Penile Cancer And Treatment Outcomes

Penile cancer refers to uncontrolled growth of penis lining cells. In most cases, the lesion develops at or around the penile tissue. The external sexual organ penis serves as a primary organ for sexual, reproductive as well as urinary systems.

About 90-95% of all the penile cancers arise from the squamous (flat) lining cells of penis (also known as squamous cell carcinoma). Other less frequently occurring histological varieties of penile cancer includes adenocarcinoma, verrucous carcinoma, basal cell carcinoma, melanoma, sarcoma, and others.

What Are Some Surgical Options To Treat Penile Cancer?

Penectomy is an invasive procedure that involves removal or surgical excision of penis. Depending upon the size and involvement of tissues, penectomy may be complete or partial. Other less aggressive surgical options that may help in addressing penile cancer are:

• Tumor excision: Depending upon the size and depth of tumor, your surgeon may advise excision (a procedure that is usually ideal for small-sized superficial tumors)
• Mohs surgery: This is a unique procedure that involves removal of cancer tissue layer by layer. After each layer is removed, it is immediately examined under the microscope to see if cancer cells are still present in the excised mass.
• Circumcision: Circumcision is employed as a useful tool for very superficial penile cancers that are only limited to the foreskin. Individuals who opt radiation therapy for penile or associated cancers should also go for circumcision as radiation therapy leads to constriction of penile foreskin leading to complications.

Other treatment options include immunotherapy (also referred to as biological therapy) and chemotherapy. Secondary treatment reduces the risk of recurrence.

Adjustments After Penile Surgeries

Recovery from penile cancer is usually challenging; partly because of the surgery itself and partly because the penis is linked to the idea of manhood. A lot of physical and emotional adjustments are needed to ensure optimal recovery.

Here are some areas of adjustment after penile cancer surgery:

• Urination: Penile cancer surgeries changes the way a man will urine. In partial excision, the man would still be able to urinate in standing position, but for advanced cancers in which complete penile excision is performed, the man would have to sit in order to pass urine.
• Sexual Dysfunction: Sexual dysfunction is a fairly common complication of penile surgeries. In partial penectomy, sexual dysfunction may be progressive, whereas in complete penectomy, penetration may not be possible. It is highly recommended to speak to your doctor regarding sexual expectations and complications prior to the surgery.
• Reconstructive surgery: After surgical excision of penis, reconstructive surgeries such as phalloplasty, are performed once initial recovery is complete. The goal of surgery is to restore the confidence as well as improve the self-image of the individual.
• Emotional Recovery: Emotional journey after cancer diagnosis, treatment and penile surgeries is challenging for most men. It is very important to start the process of emotional healing as early as possible to address anxiety, depression after treatment.

References

• Sharma, P., Protzel, C., & Spiess, P. E. (2016). Future Directions and Clinical Trials in Penile Cancer. In Textbook of Penile Cancer (pp. 311-324). Springer, Cham.
• Burt, L. M., Shrieve, D. C., & Tward, J. D. (2014). Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. International Journal of Radiation Oncology* Biology* Physics, 88(1), 94-100.