy when it is not possible to remove cancer by surgery;
Administer it before surgery to reduce the size of the tumor;
Administer it after surgery to destroy the remaining cancer cells and reduce the risk of recurrence of cancer;
Administer it to relieve the symptoms of advanced stage penis cancer.
If you can not or do not want to receive cancer treatment
You might want to consider care that aims to make you feel better without treating cancer even, perhaps because cancer treatments no longer work, it is no longer likely that they will improve your condition or that their side effects are difficult to tolerate. Other reasons may explain why you may not or don't want to receive cancer treatment.
Talk to the members of your healthcare team. They can help you choose the care and treatment of advanced cancer.
Followed
Follow-up after treatment is an important component of care for people with cancer. You will need to have regular follow-up visits, especially during the first 5 years after the treatment. Some men may have regular follow-up visits even up to 10 years after being treated.
These visits allow the care team to monitor your progress and find out how you are recovering from treatment.
Clinical trials
Some clinical trials of penis cancer are underway in Canada and accept participants. The aim of the clinical trials is to find new methods for the prevention, detection and treatment of cancer. Learn more about clinical trials
Questions to ask about treatment
In order to make the right decisions for you, ask questions about the treatment to your care team.
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