Cancer of the Penis (Squamous Cell Carcinoma of the Penis)

What is Cancer of the Penis?

Penile cancer arises on the penis. The usual location for the malignancy is in the glans, corona and/or frenulum.

Statistics on Cancer of the Penis?

Penile cancer is rare in Australasia. It accounts for less than 1% of cancers in males. It is more common in patients between the ages of 40 and 70. In contrast, its incidence may increase to cause around 10 to 20% of cancers in men in some parts of Asia and Africa. Circumcision confers protection, hence this cancer is extremely rare amongst Jews and Muslims.Most patients are between 40-70 years of age.

Risk Factors for Cancer of the Penis

Infection with the Human Papillomavirus (HPV) is found in 50% of all carcinoma of the penis. Type 16 is the most frequent. Circumcision and better genital hygiene protects against carcinoma of the penis. Cigarette smoking increases the risk of SCC of the penis.

Progression of Cancer of the Penis

Squamous Cell Carcinoma of the penis grows slowly and metastasizes locally. It is often present for greater than 12 months before medical attention is sought. Lymph node metastases characterises the next stage of spread. Widespread dissemination is rare.

How is Cancer of the Penis Diagnosed?

A biopsy is performed with histological analysis.Assessment of lymph node involvement and disseminated disease is conducted.

Prognosis of Cancer of the Penis

Prognosis depends largely on the level of metastases and invasion. The 5 year survival rate for local invasion in 66% but decreases to 27% with lymph node involvement.

How is Cancer of the Penis Treated?

The treatment of choice for squamous cell carcinoma is surgical excision to a margin of at least 0.5cm both in depth and laterally. Simple excision gives cure rates of approximately 90% whilst Moh's surgery is associated with cure rates of around 97%. Adjuvant radiotherapy can be used when the margins are compromised by adjacent vital structures. Radiotherapy is also associated with good cure rates, but is reserved for patients not able to tolerate surgical excision. Interferon and photodynamic therapy are newer experimental treatment modalities being explored.