Why is it important to know about this disease?
Penile cancer is rare, so it's hardly talked about. But it is precisely because of the rarity and delicacy of localization that men apply late: the change does not hurt, it seems like irritation or a manifestation of infection, and they try to treat it with ointments for months.
At the same time, a tumor at an early stage is highly sensitive to treatment, and modern methods make it possible to preserve the organ and its function. The difference between treatment after a month and after a year can be fundamental - from a small local intervention to a crippling operation.
Another reason for attention to the topic is precancerous conditions. Their identification and treatment can prevent the development of cancer in general.
Risk factors
- Human papillomavirus of oncogenic types is the most important factor
- Phimosis and inability to expose the head for hygiene
- Chronic inflammation: recurrent balanoposthitis
- Lichen sclerosus is a recognized precancerous condition.
- Smoking, including chewing tobacco
- Insufficient hygiene and accumulation of smegma
- Multiple sexual partners without barrier contraception
- Immunodeficiency, including HIV
- Age over 60 years, although the disease occurs earlier
- Previous PUVA therapy for psoriasis
Precancerous conditions
- Lichen sclerosus - whitish dense areas, cicatricial changes in the foreskin and glans
- Erythroplasia Keira - red velvety plaque on the head
- Bowen's disease is a lesion on the skin of the shaft of the penis
- Giant condyloma
- Leukoplakia
- Chronic balanoposthitis with scarring changes
All these conditions require observation by a urologist and a biopsy in case of suspicious dynamics. Their timely treatment is a real prevention of cancer.
Symptoms
- Painless ulcer or erosion on the glans or foreskin that does not heal for weeks
- Red plaque with a velvety surface
- Whitish dense spot
- Warty growth resembling cauliflower
- Seal palpable in the thickness of the head
- Bloody or foul-smelling discharge from under the foreskin
- Itching and burning
- Phimosis that first appeared in an adult man, hiding changes on the head
- Enlarged dense inguinal lymph nodes
- Pain is usually a late sign
Diagnostics
- Examination by a urologist with mandatory exposure of the head; phimosis may require incision or circumcision for inspection
- Biopsy of the changed area with histological examination is the only way to confirm the diagnosis
- HPV test
- Ultrasound of the penis and groin areas
- MRI of the penis to assess the depth of penetration
- Ultrasound of inguinal lymph nodes with biopsy if they are enlarged
- CT or PET-CT to assess prevalence
- Screening for sexually transmitted infections and HIV
Key practical point: any change on the head that has not healed within two to three weeks with conventional treatment requires a biopsy, and not a change in the next ointment.
Treatment
- Circumcision is sufficient if only the foreskin is affected
- Local therapy and laser destruction for superficial precancerous changes
- Resection of the head or its plastic surgery - organ-preserving operations in the early stages
- Partial amputation for deeper lesions
- Total amputation with the formation of a perineal urethrostomy - for common tumors
- Removal of inguinal lymph nodes is an important step that affects the prognosis
- Sentinel lymph node biopsy to determine whether lymphadenectomy is necessary
- Radiation therapy and brachytherapy as an organ-preserving alternative in selected cases
- Chemotherapy for advanced disease
- Reconstructive surgeries and prosthetics after treatment
Prevention
- Daily hygiene with head exposure
- Timely treatment of phimosis - do not delay in adulthood
- Treatment of recurrent balanoposthitis and search for its cause, including checking sugar levels
- Observation and treatment of lichen sclerosus
- Vaccination against HPV
- Using a condom
- Quitting smoking
- Regular self-examination and contact a urologist for any non-healing changes
Where to get examined in Tashkent
An examination by a urologist is required, the ability to perform a biopsy with histological examination and, if necessary, circumcision for a full examination of the head.
In Tashkent, such an examination is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic, and if the diagnosis is confirmed, treatment is determined jointly with the oncology service.
The main practical advice: do not treat a non-healing ulcer on the head with ointments for months. Two to three weeks without healing is a sufficient reason to see a urologist. It is at this stage that treatment is minimal in volume. Clinic contacts are below.
