Makindo Medical Notes.com

Penile cancer is a rare type of cancer that occurs on the skin of the penis or within the penis itself. It most commonly affects the glans (head) or the foreskin, and is often associated with certain risk factors, including poor hygiene, human papillomavirus (HPV) infection, and smoking.

About

• Rare form of cancer

Pathology

• Squamous cell carcinoma: Accounts for more than 95% of penile cancer cases. It typically starts in the glans or foreskin.
• Basal cell carcinoma: A less common form that tends to grow slowly and is less likely to spread.
• Melanoma: A rare but aggressive form that starts in the melanocytes (pigment-producing cells) of the penis.
• Adenocarcinoma: Another rare form that arises from the sweat glands in the skin of the penis.

Risks

• Human papillomavirus (HPV) infection: strains HPV 16 and 18, also linked to other cancers.
• Poor hygiene: uncircumcised men, where the buildup of smegma can increase the risk.
• Smoking: possibly due to the carcinogenic effects of tobacco.
• Phimosis: foreskin cannot be fully retracted, leading to chronic inflammation.
• Age: Most cases occur in men over 50 years old.

Clinical

• Growths or sores on the penis: Usually on the glans or foreskin, which may be painless initially.
• Bleeding: From the lesion, particularly if it becomes ulcerated.
• Foul-smelling discharge: Especially under the foreskin.
• Changes in skin color: Or thickening of the skin on the penis.
• Pain: May occur in advanced stages.

Investigations

• Bloods: FBC, U&E, LFTs, Ca
• Biopsy: histological examination to confirm the diagnosis.
• Imaging: Staging MRI, CT scans, or USS to assess extent of the cancer and if it has spread.

Management

• Surgery: local excision, partial or total penectomy, or lymph node dissection.
• Radiation therapy: primary treatment or after surgery to eliminate remaining cancer cells.
• Chemotherapy: advanced cases or when the cancer has spread to other parts of the body.
• Topical treatments: early-stage cancers, such as imiquimod or 5-fluorouracil creams.