Penile Cancer Treatment
When you're treated at MD Anderson for penile cancer, some of the nation's top specialists focus their expertise on you. They communicate with each other ¨C and with you ¨C to ensure you receive the most advanced penile cancer treatment with the least impact on your body.
As one of the nation's leading cancer centers, MD Anderson sees many more penile cancer patients than the average oncologist. This means we have a higher level of experience and expertise, which is crucial to your treatment and recovery.
Like all surgeries, penile cancer surgery often is more successful when performed by a specialist with a great deal of experience. This is particularly true for organ-preserving surgeries, Mohs surgery and plastic surgery reconstruction, which usually are used to treat penile cancer.
Since MD Anderson is one of the nation's most active cancer centers, clinical trials of new agents are available for some penile cancer patients.
Penile Cancer Treatments
If you are diagnosed with penile cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer and your general health.
Surgery is the most frequent form of penile cancer treatment, but laser therapy and radiation may be used for smaller tumors. The type of treatment usually depends on how far the cancer has spread.
Your penile cancer treatment will be customized to your particular needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Penile Cancer Surgery
Surgery to remove all or part of the penis is called penectomy. Penile preservation surgery (the penis is not removed) is used to treat penile cancer whenever possible.
Circumcision: Surgical removal of the penis foreskin and some of the nearby skin. This procedure may be done if the penile cancer has not spread beyond the foreskin. It also may be done before radiation therapy.
Partial penectomy: The tumor is removed along with a margin of healthy tissue. In the past, a 2-centimeter margin was removed in all cases of penile cancer. Recent research suggests such wide margins may not be needed. Surgeons try to spare as much of the glans (head) and shaft as possible to keep urinary and sexual function.
Total penectomy: Removal of the entire penis for treatment of large penile cancer tumors. The surgeon reroutes the urethra (tiny tubes that urine passes through) behind the testicles, and an urethrostomy (hole) is created so you can urinate. Penile reconstruction surgery using a flap of skin from the forearm to create a new penis has been done, but the procedure is rare.
Mohs surgery (microscopically-controlled surgery): The surgeon surgically removes a thin layer of skin and looks at it right away under a microscope. This process is repeated until the cells are free of cancer.
Laser surgery: Light from a laser vaporizes penile cancer cells.
Radiation Therapy
New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target penile cancer more precisely, delivering the maximum amount of radiation with the least damage to healthy cells. In penile cancer, radiation therapy may be used to treat early stage tumors, with surgery to remove lymph nodes, and in advanced cancers to control spread and help relieve symptoms.
Chemotherapy
MD Anderson offers the most up-to-date and advanced chemotherapy options for penile cancer.
Topical chemotherapy: An anti-cancer medicine, usually 5-fluorouracil or 5-FU, is applied as a cream for several weeks. This generally is used only for precancerous or very early penile cancer.
Systemic chemotherapy: Medicine injected into a vein or given by mouth.
Imiquimod: A drug in a cream form that boosts the body's immune system. It sometimes is used to treat very early stage penile cancer.
Learn more about penile cancer:
10 cancer symptoms men shouldn't ignore
Nagging back pain. Indigestion. Frequent urination. You may assume these are minor health issues that don¡¯t need a doctor¡¯s visit. But think again.?
Cancer symptoms are often vague. In fact,?prostate cancer?¨C the most common cancer in men ¨C has some of the least obvious symptoms.?
¡°Men shouldn¡¯t ignore their health,¡± says?, medical director of?MD Anderson¡¯s?Cancer Prevention Center. ¡°It¡¯s vital to pay attention to changes in your body and report unusual symptoms to your doctor right away.¡±?
Knowing what symptoms to look for can help your doctor find cancer early when it¡¯s most treatable.?
Bevers shares some of the most common cancer symptoms in men.?
Abnormal lump?
Have you recently felt a mass or lump right below your skin? This may be a sign of cancer. Lumps normally show up in the breast, testicles, lymph nodes and soft tissues, like tendons and ligaments. Report it to your doctor immediately, especially if you just found it, or it has grown in size.?
Changes in your testicles?
Have you noticed changes in the size of your testicles, like one or both have gotten bigger? Maybe you¡¯ve found a lump, or your testicles feel swollen or extra heavy. Any of these signs should send you straight to your doctor.?Testicular cancer?is most common in young and middle-aged men.?
Changes in your bathroom habits?
Suddenly need to use the restroom all the time? Or have pain when you go? This may be a sign of?bladder?or?prostate cancer. Other signs to look out for are?blood in your stool?or urine. Changes in your bowel habits, like constipation or diarrhea that won¡¯t go away, matter, too.?
Changes in your skin?
If you work long hours outside or have a history of blistering sunburn, check your skin closely for?skin cancer.??
Skin cancer symptoms include:?
- Unusual bleeding?
- Scaling?
- Sores that do not heal?
- Warts, moles or freckles that change in color, size or shape
Bottom line: If you¡¯ve got a strange spot on your skin, see a dermatologist.?
Indigestion or trouble swallowing?
A prolonged painful burning sensation in your throat or chest shouldn¡¯t be ignored ¨C even if you suspect it¡¯s from eating spicy food. Don¡¯t assume that regular indigestion or trouble swallowing is a normal part of aging either. It can be a sign of?esophageal,?stomach?or?throat cancer.??
Persistent cough or hoarseness?
Do you have a nagging cough that lasts more than three weeks? This could be a sign that something is wrong. Whether you smoke or not, a cough that doesn¡¯t go away can be a sign of?lung cancer. Persistent hoarseness, wheezing, shortness of breath or coughing up blood are also signs to call your doctor right away.?
Changes in your mouth?
If you smoke, chew, dip, spit or vape?tobacco, you need to pay close attention to changes inside your mouth. White patches inside your mouth or white patches on your tongue may be pre-cancers. Left untreated, these areas can turn into?oral cancer. Sores, unexplained bleeding, numbness or tenderness in the area around your mouth ¨C like your tongue, lips and cheeks ¨C should tell you that it¡¯s time for a checkup.?
Unexplained weight loss?
Are you dropping pounds without changing your diet or exercise habits? Call your doctor ¨C even if you think they¡¯re pounds you need to lose. Losing 10 pounds or more for no known reason can be a sign of?pancreatic,?stomach,?esophageal?or?lung cancer.?
Constant fatigue?
Are you too tired to play with your kids or hang out with friends after work? Are you constantly tired no matter how much rest you get? Don¡¯t brush it off. Constant fatigue can be a sign of?leukemia, as well as some?colon?and?stomach cancers.?
Persistent pain?
Nagging back pain, a headache that won¡¯t go away, abdominal or stomach pains ¨C your doctor needs to know. Persistent pain, no matter the location, may be the first sign that something¡¯s wrong. See your doctor about any pain that lasts for several weeks or longer.?
See a doctor if your symptoms persist?
Remember, having one or more of these symptoms doesn¡¯t mean you have cancer. But if they¡¯re persistent, head in for a checkup.??
The sooner you see a doctor, the sooner you can figure out what is causing your symptoms. And, if your symptoms are caused by cancer, it is best to find out early when cancer is most treatable.?
The bottom line: see your doctor to determine what is causing your symptoms and get you on the road to recovery. ?
?or call 1-877-632-6789.?
10 things to know about Mohs surgery?
Mohs surgery is a minimally invasive procedure used to treat some skin cancers. It is named after Frederic Mohs, M.D., a doctor from Wisconsin who pioneered the technique in the 1920s.????
About 90% of patients who undergo Mohs surgery at MD Anderson have either?basal?or?squamous cell carcinoma?of the skin.??
But is Mohs surgery ever used to treat any other types of cancer? How does it differ from regular surgery? And, does it ever require general anesthesia???
Here are answers to these and seven other questions I hear frequently about Mohs surgery.???
How is Mohs surgery different from regular surgery???
The biggest difference is in how tissue is processed once it¡¯s removed.???
During regular surgery, a certain amount of healthy skin is taken from around a tumor as a safety precaution. We sample the edges of this tissue at various intervals and perform a biopsy to make sure we got all the cancer. But only about 5% of the margins are evaluated during conventional surgery.?????
With Mohs surgery, we assess 100% of the margins. That means we look at all of the tissue¡¯s edges before ending the procedure to make sure we got all the cancer. That¡¯s what gives Mohs procedures a much higher cure rate than standard surgery. Between 97% and 99% of patients who have Mohs surgery will not see the cancer return in that location throughout their lifetimes.????
Mohs surgery is also performed under local anesthesia in an outpatient setting.?
What types of cancer is Mohs surgery used for???
Right now, Mohs surgery is still only used for certain types of skin cancer:??
- Basal cell carcinoma??
- Squamous cell carcinoma??
- Melanoma in-situ (meaning, ¡°in its original place,¡± not metastatic)??
But the technique of looking at the entire perimeter of a tumor¡¯s margins ¡ª called peripheral and deep en-face margin assessment (PDEMA) ¡ª is now being mirrored in the operating room with some large?sarcomas and other cancers to enhance their cure rates.??
Which patients might benefit the most from Mohs surgery????
Patients with cancers in areas where it¡¯s especially important to conserve tissue are ideal candidates for Mohs surgery. The face, head, neck, fingers and genitals are all places where there¡¯s not a lot of extra skin to work with.????
Elderly or very sick patients may also benefit from Mohs surgery because it uses local anesthetic instead of general anesthesia, which can sometimes put them at greater risk for complications. ???
You might also benefit from this technique if you:??
- Have amelanotic melanoma?in situ, which can be hard to see?
- Have a growth that was incompletely removed through standard surgery??
- Only learned that a skin growth was cancer after it was lasered off, so you can¡¯t see it anymore and/or don¡¯t know exactly where it is/was??
How do doctors determine if Mohs surgery is appropriate for a particular patient???
The American Academy of Dermatology has created criteria to help providers determine if Mohs surgery is a patient¡¯s best skin cancer treatment option. These criteria consider the patient¡¯s: ????
- tumor type???
- tumor location??
- age??
- medical history??
- overall state of health??
- other conditions, such as leukemia,?lymphoma or being immunocompromised??
At MD Anderson, we make these decisions on a case-by-case basis.??
Are there any situations in which Mohs surgery is not appropriate? ??
Absolutely. Mohs is not appropriate for patients with:??
Spread-out skin tumors?
The cancer has to be in one mass for us to get at its ¡°roots.¡± It can¡¯t be growing in a ¡°splatter¡± pattern.??
Metastatic cancer on the skin?
Treating the primary cancer is the main focus here.???
Very large tumors?
Some are so big that local anesthetic would not be sufficient to prevent a patient from feeling pain during the procedure.??
High-risk tumors?
Many require sentinel lymph node testing.??
If you have an invasive melanoma right next to a basal cell carcinoma, Mohs would also not be appropriate. When you have two types of cancer cells right next to one another or mixed together in a single tumor, we determine treatment based on the most invasive type.??
How long does Mohs surgery usually take???
The average Mohs surgery takes about three hours. But it could take longer, depending on what we find, so I usually tell patients to plan on being here all day. ??
How painful is Mohs surgery, and how long does it take to recover???
Mohs surgery is considered a minor procedure. It is most often performed using local anesthetic, and patients are awake the whole time. So, patients don¡¯t usually need narcotics afterward to manage pain. Any lingering discomfort is generally minimal and can be managed easily with over-the-counter pain relievers.???
Does Mohs surgery ever require general anesthesia or an overnight stay in the hospital????
The vast majority of cases do not. If you have a very large or complex tumor and need plastic surgery to close the wound, we may keep you overnight. But MD Anderson dermatologists perform about 120 Mohs surgeries per month, and only about three of those require plastic surgery. That¡¯s less than 3%.??
What are the potential risks of Mohs surgery???
Any medical procedure carries some risk. The most common risks following Mohs surgery are:??
- pain??
- bleeding??
- infection??
We do our best to minimize those, but if you have any concerns, please be sure to mention them so that they can be addressed quickly. Your care team will tell you what to expect after your Mohs surgery and when to reach out for assistance.?
What¡¯s the most important thing to know about Mohs surgery???
Historically, Mohs surgery was a multi-day procedure. But once we learned how to flash-freeze tissues in the 1970s, it became a multi-hour one. So, it took about 50 years for technology to catch up with what the doctor who invented it originally envisioned. It¡¯s a wonderful tool.??
, is a dermatologist who specializes in Mohs surgery and serves as director of the Mohs Center.?
or call 1-877-632-6789.