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Cancer of the Penis is Treatable if Found Early
Unlike testicular cancer, which is highly curable, cancer of the penis is an aggressive, destructive disease. But it is detectable and it is treatable, says urological cancer expert Antonio Puras-Baez, MD.
Dr. Puras-Baez, from the University of Puerto Rico Medical School, spoke about penile cancer to fellow urologists at the annual meeting of the American Urological Association in Atlanta last week. He emphasized that the disease can be managed with current treatments, but that urologists must be "highly vigilant" in their diagnosis and assessment.
The rates of cancer of the penis vary widely by race and geography. This cancer is rare in circumcised men and common in places where circumcision isn't usually performed, particularly Brazil, Columbia, Africa and parts of India. It usually strikes men in their 40s and 50s. Other risk factors include chronic irritation, poor genital hygiene and frequent viral infections, Dr. Puras-Baez said.
Dr. Puras-Baez explained that in treating penile cancer, there are three goals: first, to completely remove the tumor; second, to preserve the appearance and function of the penis; and third, to prevent subsequent death.
He also emphasized that the patient's lymph nodes do not have to be removed in all cases of penile cancer. "With the data we have, there is no need to do a lymphadenectomy for low grade, low stage tumors," he stated.
When all cases are analyzed together, about 60 percent of men with penile cancer survive for five years. The survival rates are higher for men with tumors that haven't spread and lower for those whose cancer has invaded other parts of the body (metastases).
"The most important prognostic factor is lymph node invasion," Dr. Puras-Baez explained. Even when the cancer has spread, patients with only one cancerous lymph node have a better chance of survival than those with more than one involved.
The type of lesion in the penis also affects survival. "Patients with low grade lesions have a low rate of metastasis and a higher survival rate," he said.
The outlook for treating penile cancer that is found early is good, Dr. Puras-Baez concluded. "I believe that we can improve treatment of this cancer, and there is enough evidence [from research] to help with the management of it."