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| Photo from medindia.net |
The penis is the male genital organ that is visible from the outside. It is made up of three spongy tissue chambers that include smooth muscle as well as numerous blood arteries and nerves. The corpora cavernosa comprises two chambers placed on both sides of the top section of the penis. The corpus spongiosum surrounds the urethra and is found underneath the corpora cavernosa. The urethra is the tube through which urine and sperm exit the body through an opening known as the meatus. The corpora cavernosa expands to create the head of the penis, or glans, at the tip of the penis.
Cancer occurs when healthy cells mutate and proliferate uncontrollably, generating a mass known as a malignant tumor. The term “malignant” refers to a tumor that is cancerous and has the potential to grow and spread to other sections of the body. There are also benign penile tumors that are not cancerous. They have the ability to grow but do not spread.
Penile cancer is an uncommon type of cancer that usually affects uncircumcised penises. Uncircumcised indicates that the foreskin, or piece of skin covering the head of the penis, has not been removed. Circumcision, or the removal of the foreskin, may lower the risk of penile cancer.
PENILE CANCER TYPES
Penile cancer can be classified into numerous types:
- Epidermoid/squamous cell carcinoma: The most common type of penile cancer is epidermoid, or squamous cell, carcinoma, which accounts for 95% of all cases. When viewed through a microscope, the cells resemble the tissues that make up skin. Squamous cell carcinoma can develop on any part of the penis. However, it frequently appears on or beneath the foreskin. Epidermoid carcinoma is frequently curable if detected early.
- Basal cell carcinoma: Basal cells can become malignant at times. These are spherical cells found beneath the squamous cells in the lower epidermis of the skin. Basal cell carcinoma is a kind of skin cancer that is not melanoma. Basal cell tumors account for less than 2% of all penile malignancies.
- Melanoma: Melanocytes are dispersed cells found in the epidermis’s lowest layer. These cells produce melanin, which gives skin its color. Melanoma begins in the melanocytes. It is the most severe kind of skin cancer. This form of cancer can develop on the surface of the penis.
- Sarcoma: Sarcomas account for about 1% of all penile malignancies. Sarcomas form in the body’s supporting and connecting tissues, such as blood vessels, muscle, and fat.
SYMPTOMS AND SIGNS OF PENILE CANCER
Penile cancer patients may exhibit the following symptoms or indicators. A symptom, such as weariness, nausea, or discomfort, is something that only the person experiencing it can identify and explain. A symptom is something that others can recognize and quantify, such as a fever, rash, or an increased pulse. Signs and symptoms, when combined, can assist describe a medical situation. People with penile cancer may not exhibit any of the signs and symptoms listed below. Alternatively, the origin of a symptom or sign could be a medical disease other than cancer.
- A growth or sore on the penis, most commonly on the glans or foreskin, but cancer can also occur on the shaft
- Changes in the color of the penis
- Penis skin thickening
- Consistent discharge with a bad odor beneath the foreskin
- Blood oozing from the tip of the penis or from beneath the foreskin
- Unexplained pain in the shaft or apex of the penis
- Irregular or developing bluish-brown flat lesions or scars beneath the foreskin or on the penis
- A reddish, velvety rash beneath the foreskin
- Small, crusty lumps beneath the foreskin
- Swollen lymph nodes in the groin
- Irregular swelling at the tip of the penis
Please consult your doctor if you are concerned about any changes you are experiencing. In addition to other questions, your doctor will inquire as to how long and how frequently you have been experiencing the symptom(s). This is done to assist in determining the cause of the condition, which is referred to as a diagnostic.
If cancer is discovered, symptom relief is an important element of cancer care and treatment. This is known as “palliative care” or “supporting care.” It is frequently initiated shortly after diagnosis and continues throughout treatment. Make an appointment with your health care provider to discuss your symptoms, especially any new or changing symptoms.
STAGES AND GRADES OF PENILE CANCER
Grading and staging are terms used to describe how quickly and how far the cancer has progressed. This covers the location of the cancer and whether or not it has spread.
Doctors utilize diagnostic tests to determine the grade and stage of cancer. As a result, grading and staging may not be completed until all tests have been completed. Knowing the grade and stage allows the doctor to propose the best treatment and forecast a patient’s prognosis, or possibility of recovery. A lower grade or stage of cancer has a better probability of recovery than a higher grade or stage of cancer.
Grade (G)
Doctors classify penile cancer based on its grade (G). When viewed through a microscope, the grade describes how much the cancer cells resemble healthy cells. The grade of the cancer is significant because it predicts how probable it is to move to the lymph nodes in the groin. And this information assists the doctor in developing a treatment strategy.
The doctor compares malignant tissue to healthy tissue to establish the cancer’s grade. Many distinct types of cells are typically clustered together in healthy tissue. If the cancer resembles healthy tissue and has various cell groupings, it is referred to as “differentiated” or a “low-grade tumor.” When malignant tissue differs significantly from healthy tissue, it is referred to as “poorly differentiated” or a “high-grade tumor.” Because higher grade penile tumors are more prone to spread to the lymph nodes and other regions of the body, they may necessitate more aggressive therapy.
GX: The tumor grade is unknown.
G1: Describes cells that resemble healthy tissue cells and are referred to as well differentiated.
G2: The cells are moderately differentiated, meaning they are slightly different from healthy cells.
G3: Describes tumor cells that seem considerably different from healthy cells. This is known as poorly differentiated or high grade.
TNM system of staging
Aside from the grade, staging can help assess a patient’s prognosis and suggest treatment. Early-stage malignancies have a better prognosis and may require less intensive therapy than later-stage tumours.
The TNM system is one technique that clinicians use to describe the stage. Doctors use diagnostic test and scan results to address the following questions:
- Tumor(T): How far into the penis has the main tumor grown? Is it spreading from the penis to other parts of the body, such as the pubic bone, scrotum, or prostate? What is the tumor’s grade?
- Node(N): Has the tumor spread to the lymph nodes? If so, where are they and how many are there?
- Metastasis(M): Has the malignancy migrated to other places of the body or lymph nodes other than the groin and pelvic region? If so, where and how much?
The results are aggregated to establish each person’s cancer stage. There are five stages: stage 0 (zero), stages I through IV, and level V. (1 through 4). The stage provides a common language for doctors to describe the cancer so that they can collaborate to determine the best treatments.
More information on each component of the TNM system for penile cancer may be found below:
Tumor (T)
The “T” plus a letter and/or number (0 to 4) is used in the TNM system to describe the size and location of the tumor. The size of a tumor is measured in millimeters (cm). A centimeter is approximately the width of a normal pen or pencil.
Stages can also be subdivided into smaller groups to assist define the tumor in greater depth. This enables the doctor to devise the most effective treatment strategy for each patient. The following information about tumor stages is provided:
TX: There is no way to analyze the original tumor.
T0: There isn’t any tumor.
Tis: A noninvasive, early precancerous development. This is sometimes referred to as cancer in situ.
Ta: A noninvasive squamous cell carcinoma that only affects one location.
T1: The tumor has spread to one of the penis’s outer layers. Depending on where the cancer is growing on the penis, they may include the lamina propria, the dermis, the dartos fascia, or the connective tissue beneath the skin. This stage is further subdivided into two substages dependent on the tumor’s grade and whether it has spread to blood arteries, lymph vessels, or nerves:
- T1a: The tumor has not formed blood vessels, lymph vessels, or nerves, and it is not of high grade or G3
- T1b: A high-grade tumor that has expanded into blood vessels, lymph vessels, and/or nerves (G3)
T2: The tumor has spread to the corpus spongiosum, a penile internal chamber. It could have grown into the urethra or not.
T3: The tumor has spread to the corpora cavernosum, a penile internal chamber. It could have grown into the urethra or not.
T4: The tumor has spread to other structures nearby, such as the pubic bone, the scrotum, or the prostate.
Node (N)
The letter “N” in the TNM staging system denotes lymph nodes around the malignancy, also known as regional lymph nodes. The lymph nodes for penile cancer are found in the groin and pelvic. Lymph nodes located in other sections of the body are referred to as distant lymph nodes. Cancers are staged differently depending on whether they have progressed to regional lymph nodes or distant lymph nodes. The letter N in TNM staging refers only to the regional lymph nodes.
If the clinician assesses the lymph nodes prior to biopsy or surgery based on a physical examination and/or other tests, the letter “c” for “clinical” staging is inserted in front of the N. If the doctor assesses the lymph nodes following a biopsy or surgical excision of the lymph nodes, the letter “p” for “pathologic” staging is inserted in front of the N. The pathologic stage is described in detail below.
pNX: The lymph nodes in the region cannot be examined.
pN0: The cancer has not spread to the lymph nodes in the surrounding area.
pN1: On the same side of the body, cancer has progressed to two or fewer inguinal lymph nodes. The groin contains the inguinal lymph nodes.
pN2: On one or both sides of the body, cancer has progressed to three or more inguinal lymph nodes.
pN3: The cancer has spread from the inguinal lymph nodes to the surrounding groin tissue, and/or the cancer has progressed to the pelvic lymph nodes.
Metastasis (M)
The letter “M” in the TNM system indicates if the cancer has moved from the penis to other regions of the body, a process known as metastasis.
M0: There is no evidence of distant metastases.
M1: Metastasis has spread to regions of the body other than the penis and regional lymph nodes.
Cancer stage grouping
Doctors determine the cancer stage by integrating the T, N, and M classifications.
Stage I: A low-grade cancer that has spread just beneath the skin’s surface but not to nerves, lymph vessels, or blood vessels. It hasn’t spread to the lymph nodes or other regions of the body (T1a, N0, M0).
Stage IIA: The cancer is high grade or has grown into blood vessels, lymph vessels, or nerves. Or it has developed into the corpus spongiosum and may or may not have developed into the urethra. It hasn’t spread to the lymph nodes or other regions of the body (T1b or T2; N0, M0).
Stage IIB: The cancer has spread to the corpora cavernosum and may or may not have spread to the urethra at this stage. It hasn’t spread to the lymph nodes or other regions of the body (T3, N0, M0).
Stage IIIA: The tumor has not spread beyond the penis and urethra at this stage. It has spread to 1 to 2 groin lymph nodes but has not moved to other regions of the body (T1, T2, or T3; N1, M0).
Stage IIIB: The tumor has progressed to three or more groin lymph nodes but has not gone beyond the penis and urethra. It has not spread beyond the groin lymph nodes, pelvic lymph nodes, or to other areas of the body (T1, T2, or T3; N2, M0).
Stage IV: One or more of the following:
- The cancer has spread to adjacent tissues including the pubic bone, scrotum, or prostate (T4, any N, any M).
- The cancer has spread from the lymph nodes in the groin to the surrounding tissue (any T, N3, any M).
- The cancer has progressed to one or more of the lymph nodes in the pelvis (any T, N3, any M).
- Cancer has spread to other regions of the body (any T, any N, M1).
Recurrent: Cancer that recurs after therapy is referred to as recurrent cancer. If the cancer returns, more tests will be performed to determine the degree of the recurrence. These tests
and scans are frequently identical to those performed at the time of the first diagnosis.
DIAGNOSIS OF PENILE CANCER
Many tests are used by doctors to detect or diagnose cancer. They also perform tests to see whether the cancer has spread to another place of the body from where it began. This is referred as as metastasis. Imaging tests, for example, can reveal whether or not the cancer has spread. Images of the inside of the body are produced via imaging tests. Doctors may also conduct tests to determine which treatments are most likely to be effective.
A biopsy is the only guaranteed way for a doctor to know if a part of the body has cancer in most cases of cancer. During a biopsy, the doctor extracts a small sample of tissue for laboratory testing. If a biopsy is not possible, the doctor may recommend alternative tests to aid in the diagnosis.
How is penile cancer diagnosed?
There are numerous tests available to diagnose penile cancer. Not all of the tests outlined here will be utilized on every individual. When selecting a diagnostic test, your doctor may take the following variables into account:
- The cancer type suspected
- Your symptoms and signs
- Your age and general well-being
- The outcomes of previous medical tests
The following tests, in addition to a physical examination, may be used to diagnose penile cancer:
Biopsy: A biopsy may be required to learn more about an unexpected alteration on or in the penis or adjacent lymph nodes. A biopsy is the removal of a small sample of tissue for microscopic examination. Other tests can indicate the presence of cancer, but only a biopsy can provide a definitive diagnosis. The material is next examined by a pathologist (s). A pathologist is a medical professional who specializes in interpreting laboratory tests and assessing cells, tissues, and organs to identify disease.
If malignant cells are found in a tissue sample, the biopsy is considered cancerous. If no cancer is identified, the biopsy is referred to as benign or negative for malignancy. When a pathologist is unable to determine if the cells obtained are malignant, the biopsy is referred to as indeterminate or non-diagnostic.
Biopsies of the following categories may be used to diagnose penile cancer:
- A punch biopsy or elliptical excision may be performed to treat an abnormal alteration on the penis. A punch biopsy is performed by removing a round piece of tissue with a sharp round surgical tool. The doctor performs an elliptical excision by cutting off a section of tissue with a knife or other tool.
- A fine needle aspiration is a kind of biopsy. To begin, the skin is normally numbed with a topical drug that suppresses the sensation of pain. Then, to prevent pain in tissues beneath the skin, a drug is injected into the area near the tumor. After that, the doctor will introduce a thin needle into the tumor and remove some cells and fluid. The process may be performed two or three times in order to gather samples from various locations of the tumor.
- A sentinel lymph node biopsy is a procedure used to determine whether cancer cells have migrated to lymph nodes surrounding the penis. The doctor uses this approach to remove one or more sentinel lymph nodes to look for cancer cells. Lymph nodes are small, bean-shaped structures that aid in the fight against infection. They are linked together by microscopic vessels known as lymphatic vessels. Sentinel lymph nodes are the first lymph nodes into which the tumor’s lymph fluid drains. There may be more than one sentinel lymph node if there are several lymph veins draining the area where the tumor is located. The sentinel lymph nodes in the groin are situated directly beneath the skin in the case of penile cancer. If cancer cells are discovered in these lymph nodes, it indicates that the cancer has migrated to other surrounding lymph nodes or to other areas of the body. Even if cancer cells are not discovered during a sentinel lymph node biopsy, the malignancy may have spread.
Inguinal (groin) lymph node dissection: This is the most precise method of determining whether the cancer has progressed to any lymph nodes surrounding the penis. It may be advised if certain risk factors for dissemination are present, or if physical examination or imaging examinations reveal enlarged lymph nodes. The lymph nodes near the penis are removed and tested for malignancy during this surgery. This method yields more data than removing a single lymph node or a group of lymph nodes. However, there may be issues with wound healing as well as long-term and potentially severe leg swelling, known as lymphedema, following this treatment.
Computed tomography (CT) scan: A CT scan uses x-rays captured from various angles to create images of the inside of the body. A computer merges these images to create a detailed, three-dimensional image that reveals anomalies or tumors. A CT scan can be used to determine the size of a tumor. To improve image detail, a specific dye known as a contrast medium is sometimes administered before to the scan. This dye can be injected into a patient’s vein or given to them in the form of a pill or liquid to consume. A CT scan can assist determine whether the cancer has progressed to lymph nodes in the groin, pelvis, or abdomen. It also enables the doctor to determine whether the cancer has progressed to the lungs, liver, or other tissues.
Magnetic resonance imaging (MRI): An MRI produces detailed images of the body by using magnetic fields rather than x-rays. The tumor’s size can be determined via an MRI. To provide a crisper image, a special dye known as a contrast medium is administered before to the scan. This dye can be injected into a patient’s vein or given to them in the form of a pill or liquid to consume.
X-ray: An x-ray is a technique that uses a small amount of radiation to create a picture of the structures inside the body.
TREATMENT OF PENILE CANCER
Different types of specialists frequently collaborate in cancer care to develop a patient’s overall treatment plan, which mixes many sorts of therapy. This is referred to as a multidisciplinary team. In the case of penile cancer, this team may include a surgeon, a urologist (a specialist who specializes in urinary tract disorders), a medical oncologist, and a radiation oncologist. Other health care professionals on cancer care teams include physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, nutritionists, and others.
Surgery, radiation therapy, and chemotherapy are common treatments for penile cancer. Each is detailed in greater depth below. Treatment for symptoms and side effects, which is an important element of cancer care, may also be part of your treatment plan.
The type and stage of cancer, potential side effects, and the patient’s preferences and overall health all influence treatment options and recommendations. Take the time to read about all of your treatment options, and don’t be afraid to ask clarifying questions. Discuss the aims of each treatment with your doctor, as well as what you can expect during treatment.
Patients may be concerned that their treatment will have an impact on their sexual health and fertility. Before beginning treatment, discuss these issues with your doctor. These discussions are known as “shared decision-making.” When you and your doctors collaborate to identify therapies that meet the goals of your care, this is referred to as shared decision-making. Because there are various treatment choices for penile cancer, shared decision-making is very vital.
Surgery
During a surgery, the tumor and some surrounding healthy tissue, known as a margin, are removed. A surgical oncologist is a specialist who specializes in the surgical treatment of cancer. Penile cancer surgical oncologists are typically urologists with additional training in cancer surgery.
Penile cancer surgery is typically performed under local or general anesthesia, depending on the patient’s preferences and the doctor’s recommendations. To numb the area where the procedure is being performed, local anesthetic is injected. General anesthesia renders the patient asleep and prevents all pain during surgery, leaving the patient with little or no consciousness or memory of the process. The following sections detail the many types of surgery that may be performed to treat penile cancer.
Laser therapy: Laser therapy is the employment of a high-powered light beam to eliminate cancer cells. Some patients with early-stage penile cancer may benefit from laser therapy, including:
- Tis, as well as tiny T1 squamous cell carcinoma of the penis
- When a patient does not want surgical excision for a small T2 tumor, the procedure is used.
One disadvantage of laser therapy is that the doctor may struggle to detect how far the cancer has spread.
Cryosurgery: Cryosurgery, also known as cryotherapy or cryoablation, is the use of liquid nitrogen to freeze and kill cells. Later, the skin will blister and peel. This surgery may result in a scar. It is possible that more than one freeze will be required.
Circumcision: If the cancer is only on the foreskin, circumcision is usually employed.
Excision: An excision is the surgical removal of a tumor and some healthy tissue surrounding it with a knife or other surgical tool. To ensure that all of the cancer is eliminated, the surgeon may sometimes remove a greater amount of healthy tissue around the tumor. A skin graft is sometimes required to cover the area where the skin was removed. A skin graft is a procedure that uses skin from another part of the body to heal a wound and minimize scarring.
Penectomy: This is the surgical removal of a portion or the entire penis. It is the most common and efficient method of treating penile cancer that has spread inside the penis. Because this is a disfiguring procedure, it is critical to assess whether it is necessary or if merely the malignancy can be removed. If a penectomy is required to properly treat the cancer, a partial penectomy rather than a total penectomy is preferable if the malignant tissue and a 2 cm margin of healthy tissue can be removed while leaving enough length of the penis for the patient to urinate naturally. When this is not possible, a total penectomy, or removal of the entire penis, is performed. The surgeon will then tunnel the urinary tract beneath the scrotum, allowing the patient to urinate while sitting.
Mohs surgery: This method is performed to eliminate cancer that is visible on the surface of the penis. A small quantity of healthy tissue around the edge is removed in addition to the tumor to ensure that no cancer is left behind. Each small bit of tissue is examined under a microscope during the procedure until all of the malignancy is eliminated. This is most commonly used for a tiny tumor on the surface of the penis. This procedure may cost more than an excision.
Lymph node dissection: The removal of lymph nodes in the groin and/or pelvis is commonly used to determine the stage of or treat penile cancer. Even if there are no evidence that the cancer has gone to the lymph nodes, this procedure may be performed. If the groin lymph nodes are swollen before surgery, the procedure to remove these lymph nodes will be more thorough. While removing groin lymph nodes on both sides is frequent, removing deeper lymph nodes in the pelvis is usually reserved for when malignancy is discovered in the groin lymph nodes. When cancer has spread to the lymph nodes but not elsewhere, removing the lymph nodes can cure the cancer, and lymph node surgery can boost the likelihood of cure.
When the lymph nodes in both the groin and the pelvis are removed on the same side of the body, the leg on that side of the body commonly suffers from significant swelling known as lymphedema. This might result in substantial discomfort and recurring infections. When making such a treatment decision, you and your doctor should carefully consider the benefits of removing any cancer that has progressed to lymph nodes against the risk of surgery-related side effects.
Overall, the potential adverse effects of surgery are determined by the stage of disease and the type of procedure, among other things. Before surgery, discuss with your health care team the potential side effects of the specific surgery you’ll be having and how they can be controlled.
Radiation therapy
The use of high-energy x-rays or other particles to eliminate cancer cells is known as radiation therapy. A radiation oncologist is a doctor who specializes in the use of radiation therapy to treat cancer. External-beam radiation therapy, which delivers radiation from a machine outside the body, is the most prevalent method of radiation treatment. Internal radiation therapy, also known as brachytherapy, is a type of radiation therapy that uses implants to deliver radiation.
A radiation therapy regimen, or schedule, typically consists of a predetermined number of treatments administered over a predetermined time period. Radiation therapy for penile cancer can be directed towards the tumor in the penis and/or the lymph nodes in the groin and sometimes the pelvis to eradicate any cancer cells that have spread there.
Radiation therapy might cause fatigue, moderate skin responses, upset stomach, and loose bowel motions. Furthermore, radiation therapy may raise the likelihood of getting other cancers in the future. There is a danger of lymphedema in the leg(s) if radiation therapy is focused on the groin due to damage to the lymphatic pathways that drain fluid from the legs. Most side effects fade quickly after treatment is completed, while lymphedema can be a long-term issue.
Chemotherapy
Chemotherapy is the use of medications to eradicate cancer cells, typically by preventing the cancer cells from growing, dividing, and proliferating. Chemotherapy is administered by a medical oncologist, a doctor who specializes in the medical treatment of cancer.
A chemotherapy regimen, or schedule, typically consists of a predetermined number of cycles of treatment administered over a predetermined time period. For example, a treatment cycle may last three weeks, and the treatment plan may consist of four cycles of three weeks each, for a total of 12 weeks.
For penile cancer, two types of chemotherapy may be used: topical chemotherapy and systemic chemotherapy.
Topical chemotherapy
Lower doses of chemotherapy can be applied on the skin’s surface for small, noninvasive tumors known as “carcinoma in situ.” Fluorouracil (5-FU) and imiquimod are examples of such medications (Aldara).
Systemic chemotherapy
Systemic chemotherapy is administered directly into the bloodstream in order to reach cancer cells located throughout the body. Chemotherapy for penile cancer is often administered by an intravenous (IV) tube inserted into a vein with a needle or as a pill or capsule that is ingested (orally). If you are given oral drugs, make sure to ask your health care team how to store and manage them securely. Chemotherapy is frequently suggested following surgery for penile cancer when excision of pelvic lymph nodes reveals malignancy in more than one node. Chemotherapy may also be administered prior to surgery if the doctor believes that the tumor in the penis is too large to be entirely removed with surgery or that the cancer has spread to the regional lymph nodes, making surgical removal of the lymph nodes problematic. Chemotherapy may be done in this situation to shrink the cancer so that it can be totally removed.
When surgery cannot be used to remove penile cancer, it is sometimes treated with a combination of chemotherapy and radiation therapy. If the cancer has not gone beyond the pelvis, chemotherapy and/or radiation therapy may be administered to destroy enough cancer to allow surgery. Chemotherapy is also employed in the treatment of penile cancer that has progressed to other regions of the body.
Systemic medicines commonly used to treat penile cancer include:
- Cisplatin (available as a generic drug)
- Ifosfamide (Ifex)
- Paclitaxel (available as a generic drug)
- Fluorouracil (5-FU)
Systemic medications that are less typically utilized include:
- Bleomycin (Blenoxane)
- Docetaxel (Taxotere)
- Gemcitabine (Gemzar)
- Methotrexate (multiple brand names)
- Pembrolizumab (Keytruda), which is an immunotherapy that is used only if certain genetic abnormalities are detected
Not all of these medications are widely available to persons suffering from penile cancer. They might be provided only as part of a clinical trial. Because penile cancer is uncommon, less studies of chemotherapy and other medications for penile cancer have been conducted than for more frequent malignancies. As a result, there is no clear evidence that chemotherapy for penile cancer improves or extends patients’ lives. As a result, deciding whether to utilize systemic chemotherapy for penile cancer is not an easy option.
When chemotherapy is employed, cancer doctors generally believe that drug combinations that include cisplatin and involve two or three drugs work better than a single agent, but this has not been demonstrated in clinical trials. Cisplatin, ifosfamide, and paclitaxel are the two most widely utilized combinations, followed by cisplatin with fluorouracil. Other combinations under investigation include cisplatin and fluorouracil in conjunction with either paclitaxel or docetaxel. Discuss the particular drugs in the treatment plan that is recommended for you with your health care provider.
Chemotherapy side effects vary according to the individual and the dose administered, but they can include exhaustion, infection risk, nausea and vomiting, mouth sores, hair loss, loss of appetite, and diarrhea. These adverse effects normally fade away once the treatment is completed. Some side effects, however, can be permanent or manifest themselves in the future; they are referred to as late consequences. Chemotherapy, for example, may increase the risk of cardiovascular disease and other cancers, known as secondary cancers, in the future.
Cancer treatments are always being researched and tested. Talking with your doctor is often the best method to understand about the medications your doctor has prescribed for you, their purpose, and any potential adverse effects or interactions with other medications.
It is also critical to inform your doctor if you are using any other prescription, over-the-counter, or herbal drugs or supplements. Herbs, vitamins, and other pharmaceuticals can interact with cancer therapies, resulting in unpleasant side effects or decreased efficacy.
Metastatic penile cancer
Doctors refer to cancer that has spread to another place of the body from where it began as metastatic cancer. If this occurs, it is advisable to consult with specialists who have treated similar cases in the past. Different doctors may have differing views on the optimal conventional treatment strategy. Clinical trials are another possibility. Learn more about getting a second opinion before beginning treatment so that you are confident in your treatment plan.
Although metastatic penile cancer is generally incurable, there are treatments that may help decrease the cancer and relieve symptoms, allowing you to live a more comfortable life. Surgery, radiation therapy, and chemotherapy may all be part of your treatment plan. Chemotherapy is used to decrease penile cancer that has spread to other parts of the body and to keep it from developing or spreading for as long as feasible. Palliative treatment is equally useful for symptom relief and side effects.
A diagnosis of metastatic cancer can be extremely stressful and traumatic for many people. You and your family are encouraged to express your feelings to doctors, nurses, social workers, chaplains, and other members of the health care team. Talking with other patients, such as in a support group or other peer support program, may also be beneficial.
