penile cancer

Question 1

name 3 radical tx options for penile cancer

Answer 1

Partical penectomy - most common (surgery)
EBRT
Brachytherapy

Question 2

role of surgery for penile cancer

Answer 2

partial penectomy is the removal of cancerous area on penis - only suitable if tumour of glans ones or foreskin and NOT an option if tumour invades shaft

Question 3

role of EBRT for penile cancer

Answer 3

66Gy in 33# or 55Gy in 22#
used for early stage cancers and whole penis irradiated if the shaft is invaded
wax block used to stabilise and acts as bolus to bring dose superficially

Question 4

role of brachytherapy for penile cancer

Answer 4

single or double impact at 60-65Gy in 6 -7# with lead shielding over testicles
tx delivered with penis upright in foam support, pt catheterised and receives GA
not an option if tumour >4cm or invaded crop cavernosa

Question 5

palliative tx for penile cancer

Answer 5

4-6 cycles of cisplatin with 3 weeks between each cycle

Question 6

give the 4 stages of penile cancer

Answer 6

stage I = tumour confined to glans penis or foreskin
Stage II = tumour invaded shaft
Stage III= tumour has operable inguinal LNs
Stage IV= has inoperable inguinal LNs

Question 7

name 5 aetiological risk factors for penile cancer

Answer 7

uncircumcised men - inc. risk
poor penile hygiene
Previous STDs
HPV - 50% of cases
Phimosis - foreskin doesn’t move as too tight

Question 8

name 3 tumour histologies for penile cancer

Answer 8

majority - squamous cell carcinoma
from bladder - transitional cell carcinoma
from prostate - adenocarcinoma

Question 9

give example of local/lymphatic/blood spread

Answer 9

local - invade rest of penis
lymph - inguinal LNs
Blood - RARE