Penile Cancer Treatment In Delhi

I am Dr Vijayant Govinda Gupta. I am a Mch Urology qualified Urologist in India with specialization in Uro oncology. In this article I discuss about penile cancer treatment options and penile cancer surgery. I offer Glans Preserving approaches, Partial and Total penectomy for my patients suffering from Penile Cancer.

What Is Penile Cancer?

Penile cancer is a cancer that is very common in the Indian population. This cancer occurs on the male organ or the penis. It usually involves the tip of the penis but can also occur on the penile base. It is an aggressive cancer and requires prompt treatment in the form of surgery like partial penectomy and inguinal lymph node dissection.

Why Is Penile Cancer Common In India (New Delhi)?

It is not known for sure, but one reason why it may be more common is that circumcision is not commonly practiced routinely in Indian society. Research has shown that in Muslims and other religions where circumcision is common at birth, penile cancer does not occur.

But it has also been linked to age and poor penile hygiene. If uncircumcised men, maintain good hygiene and cleanliness, penile cancer is rare.

What Are The Risk Factors For Penile Cancer?

The known risk factors for developing penile cancer are –

  1. Age
  2. Phimosis
  3. Smoking
  4. Poor penile hygiene
  5. Radiation
  6. Herpes infection
  7. Sexually transmitted diseases
  8. Multiple sexual partners

Can I Prevent Penile Cancer?

Yes, by maintaining good penile hygiene. Even a ZSR Circumcision can completely eradicate the risk of penile cancer occurrence.

What Tests Are Required To Diagnose Penile Cancer?

Penile cancer is a clinical diagnosis.

Once formed, penile cancer can look terrifying. Patients will develop symptoms like –

  1. FOUL SMELLING DISCHARGE
  2. PHIMOSIS OR TIGHT FORESKIN
  3. DIFFICULTY IN PEEING
  4. SWELLING IN GROIN
  5. BLEEDING
  6. DIFFICULTY IN INTERCOURSE

But once diagnosed, it requires urgent surgery to prevent metastasis and spread.

Some tests may be required before proceeding to treatment.

What Are The Surgical Options For Penile Cancer?

Penile cancer is a disease best treated by Surgery. Chemotherapy and radiotherapy are inferior and may reduce survival.

  1. PARTIAL PENECTOMY – GOLD STANDARD – Removal of the diseased penis and recreation of the penis.
  2. INGUINAL LYMPH NODE DISSECTION – Required in cases if the disease has spread to the groin.
  3. GLANS PRESERVING APPROACHES – Certain organ preservation approaches are gaining acceptance. Though inferior in terms of recurrence or re cancer, they provide sensation and leave the penis intact

What Is Partial Penectomy For Penile Cancer?

Partial penectomy is a surgery for the cure of penile cancer. In this surgery the involved organ of the penis is removed and the tip of the penis recreated. Because penile cancer is an aggressive cancer with very poor prognosis if it spreads, partial penectomy is the gold standard procedure for the treatment of penile cancer.

After the surgery, there are a few things to expect –

  • Because the tip of the penis is removed, the penis length will become short.
  • The penile length will be enough to pass urine while standing, but may not be enough for successful intercourse.
  • The penis retains its erections, but as the glans and the distal part is gone, sexual satisfaction and enjoyment are lessened or absent.

Fortunately, penile cancer affects men in their old age and many men are not desirous of sex or intercourse. But, it can be a dissatisfying surgery for men with active libido.

Despite this, life is more essential than sex and partial penectomy, will ensure the best cancer control for long term.

What Are The Alternatives To Partial Penectomy?

In younger men, and even in older men, who wish to preserve ability to have sex, certain glans preserving approaches are possible. Though, they require very very close watch, and may need conversion to a formal partial penectomy when required.

Glans Preserving Approaches For Penile Cancer

  • GLANSECTOMY AND HEMIGLANSECTOMY – In patients with cancer limited to only the glans or penis head, only that part may be removed and it allows the penile length and sensations to be preserved.
  • Mohs microsurgery or Skin resurfacing – Only the cancerous lesion is shaved off and the penile skin reconstructed with other flaps. Allows sexual sensation
  • Laser Dermabrasion – Using CO2 laser or ND Yag Laser, the penile lesion can be removed while preserving sensation and length

What About Radiotherapy And Chemotherapy For Penile Cancer?

Though advocated and recommended, I personally do not recommend radiotherapy or medicines for treatment of penile cancer. I have seen patients die due to the delay in treatment and the local side effects are terrible.

Total Penectomy

If the cancer is far advanced and no penis can be saved, it is best to remove the entire penis and make a new opening to pass urine below the scrotum (Perineal urethrostomy). This procedure provides good results. But removes the entire penis.