What Are the Symptoms of Penile Cancer?

Penile cancer is a malignant tumor that originates in the mucosa of the penile head, coronary sulcus and foreskin, and the skin of the penis. Is the most common malignant tumor of the penis, accounting for more than 90% of penile tumors. The most common pathological type is squamous cell carcinoma of the penis, which accounts for about 95% of penile cancer. Therefore, penile cancer has almost become synonymous with squamous cell carcinoma of the penis, causing everyone to ignore the existence of other types of penile cancer. According to the 2004 WHO histological classification of penile malignant epithelial malignant tumors, the pathological types of penile cancer were divided into penile squamous cell carcinoma, Merkel cell carcinoma, neuroendocrine small cell carcinoma, sebaceous carcinoma, clear cell carcinoma, and basal cell carcinoma. Bowen disease and Paget disease of the penis are classified as precancerous lesions. In fact, these two diseases also belong to special types of penile cancer. Before the 1950s, penile cancer was one of the most common malignant tumors of the male genitourinary system in China. With the continuous improvement of people's health conditions, the incidence of penile cancer has rapidly declined, especially after the reform and opening up. Cancer has become a rare tumor.

Basic Information

English name

carcinoma of penis

Visiting department

Urology

Multiple groups

40 to 60 year old men, those with long foreskins or phimosis

Common locations

Penis head, coronal groove, inner foreskin

Common causes

unknown

Common symptoms

There are nodules or masses in the foreskin, and purulent or bloody secretions often flow out of the foreskin

Causes of penile cancer

The exact etiology of penile cancer is still unclear. It is generally acknowledged that it is closely related to phimosis and foreskin. Foreskin scale and chronic inflammation are important causes of penile cancer. A large number of research results show that circumcision can prevent the occurrence of penile cancer in infants and young children, and circumcision in childhood or adulthood cannot reduce the incidence of penile cancer. Therefore, patients with phimosis should be treated as soon as possible. For people with too long foreskins, it is most important to keep the foreskin clean and to reduce the incidence of penile cancer. The vast majority of patients with penile cancer seen clinically now have phimosis. In addition, the causes of penile cancer include penile sclerosing moss, warts, genital warts, human papilloma virus infection, and incomplete circumcision. Therefore, patients with these conditions should also be treated as soon as possible.

Clinical manifestations of penile cancer

Penile cancer usually starts on the mucous membranes of the penis head, coronary sulcus, and inner foreskin. It is not easy to detect lesions in patients with phimosis in the early stage. It can touch nodules or masses in the foreskin, and it gradually increases and can penetrate The foreskin showed cancer. The foreskin is often purulent or bloody. Patients whose foreskin can be turned out and can reveal the head of the penis show pimples, papillary or flat protrusions, warts or cauliflower-like plaques, ulcers at the lesion, the lesions gradually increase, and the surface is often accompanied by malodor. Penile cancer rarely occurs in the body of the penis. Due to the associated infection, patients with penile cancer often have unilateral or bilateral inguinal lymphadenopathy. About 50% of patients with enlarged lymphadenopathy have pathologically confirmed lymph node metastasis.

Clinical diagnosis of penile cancer

The diagnosis of typical penile cancer patients is not difficult by clinical examination. The diagnosis of the disease requires pathological examination of the diseased tissue. The most common under the microscope are keratinized and moderately differentiated squamous cell carcinoma. There are 7 subtypes of basal-like carcinoma, genital wart-like carcinoma, papillary carcinoma, sarcomatoid carcinoma, mixed carcinoma and adenosquamous carcinoma in penile squamous cell carcinoma. Other types of penile cancer are rare.

Penile Cancer Treatment

Surgical resection is the most important and effective treatment. The choice of circumcision, partial penile resection, and total penile resection plus urethral plastostomy can be made according to the location, size, and stage of the lesion. Partial penile resection should be performed at least 2 cm from the tumor margin to normal tissue. Because infection is often accompanied, anti-inflammatory treatment is best for one week before surgery, including local anti-inflammatory treatment. For patients with inguinal lymphadenopathy, routine inguinal dissection is not currently recommended. If biopsy confirms that the inguinal lymph node has metastasis, inguinal lymph node resection or dissection can be performed. Combined radiotherapy can be considered after surgery.

For patients with advanced penile cancer accompanied by distant metastasis, chemotherapy should be considered. Commonly used chemotherapy drugs are pingyangmycin, 5-fluorouracil, cyclophosphamide and so on. Chemotherapy can also be combined with surgery and radiation therapy.

Prognosis of penile cancer

Most penile cancers have a low degree of malignancy, and proactive treatment has a good prognosis. The postoperative cure rate of patients with early penile cancer can reach 70% to 80%, and the 5-year survival rate of patients with inguinal lymph node metastasis is only 20% to 30% after treatment. If not treated, it usually dies within 2 years and has no 5-year survival rate.