Penile cancer: How do doctors think it’s a sexual disease… but it can steal a man’s genitalia –

Experts say hundreds of British men are forced to undergo life-changing surgeries every year because doctors don’t see the warning signs of penile cancer.

The disease, which affects about 700 men each year, can be treated with little impact on sexual life if caught early.

But research shows that half of all penile cancers are diagnosed at an advanced stage when it is impossible to save the organ. And one-fifth of patients die from the disease.

Cancer is often mistaken for a sexually transmitted disease by family doctors and sex nurses, as the first symptoms are often small lesions or red spots.

“It’s very common for doctors to misdiagnose penile cancer,” says Arie Parnham, consultant urological surgeon at Christie NHS Foundation Trust in Manchester and UK’s leading expert on disease.

‘This is a relatively rare cancer, so most primary care doctors will only see it two or three times in their career. Also, there are many relatively harmless diseases that cause non-cancerous red spots on the penis, so doctors really need to know what to look for. “

Parnham and other urologists want family doctors to be better informed about the disease to reduce the number of late diagnoses. “This disease kills men every year, but we never talk about it,” said Marc Lucky, consultant urologist and surgeon at Aintree University Hospital NHS Foundation Trust in Liverpool.

“The NHS needs to do more to ensure these patients are diagnosed and treated early.”

Doctors believe there are two main causes of penile cancer. Human papillomavirus (HPV), a sexually transmitted infection that causes a number of other cancers, including cervical cancer, is thought to cause about half of all cases.

It is estimated that eight out of ten people will become infected with HPV at some point. The virus normally lives harmlessly on the skin and mucous membranes of the body – around the mouth and genitals – and causes very few problems. Eventually, the immune system fixes it. But in rare cases, it can cause changes in cells that become cancerous.

After the HPV vaccine became available for teenage girls in 2008 and for boys in 2019, experts believe penile cancer cases will eventually decrease as fewer boys will be susceptible to the virus.

However, the other half of cases are believed to be due to skin damage. Conditions such as phimosis and lichen sclerosus, which cause inflammation around the foreskin, can cause cancer cells to form. Therefore, circumcised men are significantly less likely to develop penile cancer.

Cancer symptoms usually first appear as raised red dots or white patches on the top of the penis. When caught at this stage, surgery can be done to remove the cancerous tissue, leaving the organ largely intact. The longer the disease is left untreated, the more invasive the operation becomes.

One of the most common surgeries to deal with cancer is to remove the head of the penis. This is then replaced with a skin graft taken from the thigh.

The disease, which affects about 700 men each year, can be treated with little impact on sexual life if caught early. But research shows that half of all penile cancers are diagnosed at an advanced stage when it is impossible to save the organ. And one-fifth of patients die from the disease. (archive photo)

“It sounds strange, but it has surprisingly good results,” says Parnham. “If you were in a public shower, no one would notice the difference at a glance.”

This procedure is called “penis preservation” surgery, which means the organ is still working.

But data show that in many cases, the disease is also detected too late. Analysis by Mr. Parnham in 2009 found that 47% of men with penile cancer were diagnosed late for penile-sparing surgery.

This means that these men have cancer that has spread to the organ, which means that the entire penis must be removed.

Early diagnosis is also very important because if the cancer spreads to the groin, it becomes fatal.

“The average survival rate when there is cancer in the penis is about 90 percent, but if it reaches the pelvis [the bone structure around the groin] which drops below 30 percent,” says Parnham.

Experts say that some patients delay seeing the doctor because they are uncomfortable talking about their genitals.

“If you had an unreliable mole on your shoulder, you would ask your friends at the bar what they thought, but if it’s your penis, you’re more likely to keep it to yourself,” says Mr. Lucky. “You wouldn’t believe how many men didn’t come forward until the wives say it.”

One man who was recently diagnosed with penile cancer is Gavin Brooks, 44, of Crewe, who started showing symptoms in July 2021. The army officer noticed that the skin around the foreskin was beginning to swell. “It was like there was a rubber band around it. After a month, the swelling increased even more. It was really painful and could easily be cut.’

A single father of two children, Gavin eventually went to the family doctor, but was initially told there was nothing wrong. “He said it was probably thrush” [a common yeast infection] and it would go away.

But after a second opinion at a sexual health clinic, she was referred to a urologist who diagnosed her with cancer. But that didn’t come until December, five months after her symptoms started.

He says the diagnosis was a shock. “I’ve never heard of penile cancer,” she says.

Gavin has since had two surgeries and is now undergoing chemotherapy after the cancer has spread to his groin. She says she now has to sit up to go to the bathroom because of the extent of the surgery.

Gavin created an Instagram page to raise awareness about the disease and said he hopes men who notice penile cancer symptoms will show up sooner.

What is the difference between sarcoma and carcinoma?

Sarcoma and carcinoma are both types of cancer. A carcinoma develops in the cells lining organs such as the kidneys, liver, skin, breasts or prostate, and cavities such as the chest and abdomen.

Examples include basal cell carcinoma, a common skin cancer, and most breast cancers. About 85 percent of cancers are carcinomas.

Sarcomas are less common. This type of cancer begins in connective or supporting tissues such as bone, cartilage, fat, muscle or blood vessels.

Less than one in 100 cancers diagnosed each year is sarcoma. Soft tissue sarcomas usually affect the abdomen, arms or legs.