Penile%20cancer Signs and Symptoms

Signs and Symptoms

Introduction

An uncommon malignancy with a rate of <1 per 100,000 men in the United States & Europe but is more common in Asia, Africa & South America
- Incidence varies according to ethnicity, geographical location & racial group

Typically occurs in older men with rates steadily increasing with age, between 50 & 70 years, though it may occur in younger men
>95% of penile cancer cases are of squamous cell origin & subtypes include verrucous carcinoma, warty carcinoma (verruciform), & basaloid carcinoma
- Growth pattern may be through superficial spreading, nodular or vertical-phase, & verrucous
- Warty carcinoma & basaloid carcinoma are less common but appear to be more associated with human papilloma virus (HPV), specifically HPV 16
- High-risk squamous cell carcinoma variants with early metastases & high mortality rate include adenosquamous, basaloid, sarcomatoid, & poorly differentiated types

Definition

Carcinoma in situ of the penis occurring on the glans is referred to as erythroplasia of Queyrat & that occurring on the penile shaft is Bowen’s disease or Bowenoid papulosis
- Erythroplasia of Queyrat has the highest potential of developing squamous cell carcinoma

Signs and Symptoms

Often presents as a palpable visible penile lesion with signs that may include pain, bleeding, discharge or a foul odor
- The lesion may be fungating, nodular or ulcerative & may be concealed by phimosis

Risk Factors

A correlation is suggested by some studies between human papillomavirus (HPV) infection & penile cancer
- Types 16 & 18 are the most common HPV subtypes in penile cancer & cancer risk is increased with condyloma acuminata
- Mediation by HPV increases the incidence of penile cancer in HIV-infected individuals

Circumcision is associated with a lower risk of penile cancer & observational studies demonstrated that circumcised men have a lower prevalence of penile HPV
Other risk factors for penile cancer include the following:
- Poor personal hygiene
- First intercourse at early age
- Multiple sexual partners
- Tobacco smoking
- Psoralen & ultraviolet A (PUVA) photochemotherapy
- Phimosis
- Penile trauma or tear
- Urethral stricture
- Lichen sclerosus
- Chronic inflammation, balanitis

Denosumab: A critical aspect of metastatic prostate cancer treatment

Prof. Bertrand Tombal, Assoc Prof. Edmund Chiong, 18 May 2022

Men with metastatic prostate cancer (mPC) have an elevated risk of skeletal complications either due to bone metastases (skeletal-related events [SREs]), or from osteoporosis induced by androgen deprivation therapy (ADT). Two key opinion leaders recently shared their perspectives on bone complications in mPC as well as the use of bone-targeted agents (BTAs) such as denosumab (Xgeva) to reduce the risk of bone complications.

Professor Bertrand Tombal

Professor of Urology

Cliniques universitaires Saint-Luc & Université catholique de Louvain

Brussels, Belgium

Associate Professor Edmund Chiong

Head, Department of Urology

National University Hospital, Singapore

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Antioxidant and micronutrient supplementation on the sperm parameters of male patients with idiopathic infertility: An updated literature review

09 Jun 2020

Infertility is a problem faced by 5-10 percent of couples, with male factor accounting for up to 47 percent of cases. [Int J Androl 1987;7(Suppl):1]. There are many causes for male infertility but up to 15 percent of cases are idiopathic in nature. These cases may be related to unregulated excessive oxidative stress, which may impair spermatogenesis; hence, arousing research into the role of antioxidant supplementation in improving the sperm parameters.