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Cancer from A to Z

Types of cancer, how to prevent them, diagnosis and treatment.

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Penile Cancer

Penile cancer is a rare form of cancer that forms in the penis. The penis contains several types of tissues and different types of penile cancer may develop in these cells. It is important for your health care provider to determine which type of penile cells are affected in order to gauge the seriousness of the disease and plan the best treatment. 

Types
The following are common types of penile cancer:

  • Squamous cell carcinoma
  • Adenocarcinoma
  • Melanomas
  • Basal cell penile cancer
  • Sarcomas

Penile cancer starts on the glans (head), or tip, of the penis and spreads from there. Some men may have obvious symptoms in the early stages, while others may not have any symptoms until the disease has advanced. Although it may not mean cancer, any abnormalities of the penis should be reported to your doctor as soon as possible. Unfortunately, many men are reluctant to discuss these issues with their physician, and may delay seeking treatment until the disease is advanced and harder to treat.

Men who have retained their foreskin need to examine the area underneath the foreskin regularly, as well as to keep the area clean to lower their risk. Penile cancer symptoms may include:

  • A wart-like growth or lesion
  • An open sore that won't heal
  • A reddish rash
  • Persistent, smelly discharge under the foreskin
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Clinical trials
Sym015(Anti-MET) en Pacientes con tumor solido avanzado.
Ensayo de fase 1a/2a, abierto y multicéntrico, para investigar la seguridad, tolerabilidad y actividad antitumoral de dosis repetidas de Sym015, una mezcla de anticuerpos monoclonales dirigida frente al receptor MET, en pacientes con tumores malignos sólidos en fase avanzada
DU176b-D-U311
Estudio fase IIIB, prospectivo, randomizado, abierto que evalúa la eficacia y seguridad de Heparina/Edoxaban versus Dalteparina en tromboembolismo venoso asociado con cáncer.
Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética
Tumores sólidos. Antiemesis Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética (QAE). A phase III, multicenter, randomized, double blind, placebo controlled study of the safety and efficacy of Rolapitant for the treatment of Chemotherapy-induced nausea and vomiting in subjects receiving highly Emetogenic Chemotherapy (HEC)
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos.

The risks for penile cancer include:

Age: Most cases are seen in men aged 50-70, although nearly a third of cases occur in men under 50.

Smoking: Men who either chew or smoke tobacco are more at risk for penile cancer.

Human Papillomavirus (HPV): This sexually transmitted disease has more than a dozen subtypes. HPV 16 and HPV 18 are most frequently linked to penile cancer.

Lack of circumcision at birth: Studies have shown that penile cancerrates are higher in populations where circumcision is done later or not at all.

Phimosis: A condition in which it's difficult to pull back the foreskin, which can lead to the buildup of body oils, bacteria and other debris known as smegma.

Most cases of penile cancer are first detected as a change in color of the skin of the penis.   A doctor should examine the penis to check for other lesions or abnormalities as well as to screen for benign conditions which might be confused with penile cancer.  After the physical examination of the penis, a biopsy is needed to confirm an accurate diagnosis of the cancer.

Treating penile cancer depends on the stage of disease. Surgery is the most common form of therapy, but laser therapy and radiation can be used for smaller tumors. 

Surgery
Surgery to remove all or part of the penis is called penectomy:

Partial penectomy is a frequently used form of therapy. The tumor is removed along with a margin of normal tissue. Historically, a two-centimeter margin was obtained in all cases, but more recent data suggest that such wide margins may not be necessary. Surgeons are currently attempting to spare as much of the glans (head) and shaft as possible to retain urinary and sexual function.

Total penectomy involves removal of the entire penis for large tumors. The surgeon reroutes the urethra behind the testicles and a urethrostomy (hole) is created so the patient can urinate. Penile reconstruction surgery using a flap of skin from the forearm to create a new penis has been done, but the procedure is still extremely rare.

Other Treatments
For very small superficial tumors, penile cancer may be treated with a laser beam that destroys the tumor, radiation therapy and, in some cases, a cream containing the chemotherapy drug fluorouracil applied to the skin. These treatments offer the best opportunity to spare the glans, penis and sexual function. That is why it is important to find penile tumors early by seeking immediate medical attention for any abnormalities on the penis.