Penile Cancer Flashcards
What % of male cancer is penile cancer?
1%
What are risk factors for penile cancer?
Age
Premalignant lesion
Phimosis (foreskin of penis cannot be pulled back)
Asia, Africa and South America
HPV
Smoking
Immunocompromise
PUVA therapy (psoralen and UV light for psoriasis)
95% of penile cancer are…
squamous cell carcinoma (SCC)
[3% are Kaposi sarcoma]
What does PeIN stand for?
Penile Intraepithelial Neoplasia
What is the Grading for penile cancer?
G1-3
(3 is worst, 1 is best)
What is the Ta stage?
Epithelium
What is the T1 stage?
Lamina propria
What is the T2 stage?
Spongiosum
What is the T3 stage?
Cavernosum
What is the T4 stage?
Scrotum, prostate or bone
What staging is the most important prognostic factor in penile cancer?
N staging
What does N0 mean?
No nodes, over 90% chance 5 year survival
What does N1 mean?
Up to 2 unilateral inguinal nodes
85% 5 year survival
What does N2 mean?
3+ unilateral/ bilateral nodes
70% 5 year survival
What does N3 mean?
Extra nodal extension / pelvic nodes
15% 5 year survival
What does M1 mean?
Distant metastasis
0% 5 year survival
How does penile cancer present?
Hard painless lump
Red patch under foreskin
On glans or prepuce
Bloody discharge
Can be advanced.
How to diagnose penile cancer
General appearance and fitness
Examine
Abdomen
Lymph nodes in groins
Penis, lesion itself
DRE - prostate cancer also causes lymphadenopathy
Biopsy
USS
Chest and Pelvis CT to check for metastases
If clinically node negative:
Radioactive tracer given then gamma camera
Groin dissection
How to treat superficial penile SCC
Circumcision may be therapeutic
Glans resurfacing and biopsy
Eludix cream (makes skin fall off, not nice)
How to treat invasive penile SCC
Partial penectomy
