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Penile Cancer

Updated : February 8, 2024





Background

Penile carcinoma is a rare type of cancer. Squamous cell carcinoma is the most prevalent kind of penile malignancy. However, nonsquamous penile malignant neoplasms such as melanoma, basal cell carcinoma, sarcomas, and adenosquamous carcinoma also occur.

Epidemiology

Penile cancer is an uncommon malignancy in the Western community. It accounts for fewer than 1% of male malignancies in the United States, with around 2300 new cases and 400 fatalities annually. It is more widespread in developing countries such as South America, Africa, and Asia. Penile cancer accounts for up to 10% to 20% of all malignancies in males.

The greater risk in these places might be attributed to changes in hygiene habits and an increase in the proportion of uncircumcised boys. The condition relates to advanced age, and the incidence increases with age. The average age of diagnosis is around 60 years.

Anatomy

Pathophysiology

Penile malignancies usually start as tiny lesions on the glans or prepuce. The look varies widely. Others might be flat, reddish-colored, and ulcerated masses that appear as white, grey exophytic masses growing from the penile skin.

These lesions spread laterally over the surface of the penile skin, frequently covering the complete glans or prepuce before infecting the shaft of the penis and corpora. The growth rates of exophytic and ulcerative lesions are comparable, although ulcerative lesions seem to metastasize to lymph nodes quicker.

Penile lymphatics drain the shaft and the glans penis, with drainage progressing first to the superficial inguinal lymph node, then to the deep inguinal lymph nodes, and finally to the external iliac lymph node in the pelvis.

Etiology

The incidence of penile cancer varies and is linked to diverse variables. Clinicians have identified risk factors such as phimosis, chronic inflammation, balanitis, penile trauma, tobacco use, a failure of neonatal circumcision, lichen sclerosis, a history of sexually transmitted infections, including HSV and HIV, and poor hygiene.

Neonatal circumcision has been linked to decreased risks of penile cancer and has been proven to be an effective preventative technique that can eradicate the development of penile carcinoma. This is because it disrupts the enclosed preputial habitat where penile cancer develops.

This helps to prevent persistent smegma irritation, which can develop into chronic inflammation, a known risk factor for penile cancer. It also eliminates the risk of balanitis and phimosis. Patients with a history of phimosis have a 25% to 60% greater chance of developing penile cancer. Male circumcision has proven to protect against HIV-1 infection.

Sexually transmitted illnesses, including HPV and HIV, have also been linked to the formation of penile cancer. Patients living with HIV are eight times more likely to develop penile cancer. HPV is responsible for 45 to 80% of penile malignancies. Men with a history of phimosis are more likely to have high-risk HPV.

A positive HPV status may indicate increased cancer susceptibility to radiation treatment and a better prognosis. Tobacco usage is the last risk factor to consider. Cigarette smokers are three to four times as likely than nonsmokers to get penile cancer.

Genetics

Prognostic Factors

After surgical treatment, patients with stage I or II malignancies still restricted to the penis have a 5-year survival rate of roughly 85%. Cancers in stages III and IV have a five-year survival rate of roughly 59%. If cancer has spread to other body regions, the five-year survival rate is only 11%.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK499930/

Penile Cancer

Updated : February 8, 2024




Penile carcinoma is a rare type of cancer. Squamous cell carcinoma is the most prevalent kind of penile malignancy. However, nonsquamous penile malignant neoplasms such as melanoma, basal cell carcinoma, sarcomas, and adenosquamous carcinoma also occur.

Penile cancer is an uncommon malignancy in the Western community. It accounts for fewer than 1% of male malignancies in the United States, with around 2300 new cases and 400 fatalities annually. It is more widespread in developing countries such as South America, Africa, and Asia. Penile cancer accounts for up to 10% to 20% of all malignancies in males.

The greater risk in these places might be attributed to changes in hygiene habits and an increase in the proportion of uncircumcised boys. The condition relates to advanced age, and the incidence increases with age. The average age of diagnosis is around 60 years.

Penile malignancies usually start as tiny lesions on the glans or prepuce. The look varies widely. Others might be flat, reddish-colored, and ulcerated masses that appear as white, grey exophytic masses growing from the penile skin.

These lesions spread laterally over the surface of the penile skin, frequently covering the complete glans or prepuce before infecting the shaft of the penis and corpora. The growth rates of exophytic and ulcerative lesions are comparable, although ulcerative lesions seem to metastasize to lymph nodes quicker.

Penile lymphatics drain the shaft and the glans penis, with drainage progressing first to the superficial inguinal lymph node, then to the deep inguinal lymph nodes, and finally to the external iliac lymph node in the pelvis.

The incidence of penile cancer varies and is linked to diverse variables. Clinicians have identified risk factors such as phimosis, chronic inflammation, balanitis, penile trauma, tobacco use, a failure of neonatal circumcision, lichen sclerosis, a history of sexually transmitted infections, including HSV and HIV, and poor hygiene.

Neonatal circumcision has been linked to decreased risks of penile cancer and has been proven to be an effective preventative technique that can eradicate the development of penile carcinoma. This is because it disrupts the enclosed preputial habitat where penile cancer develops.

This helps to prevent persistent smegma irritation, which can develop into chronic inflammation, a known risk factor for penile cancer. It also eliminates the risk of balanitis and phimosis. Patients with a history of phimosis have a 25% to 60% greater chance of developing penile cancer. Male circumcision has proven to protect against HIV-1 infection.

Sexually transmitted illnesses, including HPV and HIV, have also been linked to the formation of penile cancer. Patients living with HIV are eight times more likely to develop penile cancer. HPV is responsible for 45 to 80% of penile malignancies. Men with a history of phimosis are more likely to have high-risk HPV.

A positive HPV status may indicate increased cancer susceptibility to radiation treatment and a better prognosis. Tobacco usage is the last risk factor to consider. Cigarette smokers are three to four times as likely than nonsmokers to get penile cancer.

After surgical treatment, patients with stage I or II malignancies still restricted to the penis have a 5-year survival rate of roughly 85%. Cancers in stages III and IV have a five-year survival rate of roughly 59%. If cancer has spread to other body regions, the five-year survival rate is only 11%.

https://www.ncbi.nlm.nih.gov/books/NBK499930/

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