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

Optimizing metastatic hormone-sensitive prostate cancer treatment in advanced prostate cancer

Assoc Prof. Darren Poon, Assoc Prof. Edmund Chiong, 14 Jan 2021

Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the condition whereby patients have metastatic prostate cancer and no prior hormonal therapy or androgen deprivation therapy (ADT). Typically, patients with mHSPC have been treated with ADT alone, following which, the overwhelming majority develop castration resistance over time and head towards eventual mortality. In recent years, the publication of various landmark trials has prompted dramatic changes in the mHSPC treatment landscape, and had favourably impacted overall survival (OS) in these patients. At a recent webinar, A/Prof Darren Poon, Honorary Consultant in Clinical Oncology, Hong Kong Sanatorium & Hospital, and Honorary Clinical Associate Professor, Department of Clinical Oncology, The Chinese University of Hong Kong, reviewed treatment options in mHSPC, while A/Prof Edmund Chiong, Head and Senior Consultant, Department of Urology, National University Hospital, Singapore, presented a case which was discussed by an esteemed panel of experts. This webinar was jointly organized by the Singapore Society of Oncology and the Singapore Urological Association, and supported by Astellas.