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• How is penile cancer treated

How is penile cancer treated?

Much progress has been made in the last few years on using less invasive treatment methods. The extent to which the cancer has spread will determine the treatment right for you.

Treatments used for cancer of the penis include surgery, radiotherapy and, occasionally, chemotherapy.

SURGERY

• Simple excision – small, surface cancers (stage 1) that have not spread are treated by removing only the affected area by conventional surgery, laser or cryotherapy (which freezes and kills the cancer). If the cancer is confined to the foreskin, circumcision alone may be all that is needed. These operations are considered simple procedures and it may be possible to perform them under local anaesthetic as an outpatient.
• Wide local excision – is necessary where the cancer has spread to deeper tissue (stage 2 and above). This means removing the cancer along with some healthy tissue around it, reducing the risk of the cancer returning. The operation is done under general anaesthetic and will require a short stay in hospital.
• Penectomy (surgical removal of part, or all of, the penis). It is the most effective procedure to treat cancer of the penis that has penetrated deep inside the penis (stage 2 and above). Partial penectomy removes only the end of the penis. If the cancerous tissue is near the base of the penis, total amputation may be the only option. This is only used in extreme cases, and in this case, the surgeon will create a new opening for the urethra so urination can still be controlled. Full reconstructive surgery may be an option.
• Lymphadenectomy (surgical removal of lymph nodes in the groin area). This is an option if it is suspected that the cancer has spread beyond the penis.

RADIOTHERAPY

• External – High energy x-rays are directed from a machine at the area of the cancer to kill it. It is normally administered as a series of short daily treatments that could last up to six weeks depending on the size and spread of the tumour.
• Brachytherapy – involves planting dozens of tiny radioactive seeds delivering a high dose of radiation to tissues in the immediate area of the tumour, therefore minimising the damage to healthy tissues. They stop being radioactive after several weeks, then remain permanently and harmlessly in place. This procedure can be done under local anaesthetic.

CHEMOTHERAPY

• Is the use of anti-cancer (cytoxic) pharmaceutical drugs circulating in the blood to destroy cancer cells, but also damaging some normal cells.
• It is rarely used for cancer of the penis in the early stages, but it is the main way of treating it when it has spread throughout the body.
• This brings with it a number of unwanted side effects such as fatigue, nausea and hair loss.

It is important to remember that new treatments for cancer are being developed all the time. Orchid aims to provide information on the latest research and treatments through leaflets, specialist factsheets, the website and low-down.