Penile cancer is a form of skin cancer of the eye or foreskin. If you seek treatment early, there are several treatments that remove the disease without affecting your ability to pee and get a hold. Most people who get penis cancer get rid of the disease.

Penile cancer is one of the most common forms of cancer that men can get in the genitals or the urinary tract. Most people who get penis cancer are over 60 years old. Penile cancer does not infect and is not hereditary.

For the most part, penile cancer is a form of cancer that begins in the skin. Sometimes cancer can grow into the swelling of the penis and spread to the lymph nodes, which are also called the lymph nodes.

It is almost impossible to say why an individual gets cancer. This also applies to penile cancer. But the risk of getting penile cancer can increase if one or more of the following is true:

  • You have foreskin constriction. Among men who have been circumcised as children, penile cancer is rare.
  • You have human papillomavirus, HPV .
  • You are smoking.
  • You have the skin disease like sclerosis et atrophicus.
  • You get treatment for psoriasis with psoralen and UVA light, so-called PUVA treatment.

Is it possible to prevent penile cancer?

Pull back the foreskin from time to time, if you have the beginning of narrow foreskin. It prevents inflammation that can increase the risk of penile cancer. A good time can be when you need to wash your penis . 

You can get help widening the foreskin with a prescription ointment with cortisone, if you need it. You can also have a doctor remove the foreskin completely or partially. 

Quitting smoking reduces the risk of getting both penile cancer and getting sick again, if you have already had penile cancer.

The variants of the HPV virus that can cause cervical cancer can also cause penile cancer. So far, only vaccination against HPV  for girls  is part of the national vaccination program.

Symptoms of penile cancer

At the beginning of the disease you may have one or more of the following symptoms of the penis cancer:

  • A difficult wound.
  • Red areas.
  • A hardening.
  • Foul smells from a narrow foreskin.
  • Bleeding.
  • Pain.
  • Swollen lymph nodes in the groin.

The symptoms need not mean you have cancer. Genital warts , scabies after intercourse and fungal infections can also cause you to get red areas, for example. 

When and where should I seek care?

Contact a health care center if you have skin changes on the penis that have not passed after two to three weeks, or if you have problems with the foreskin. You can contact many receptions by logging in .

Investigations

You are offered an examination according to a standardized course of care if a dermatologist or a urologist examines you and suspects that your complaints may be due to penile cancer.

Standardized care processes are a way of organizing the investigation so that it goes as quickly as possible. Among other things, there are times set for the surveys you may need to do.

The doctor who writes the referral tells you why you should be investigated according to a standardized course of care, what it means and when you can be told if you have cancer or not.

It is often quick to get calls for examinations in a standardized course of care. It is good if you are clear about how the staff most safely reach you so that you do not miss any time.

Tissue tests can show if you have cancer

The doctor can take a tissue sample from the skin to see if the change contains cancer cells.

Investigations if you have cancer

Your doctor may need to examine you more if it turns out you have cancer and the disease may have spread. The doctor may suspect it, for example if the cancer tumor is large or if you have swollen lymph nodes in the groin.

You will be examined with a computer tomography  or  PET camera .

You may also need to submit a tissue sample from the lymph nodes. The doctor inserts a needle into the lymph nodes, often using ultrasound . You get  local anesthesia . In addition to the stick, sampling usually does not hurt.

Sometimes the lymph nodes need further investigation. Then you will be operated on. The operation is called surgery by the gatekeepers, or sentinel node.

First, you sleep.  The surgeon then removes the lymph nodes that are closest to the cancerous tumor, the so-called doorman glands. This is done through a small incision in each groin. The doorman glands are sent for analysis to show whether they contain cancer cells. 

Most people can leave the hospital the day after surgery.

You need to remove all lymph nodes in the groin if the doorman glands contain cancer cells. Read more in the chapter Treatments when the disease was discovered later.

Treatments when the disease is detected early

You can receive treatment for the penis cancer that does not affect the body as much if the disease is detected early. Here are examples of treatments that preserve your ability to pee and get a hold.

Ointment with anti-cellulite drugs

You treat yourself with a special ointment for about a month. The treatment removes cancer but it can hurt quite a bit while the treatment is in progress.

Circumcision

It may be sufficient to remove the foreskin if the cancer is only there. The operation is called circumcision. You get local anesthesia. You can leave the hospital a few hours after the operation. It takes about four weeks for the wound to heal.

The cancer tumor is removed

A cancerous tumor on the eyelid can sometimes be cut off. It happens with a knife or laser. You get local anesthesia or sleep. The treatment can work even if the cancer tumor is a bit larger. Most often, the foreskin is removed while the cancer is being operated on.

Most people can leave the hospital the day after surgery.

Sometimes the surgical wound needs to be left open to heal by itself rather than sewn together. Then it can take up to three months for the wound to heal. During the healing time, touch can hurt, but otherwise, you can live as usual.

Some feel that the feeling is reduced after the operation, others think that the feeling is improved. It depends on how big the operation was, and how bad you were in the past. 

The skin of the eyelid is replaced

The foreskin and skin of the eyelid can be removed if the cancerous tumor is superficial. You are anesthetized when you are operated on. Skin from your thigh is used to replace the removed skin on the ulcer and to cover the wound surface after the foreskin.

You stay in the hospital for up to five days.

The wound on the thigh heals in a few weeks. The transplanted skin on the eyelid has healed after about six weeks.

The feeling may be impaired, but the treatment usually does not affect your ability to cope.

Treatments when the disease is discovered later

Sometimes the cancerous tumor has been growing for a while when it is discovered. Then you may need one of the treatments described here. 

The oak is removed

Sometimes the ulcer needs to be removed. It’s called a glossectomy. You are anesthetized before surgery.

Most often you can get a new, cosmetic ointment of skin from your outer thighs.

You need to stay for up to five days in the hospital.

The wound on the thigh heals in a few weeks. The transplanted skin on the eyelid has healed after about six weeks.

The operation will make your penis shorter and your sensation lessened. You can still pee with the penis and get a hold.

Larger penis surgery

It is unusual to have the penis removed. It may be necessary if the cancer has grown a lot. 

You are anesthetized before surgery. The surgeon removes the penis and arranges so that you can continue to urinate through an opening between the scrotum and the rectum.

It is common to have to stay for up to five days in the hospital after the operation.

Sometimes it is enough to operate the oblong and parts of the swelling bodies. Then you first get  anesthesia or become anesthetized.

It is common to have to stay one to two days in the hospital. You may need to urinate using a urinary catheter for about a week afterward. 

The operation will make the penis shorter and change its appearance. The feeling becomes impaired. You will find it harder to get a hold, though. The coffin beam is spread more and therefore you may in future have to sit down while kissing.

Lymph node operation in the groin

All lymph nodes in one or both grooves need to be removed if the cancer has spread to the groin lymph nodes. You are anesthetized before surgery. Sometimes the penis and lymph nodes are operated at the same time.

You need to stay in the hospital for about a week afterward. 

You get drainage in the operation wound. It is a small hose that carries away the lymphatic fluid that runs out. Sometimes it can take several weeks before it stops flowing and the drainage can be removed. It can easily become an infection of the wound. Contact a health care center for help changing the dressing. 

A physiotherapist will help you try out special support socks. The support socks can prevent swelling in the legs and abdomen that you can get after the lymph node surgery. It’s called lymphedema . You need to use the support socks for about six months, sometimes longer.

You can get  rose fever  if the lymph nodes have been removed. It is a bacterial infection that makes you need medical attention.

Lymph node surgery in the stomach

Sometimes the lymph nodes in the stomach must also be removed. It is done through a cut below the navel.

Radiation therapy and cytostatics

You may need more treatment besides surgery if the cancerous tumor is large and has spread to the lymph nodes.

You can get cytostatic drugs both before and after surgery. Cytostatics is a collective name for drugs that inhibit cancer cells in different ways.

You may also need external radiation therapy .

Cytostatic or radiation therapy can also slow down and relieve the disease if the cancer tumor is not operable. It is called palliative care .

Which treatment is best?

The treatment for penis cancer you need depends on how much the tumor has grown and whether it may have spread to the lymph nodes. 

What you want is very important. Sometimes you can choose treatment. Take your time so you can think through the options and make a choice that will be good for you even in the long term.

Many can receive any of the treatments that do not affect the ability to urinate and get a hold as much. However, you may need to go for checks frequently after such treatment.

The risk of getting cancer back is less if you get all or part of the penis removed. You do not need to go for post-checks as often. 

It is important that you understand the options and are involved

It is important that you understand what alternatives are available to you and how they can affect your life. You have the right to be involved in your care. 

You can talk to your doctor or curator several times, for example, if you need to hear the information again or get answers to more questions.

New medical assessment

You can get a new medical assessment if you have been diagnosed with penile cancer and feel unsure if you are getting the care and treatment that is best for you. You will then see another doctor, usually at another specialist clinic.

Ask your doctor if you want to know more about how to get a new medical assessment.

You can get care in another place

You will receive a referral to a urology clinic if the doctor at the health center suspects you have penile cancer. 

The doctor at the urological clinic will contact a group of specialists if you have cancer. The specialists advise each other and suggest the treatment that they consider to be best for you. 

You usually need to be operated on or have the lymph nodes examined more thoroughly. The clinic’s contact nurse can help you with the practical. 

Sometimes more care is needed, such as radiotherapy or drug treatment. You will receive such treatment at the hospital in your region. There are also checks that are usually necessary for five years after you have received treatment.

Back to everyday life

Life can feel different after treatment for cancer. You always have the experience of what you have been with. It can be painful periodically, but usually, it gets better – although it can take time. Some feel vulnerable and worried long after treatment is over.

Several ways to get support

Tell the contact nurse, doctor or curator how it feels. There are several ways to get help and support.

Care plan for your needs

You and the staff who have treated you plan what rehabilitation you may need, such as aids or supportive calls. It should be in your care plan. 

Contact with others

The contact nurse or the curator can sometimes help if you want to talk to someone who has also had penile cancer. There is no patient association yet for people who have had penile cancer. 

You can contact for example Cancer Counseling or Cancer Foundation. Here you will find contact information for them and others who also provide advice and support in cancer.

Sexuality and closeness

Maybe the illness and treatment have affected both your desire and self-esteem and how you function sexually.

Talk to the contact nurse or the curator. They can advise on support for you and your potential partner.

There are sexologists and psychotherapists who can help you and a possible partner return to an intimate relationship based on perhaps new conditions. It can be supported to be able to talk to each other or discover new ways of being together.

Can I get sick again?

It is called relapse if the disease recurs. Relapse is most common in the first two years after treatment. Therefore, you may need to come up with tighter post-checks in the first two years.

But most people who have had penile cancer may not relapse. The risk is higher if the cancer tumor was large or if it had spread to the lymph nodes.

It is important that you examine yourself

Over time, there may be an increased time between post-checks and after five years you are no longer called. After so long, it is uncommon for the disease to return.

You need to continue to examine yourself regularly. Contact your healthcare provider again if you notice any skin changes on the penis or feel swollen lymph nodes in the groin.

If cancer comes back

Chances are that you will notice early on if the disease will return if you go on all the checks and check yourself regularly. If you have already received a treatment that preserves the penis, you can usually receive such treatment again.

Getting a sick message

You can respond in many ways to a cancer message. It is common to need a lot of time to talk to your doctor and other healthcare professionals about what the message means.

If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.

You can also ask to have the information written down so you can read it peacefully. Ask questions if you don’t understand. You have the right to receive information in your own language. You also have the right to receive interpreting assistance if you have a hearing impairment.

In many hospitals, there are special nurses called contact nurses who should be especially accessible to the sick person and to their relatives. The contact nurse can provide support and also help with various practical things.

You can get support in several places

Talk to the contact nurse or the hospital’s curator if you feel anxious or have questions.

It is common to feel easier once treatment has begun and you know what is going to happen. Here you can read more about the first time after the message.

Children need to know

Children have the right to receive information and support based on their own needs if a relative is ill. You can get help with what you have to say if you want to and can tell the child yourself.

Often it is good to make children as involved as possible, regardless of age. But you may need to customize the information and not have to tell everything. It may be good to start with the child’s own questions. .

Being related

It can feel difficult to be close to someone who is sick. It is common to want to support while you yourself have a strong concern and feel bad.

If you have people close to you, they can be a support. Often it will be easier for them to help you if you tell them how it feels. You can also talk to the contact nurse if you are close and need supportive calls.

You can get relief if you help take care of or support the sick person. You can also get support, for example in the form of calls or help with practical things.

Muhammad Nadeem

Leave a Reply