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How general practitioners mistake penile cancer for a sexual condition… and how it might deprive a man of his genitalia.

According to specialists, each year hundreds of British men are forced to endure life-altering surgery because doctors miss the warning indications of penis cancer.

The condition, which affects approximately 700 men annually, can be cured with minimal damage to sexual life if detected early.

How general practitioners mistake penile cancer for a sexual condition... And how it might deprive a man of his genitalia.
How general practitioners mistake penile cancer for a sexual condition… and how it might deprive a man of his genitalia.

However, research indicates that half of all penile cancers are identified at an advanced stage when the organ cannot be saved. And one-fifth of individuals succumb to the illness.

The cancer is frequently misdiagnosed as a sexually transmitted infection by general practitioners and sexual-health nurses, as the initial symptoms are typically small lesions or red patches.

According to Arie Parnham, consultant urological surgeon at The Christie NHS Foundation Trust in Manchester and the UK’s foremost expert on the condition, clinicians frequently misdiagnose penile cancer.

This is a relatively rare malignancy, thus most general practitioners will encounter it just twice or thrice in their careers. In addition, other relatively harmless disorders can cause red patches on the penis that are not cancer, so physicians must know what to look for.

Mr. Parnham and other urologists are requesting that general practitioners obtain improved education regarding the disease to limit the frequency of late diagnoses. Marc Lucky, the consultant urologist and surgeon at Aintree University Hospital NHS Trust in Liverpool, states, “Every year, this disease kills thousands of men, but we never discuss it.”

The NHS must do more to ensure early diagnosis and treatment of these people.

According to doctors, there are two primary causes of penile cancer. The human papillomavirus (HPV), a sexually transmitted infection that causes a variety of different malignancies including cervical cancer, is believed to be responsible for approximately fifty percent of cases.

It is anticipated that eight out of 10 individuals will contract HPV at some point. Normally, the virus resides on the skin and mucous membranes of the body — within the mouth and around the genital area – producing minimal complications. Eventually, it is eliminated by the immune system. Rarely, though, it can cause alterations in cells that lead to cancer.

As a result of the introduction of the HPV vaccine to adolescent girls in 2008 and males in 2019, doctors predict that penis cancer cases will eventually decline, as fewer men will be vulnerable to the virus.

The remaining fifty percent of cases are believed to be caused by skin injury. Conditions that cause inflammation surrounding the foreskin, such as phimosis and lichen sclerosis, can result in the production of malignant cells. Therefore, circumcised males are significantly less likely to develop penile cancer.

Typically, cancer will first manifest as red patches or white elevated spots at the head of the penis. When detected at this stage, malignant tissue can be surgically removed, leaving the organ largely intact. The more time that passes without treating an illness, the more intrusive the surgery gets.

The removal of the penis’s head is one of the most prevalent surgical treatments for penis cancer. This is then replaced by a thigh-derived skin graft.

Mr. Parnham states, “It seems weird, yet it has very good benefits.” If you were in a public shower, I believe no one would notice any difference at first glance.

This is a “penis-preserving” operation, which means that the organ is still functional.

In many instances, however, the condition is detected too late for this. In 2009, Mr. Parnham’s analysis revealed that 47 percent of males with penile cancer were discovered too late for penis-saving surgery.

This indicates that these males had cancer that had spread throughout the penis, necessitating the removal of the entire organ.

Additionally, early diagnosis is essential since cancer becomes fatal if it spreads to the groyne.

Mr. Parnham explains, “The typical survival rate while the cancer is in the penis is over 90%, but drops to fewer than 30% if it spreads to the pelvis [the bone structure surrounding the groyne].”

According to experts, some patients delay seeing a doctor because they feel uncomfortable discussing their genitalia.

Mr. Lucky explains, “If you had a suspicious mole on your shoulder, you’d ask your friends in the bar what they thought, but if it’s on your penis, you’re more inclined to keep it to yourself.” “You wouldn’t believe the number of men who only come forward when their wives demand it.”

Gavin Brooks, 44, from Crewe, was identified with penile cancer late; he began experiencing symptoms in July 2021. The officer in the Army observed that the skin around his foreskin had begun to bulge. It was as if a rubber band had been wrapped around it. A month later, the swelling had worsened. It got quite uncomfortable and easily sliced.

Gavin, a single father of two children, eventually saw his primary care physician but was told there was nothing to worry about. ‘He told me it was likely thrush [a common yeast infection] and would go away.’

However, following a second evaluation at a sexual health clinic, he was directed to a urologist who diagnosed him with cancer. But this did not occur until December, five months after his symptoms first appeared.

According to him, the diagnosis was shocking. He states, “I had never even heard of penile cancer before.”

After cancer progressed to Gavin’s groyne, he endured two surgeries and is now undergoing chemotherapy. Due to the complexity of the surgery, he states he must now sit down to use the restroom.

Gavin has created an Instagram page to promote awareness of the disease and hopes that more men will report symptoms of penile cancer sooner.

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