Thorough hygiene prevents penile carcinomas

Penicillin Forum aims to improve treatment and research

12/21/2011

With age, the risk of penile carcinoma increases significantly in men. However, the cancer of the penis is still one of the taboo diseases in Germany, which is why those affected often remain silent for too long and the diagnosis is significantly delayed for the first time, reports the German Society for Urology.

The DGU therefore demanded alongside „intensive education“ a nationwide „Penile carcinoma registry, which should initiate more clinical research and generate therapeutic advances.“For this purpose, a forum for therapists and those affected was set up by the German Society for Urology. The shameful silence of those affected must finally be broken in order to provide them with adequate medical care as early as possible.

Peniscarcinoma register should inform those affected and improve the treatment
According to the German Society of Urology, around 600 men develop penile cancer every year in this country, with the risk of disease increasing with age and peaking at around 60 years. The DGU criticized the fact that due to the small number of cases, patients often receive little publicity. Out of the sense of shame, those affected were usually secretive for the time being, which often makes the diagnosis much delayed. Here could „Self-observation and the annual statutory cancer screening examination in the urologist from the age of 45 help to detect a penile carcinoma early“, stressed the urologist and DGU Secretary General Professor Oliver Hakenberg. Due to intensive medical care, the chances of recovery with a correspondingly early diagnosis would be good and usually an organ-preserving operation would be possible, the expert continued. However, the DGU also stated that „it is based on standardized treatments and studies for new therapies“ lacking. Here, the nationwide penile carcinoma registry should remedy the situation.

Numerous risk factors for penile cancer
The penis cancer registry has been administered for two years by the Urological Clinic and Polyclinic of the Rostock Medical University Hospital in cooperation with the Urological Oncology Association (AUO) of the German Cancer Society. By gathering all the relevant data on the diagnosis, treatment and disease progression of as many patients as possible, the experts hope to draw conclusions about the prospects of success of the different treatment strategies and new therapeutic approaches for the treatment of penile cancer. Also, the public should be much better informed than before about the causes and risks of penile cancer. Among the possible risk factors of a penile cancer disease called the German Society of Urology in the first place a foreskin (phimosis), as this complicates the genital hygiene (the foreskin is retract only partially) and inflammation of the penis favor, which in turn lead to the development of tumors can. Also, infectious diseases, such as by human papillomaviruses or genital warts are suspected to cause penile carcinoma. Similarly, ultraviolet radiation and tobacco use are considered risk factors for the development of penile cancer. „Although the causes are still largely unexplored, there are known risk factors that we want to make all men aware“, emphasized Oliver Hakenberg the intention of the Peniskarzinomregisters.

Early diagnosis through self-observation and check-ups
During self-observation, the experts advise men to pay more attention to symptoms such as skin changes, hardening or swelling of the glans or foreskin, vaginal discharge or bleeding from the penis and to take them as possible signs of penile carcinoma extremely serious. Older men should also the „annual statutory cancer screening examination at the urologist from the age of 45 years“ because it can help to detect tumor formation at an early stage. Thus, the chances of recovery could be significantly increased and usually could „organ preserving be operated“, explains the DGU Secretary General. However, if the diagnosis is made only at a later stage of the disease, depending on the extent of the tumor, a partial or complete amputation of the penis may be necessary, which, according to the expert, can not only cause physical impairments such as urinary symptoms, but also usually represents a great burden on the psyche of those affected. If the cancer has progressed even further at the time of diagnosis and has formed metastases in the inguinal lymph nodes, additional chemotherapy is necessary to prevent the spread of cancer in the organism.

Genital hygiene crucial in the prevention of penile cancer
According to the DGU, genital hygiene is especially important for the prevention of penile carcinomas. Also, circumcision for the prevention of penile cancer may be considered in men with phimosis. Because „circumcised men have a lower risk of developing penile cancer, which is why penile cancer is less common in countries or cultures where circumcision is common in childhood“, emphasized Hook Mountain. Here not only the hygienic advantage plays a decisive role, but also the fact that many penile carcinomas form on the inner part of the foreskin, which is removed in a circumcision, explained the DGU Secretary General. A vaccine to protect against infectious diseases, especially against the Human Papillomavirus (HPV), however, makes no sense in the opinion of the expert. Although the HPV vaccine for boys has already been discussed in the past, it has subsequently been rejected because of the low benefit. Thus, the vaccine is due to the low frequency of penile cancer and the not valid for all forms association with HPV little beneficial, said the German Society of Urology. Therefore, inclusion in the vaccination recommendations of the Standing Vaccination Commission of the Robert Koch Institute (RKI) is likewise not to be expected. (Fp)

Picture: Klaus Rupp