Penis Cancer – Treatment
If the lesion is small, the foreskin and the glans is not filtrated then circumcision is the treatment of choice. If damage to the glans and small peripheral portion of the corpora cavernosa is observed, then partial amputation is the best treatment. If it is selected then most of the total or radical penis is removed.
Although amputation has the highest success rate in penile cancer, there is a great psychological trauma for the patient. Thus, radiotherapy is utilised to treat penile cancer with equally viable results in selected cases.
- Short-term therapy, achieved either by radioactive needles’ (radium, iridium tantalum) implantation into the tumor or attaching radioactive material to the tumor. Most commonly implantation needles are used.
- External radiation, it is used either in cases that short-term therapy is not applicable or as palliative treatment in inoperable cases.
The criteria for shot-term therapy, include:
- Tumor size (<4 cm=”” –4–=””>
- Corpora cavernosa infiltration.
When there is extensive infiltration, avoid short-term therapy.
The results of short-term therapy are judged well. In most cases, 80% of patients are successfully treated with adequate regional cosmetic results and functionality.
a) Squamous cell carcinoma is radiation resistant and large doses are required. That often leads to complications such as formation urethral fistula, pain, edema and even glans’ necrosis – complications that usually require amputation.
b) Existing infection usually reduces the effect of radiation and increases the risk of complications.
c) Treatment extend and duration thorn elderly patient while surgery endures no regional effect. Prior to radiation application, the lesion should be circumcised to better assess disease extent, avoid complications (edema, infections) and monitor patients after therapy.
To sum up, radiotherapy should be applied in patients with little damage especially to young people, and certainly patients who refuse surgery. After the end of therapy cycle, the patient should be frequently monitored while the risk of disease recurrence is still present.
In recent years, lasers are extensively used for penile cancer.
The Nd: YAg laser is used for small superficial tumors since it causes tumor destruction to a depth of 3-5 mm, retains penis’ with very small alterations.
Results are satisfactory, but requires even longer patients follow-up, in order to be sure about the long term effects.