Penile Cancer

Question 1

Penile cancer is rare, peaking in what age groups?

1 - 30-40
2 - 40-60
3 - 50-70
4 - 70-90

Answer 1

4 - 70-90
- predominant histology is squamous cell carcinoma

Question 2

Which virus is commonly a risk factor for developing penile cancer?

1 - Epstein-Barr virus
2 - Herpes viruses
3 - Human Papilloma Virus
4 - Human immunodeficiency viruses

Answer 2

• 3 - Human Papilloma Virus
• accounts for 30-40% of cancers

Question 3

Is phimosis or para-phimosis more commonly associated with penile cancer?

Answer 3

• phimosis

Other risk factors:
- Penile Intraepithelial neoplasia (PeIN)
- Smoking
- Rural location
- Low socioeconomic status

Question 4

Is penile cancer curable?

Answer 4

• yes
• 80% are cured
• typically poor prognosis if they metastasise

Question 5

If there is penile cancer and its becomes metastatic is can spread through the lymphatics. Which lymph nodes drain the penis?

1 - lumbar lymph nodes
2 - retroperitoneal lymph nodes
3 - external inguinal lymph nodes
4 - pelvic lymph nodes

Answer 5

3 - external inguinal lymph nodes
- this is where the sentinel lymph node is that will be biopsied

Question 6

Which of the following is NOT a sign that a patient may have penile cancer?

1 - Red patches
2 - Penile mass
3 - Haematuria
4 - Reduced Flow
5 - Pain
6 - Erectile dysfunction

Answer 6

6 - Erectile dysfunction

• exam the scrotum, penis, inguinal lymph nodes and abdomen

Question 7

MRI and can be performed on the penis to assess tumour and staging. At what stage can the tumour be completely removed, with organ preservation?

1 - Ta-T2
2 - Ta-T3
3 - Ta-T1
4 - any stage

Answer 7

3 - Ta-T1

Stage T2-4
- Complete penectomy with perineal urethrostomy (opening up urethra through the perineum)
- Radiotherapy

• beyond this is palliative