Penile cancer

Question 1

What can predispose someone to penile cancer?

Answer 1

HPV (human papillomavirus) subtypes 16, 5 and 18

Question 2

What is the most common type of penile malignancy?

Answer 2

Squamous cell carcinoma - from inner prepuce or glands.

Question 3

What are risk factors for penile cancers?

Answer 3

HPV infection
Phimosis
Smoking
Lichen sclerosis
Untreated HIV infection

• circumcision can be protective

Question 4

How does someone with penile cancer present?

Answer 4

Palpable or ulcerating lesion on the penis
Typically painless
Lesions may discharge / bleed
Inguinal lymphadenopathy

Question 5

What are some differentials for penile cancer?

Answer 5

Infections - e.g. herpes simples or syphilis
Inflammatory conditions - e.g. psoriasis or balanitis
Premalignant conditions

Question 6

What investigations are done for penile cancer?

Answer 6

Biopsy
PET- CT to look for inguinal lymphadenopathy,
Chest, abdo, pelvis CT to complete staging (TNM)

Question 7

How is penile cancer managed?

Answer 7

If superficial + non invasive - topical chemotherapy agents such as 5-fluorouracil. Or laser treatment

Surgery is normally needed.
May also need neoadjuvant radiotherapy or chemotherapy.

After surgical removal, reconstruction is often needed.