Penile cancer (penile cancer)

Penile cancer or Penile cancer is mostly diagnosed in men over the age of sixty and describes the rare form of cancer of the external male genital organs. Penile cancer is one of the types of cancer that can be detected during preventive examinations and cured surgically.

What is penile cancer?

At Penile cancer or. Penile cancer Tumors form on the penis and especially on the glans and foreskin. Penile cancer rarely spreads to the rest of the body through the bloodstream. Penile cancer is a slowly growing tumor that causes little or no symptoms in the first stages.

If left untreated, however, it can affect the erectile tissue, prostate, urethra and lymph nodes in the abdomen. Squamous cell carcinoma is characteristic of the cancer. This is a malignant tumor that develops in the top layer of the skin and often looks warty or ulcer-like.

Other types of skin cancer can also develop on the penis. A degeneration of the pigment cells, as occurs in malignant melanoma, is also possible as penile cancer.

causes

In addition to age-related cell degeneration, Penile cancer a virus-related development is suspected. The focus is on infections caused by HPV, which are the cause of some uterine cancers in women.

In some cases, the scientists assume that these human papillomaviruses can also cause penile cancer in men through an infection. Since infectious diseases are generally considered to be the cause of penile cancer, poor hygiene is a risk factor for penile cancer. The foreskin sebum (smegma) that forms under the foreskin is a breeding ground for diseases if it is not carefully removed in daily body care.

In addition, there are pathological changes in the foreskin such as foreskin constriction.With so-called phimosis, the cause of penile cancer, the narrowing of the foreskin cannot be pushed back enough for sufficient cleaning of the glans.

Symptoms, ailments & signs

Penile cancer does not cause clear symptoms at the beginning. The patient initially feels tired and limp, occasionally slight pressure pain occurs in the shaft region. In the further course, swellings and hardening form in the area of ​​the glans and foreskin. These lesions are initially rough and swollen before they harden and develop into lumps.

This can be accompanied by a foul-smelling discharge. Blood is rarely excreted. When the carcinoma enlarges and spreads into the surrounding areas, this can often be felt in the groin area. The cancer can affect other areas and, depending on the affected region, cause other symptoms and complaints. Organ dysfunction, nerve disorders and neurological failures, but also swellings, ulcers and other skin changes are possible.

If no treatment is given by then at the latest, penile cancer can be fatal. Growing carcinoma of the penis also leads to serious complications during urination and intercourse. This considerably limits the quality of life and well-being of those affected. A progressive cancer can also be recognized externally.

This results in a sickly appearance and the person affected noticeably loses weight. If penile cancer is treated early, the symptoms usually subside quickly. After a few weeks to months, the urination process should return to normal.

Diagnosis & course

The examining doctor initially diagnoses a suspicion by palpation and viewing Penile cancer. A biopsy is used to determine what type of penile cancer it is, while other procedures are eventually used to determine the extent of the tumor.

The diagnosis is made via ultrasound examinations and tomography procedures. In the early stages, penile cancer initially only affects the glans and foreskin. Only in the further course does it penetrate the body via the erectile tissue and the urethra. These arise from the fact that the pathologically swollen lymph nodes in the groin block the removal of tissue water from the legs.

Rarely and at an advanced stage, penile cancer can form metastases in more distant parts of the body, which can only be detected with imaging techniques.

Complications

It is true that penile cancer (penile carcinoma) is a malignant tumor. However, since the carcinoma usually develops very slowly, there is usually a very good chance of a cure if treated early. In over 90 percent of all cases, patients treated early survive more than five years. Because the disease usually only causes unspecific complaints and often no pain, it can happen that the first treatment is too late and sometimes even only after the occurrence of metastases.

In these cases the prognosis deteriorates noticeably. Often the penis then has to be completely amputated. Sometimes metastases are observed in the lymph nodes and other organs. If distant metastases occur, additional treatment with radiation and chemotherapy must be carried out. However, in these cases a cure is no longer possible. Only the course of the cancer can be delayed. If distant metastases are present, there is only a five percent five-year chance of survival.

At this stage of the disease, often only palliative measures can help to reduce the suffering of the patient. In most cases, penile carcinoma is a squamous cell carcinoma, which progresses very slowly and is therefore easy to treat even in later stages. With the presence of the rare melanoma, an extremely malignant skin cancer, the prognosis for the disease is often very poor even in the early stages of the disease.

When should you go to the doctor?

Swelling in the genital area of ​​the man is a cause for concern. If ulcers develop, the normal skin texture changes or pain occurs, a doctor is needed. A reduced libido, erectile dysfunction and an increased urge to urinate should be examined and treated. Since penile cancer, if left untreated, leads to the spread of cancer cells and thus can lead to premature death, a doctor should be consulted at the first discrepancy. If there are irregularities when going to the toilet, a sensitivity disturbance in the genital area or pain in the groin area, a doctor should be consulted.

Lymph swellings or palpable lumps in the man's abdomen should be presented to a doctor. Further signs of a health irregularity are a loss of weight, behavioral problems and fatigue. Less resilience, apathy and general dissatisfaction are indications that should be followed up. In the case of inner restlessness, general weakness and a continuous decline in well-being, a doctor's visit is advisable. Abdominal tightness, difficulty moving, and digestive complications should be discussed with a doctor. A reduced quality of life, anxiety, insomnia and diarrhea are indications of an existing illness. If the symptoms persist over a long period of time or if they increase in intensity or extent, a doctor's visit is advisable.

Treatment & Therapy

When treating Penile cancer it is crucial to discover the tumor as early as possible. Penile cancer is mainly removed surgically. In order for the procedure to damage as little tissue as possible and to preserve the penis, early detection is necessary.

If penile cancer has already reached the erectile tissue, the only option is often the psychologically stressful amputation of the entire penis. At this stage, however, penile cancer is still curable despite the amputation. Life-saving surgery for penile cancer is only ruled out when the infestation has progressed further.

At this late stage, chemotherapy and radiation are no longer used to fight penile cancer, but are intended to relieve symptoms. Since penile cancer affects the lymph nodes in the groin, water retention in the legs occurs as a symptom of a more advanced stage, which is reduced again by radiation and lymphatic drainage.

Towards the end of the disease, penile cancer and its metastases cause painful conditions, which are treated by the individually dosed administration of painkillers.

Outlook & forecast

The prognosis for penile cancer can vary greatly. Decisive factors are the stage of cancer, the presence of metastases, the chosen form of therapy, but also the age of the patient. If penile cancer is diagnosed and treated early, the chances of a cure are very good at around 70 to 90 percent. Usually the penis can also be preserved.

Most patients do not see a doctor until the cancer has progressed and lymph node metastases have already formed. This significantly worsens the prognosis and is only around 46 percent. Often an amputation of the entire penis or parts of the penis is necessary. As soon as distant metastases have already formed, the prognosis is very poor.

The 5-year survival rate for the affected patients is only 5 percent. In general, older sufferers have far worse prospects than younger ones. The choice of form of therapy is also decisive. Surgical removal of the metastases and the affected tissue on the penis is usually more successful than chemotherapy. In the advanced stage, additional radiation therapy is usually necessary because healing will not occur without it.

prevention

There Penile cancer causes hardly any symptoms in the early stages, regular preventive medical check-ups are the best method for men from the age of 45 to detect the tumor early enough. Given the high involvement of infectious diseases, careful personal hygiene is one of the best things you can do to prevent them from developing. A foreskin circumcision to prevent penile cancer should also be considered.

Aftercare

Follow-up care is standard for every cancer. Doctors hope that this will enable them to recognize the recurrence of a carcinoma at an early stage. Because even with penile cancer, a diagnosis in the early stages leads to the best chances of recovery. Scheduled examinations extend to at least the first five years after completion of the initial therapy. They take place quarterly at the beginning.

Then the interval increases from appointment to appointment. The clinic in which the initial treatment took place is usually responsible for aftercare. Depending on the outcome of the therapy, rehab may be indicated. In this, the patient finds his way back to everyday life under expert guidance. If necessary, medication is also discontinued.

A satisfactory quality of life and the exercise of one's own sexuality are important objectives of medical action after penile cancer. Every examination includes a conversation between doctor and patient. Specific questions should clarify the question of a new disease. The prostate and male member are also examined.

If necessary, imaging methods such as CT, MRI and an ultrasound examination are used. If there is a justified suspicion of a new disease, a tissue sample is also taken and examined under a microscope. This complex procedure is intended to prevent life-threatening complications in advance.

You can do that yourself

Those affected are well advised if they have been diagnosed with penile cancer if they follow the doctor's instructions. Since the disease can lead to death, early and comprehensive medical care should be provided. A visit to a doctor is advisable as soon as the first irregularities and abnormalities occur in the genital area. Since self-healing is not to be expected in this disease, changes in the area of ​​the genital organ should be discussed with a doctor as soon as possible.

In order to be able to rule out other diseases quickly, adequate contraception should always be used during sexual intercourse. The use of condoms is advisable for changing sex partners. The disease is common in men over the age of 60. Participation in regular check-ups is recommended so that the disease can be diagnosed at an early stage. Men in whom the sex partner has suffered an infection from HPV, in particular, should participate in check-ups. Since the virus is often the cause of later penile cancer, early treatment with antibiotics against the viral disease is recommended.

The foreskin of the penis should be cleaned daily. After intercourse, it is particularly important to remove the foreskin sebum so that diseases do not develop. If the foreskin is narrowed, it is advisable to clean the external genital organs several times a day.