A doctor has urged people to be on the lookout for the early symptoms of penile cancer, a less common type of cancer that can lead to partial or total amputation of the penis in more advanced cases.
Early symptoms of penile cancer can be easily brushed off as temporary or might have you embarrassed to make a doctor’s appointment, which is exactly why it’s paramount to be familiar with them to improve the chances of a full recovery.
Writing in The Times, Dr Mark Porter said: "Late presentation is all too common in penile cancer, because men are either unaware of the threat posed by early symptoms or too embarrassed to seek help.
"Early presentation may not only save your life, but your penis too."
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According to Cleveland Clinic, penile cancer is still rare, making up less than one percent of cancers among people with a penis, with a prevalence of cases in Africa, Asia and South America.
A bigger killer than testicular cancer, penile cancer can develop anywhere on the penis, but normally starts under the foreskin or on the head, known as glans. While it is more common in middle age and beyond, it’s worth knowing the symptoms to watch out for, which can include discoloration and a persistent rash.
Discoloration that’s usually red or bluish-brown and a rash or sore that lasts for longer than a month are potential alarm bells, as well as bleeding, an abnormal - sometimes smelly - discharge and an obvious lump, either on the penis or on a lymph node in the groin.
Dr Porter added: "In some cases it can also tether the foreskin, making it hard to retract."
Macmillan Cancer Support adds that other symptoms could include thickening or raised areas on the skin anywhere on the penis, or pain, a lump or discharge underneath the foreskin.
Penile cancer survivor Cormac France shared his story with Ireland's Health Service Executive. He said early symptoms could be brushed off, including weight loss and fatigue. But then he noticed some horrifying changes to his penis.
He said: "As time progressed, the smell from my penis was horrendous and then the penis started to split. That was due to the tumors."
Do these symptoms always mean you have penile cancer?
There are many other possible causes for these symptoms, including infections such as thrush (candida) or conditions such as lichen sclerosus, balanitis and psoriasis, or trauma in the case of bleeding.
Dr Porter said: "So when you see your GP or specialist, there is a good chance the result won’t be as bad as you feared — but that doesn’t mean it’s OK to put off that appointment.
"Caught early, penile cancer is relatively easy to treat, with more than 90 percent of men still alive five years after diagnosis.
"However, the outlook for men with the most advanced cancer, where it has spread to other parts of the body, is bleak: no men in this group are expected to survive for five years.
"The other major advantage of early diagnosis is that often it means treatment is less invasive."
Treatment for penile cancer
If caught early, penile cancer is relatively easy to treat, with early lesions burnt off using lasers or chemotherapy and immunotherapy creams.
More advanced cases require more aggressive treatment, ranging from circumcision of the foreskin and/or local excision with skin grafting to amputating the head of the penis, known as glansectomy, or even total removal, called penectomy.
In the case of a penectomy, a new outlet for the bladder is fashioned between the anus and scrotum, which means the patient will have to sit down to pee but will retain continence as the muscles that control urine flow are left intact. But that may be little comfort for some.
Patients more at risk of penile cancer are smokers, those infected with the human papillomavirus (HPV), those with a weakened immune system because of an underlying disease such as HIV, and those who have not been circumcised.
Stefania Sarrubba