Penile squamous cell carcinoma is a rare form of cancer that develops on the surface of the penis. This condition originates from specific cells found in the outermost layer of the skin. Though uncommon, its presence can significantly affect an individual’s health and well-being.
What is Penile Squamous Cell Carcinoma
This cancer accounts for approximately 95% of all penile cancers. It typically originates on the glans (head of the penis) or foreskin in uncircumcised individuals. These tumors generally grow slowly and are often treatable if detected early. While rare globally (0-2% of cancers worldwide), incidence can be higher in certain regions, particularly in underdeveloped countries.
Risk Factors
Several factors increase the likelihood of developing penile squamous cell carcinoma. Human papillomavirus (HPV) infection is a contributor, with high-risk types like HPV-16 and HPV-18 frequently associated. HPV can damage cells, leading to cancerous changes if the immune system doesn’t clear the infection.
Phimosis, a condition where the foreskin is too tight to retract, also poses a risk. This can lead to chronic inflammation and smegma accumulation (dead cells and oils), increasing cancer risk. Poor hygiene, often linked with phimosis, contributes to this inflammatory environment.
Smoking and other tobacco use are additional risk factors, as carcinogenic chemicals can harm DNA in penile cells. The risk also increases with age, with most cases occurring in men over 50. Other factors, such as a weakened immune system (e.g., AIDS) or certain skin conditions like lichen sclerosus, can also elevate risk.
Recognizing Signs and Diagnosis
Early recognition of penile squamous cell carcinoma signs is important for effective treatment. Signs often involve changes in the skin of the penis, typically on the glans or foreskin. These may include:
Thickening of the skin
Alterations in skin color
A lump or sore that does not heal within four weeks
A reddish, velvety rash under the foreskin
Small, crusty bumps
Flat, bluish-brown growths
Smelly discharge or bleeding from the penis or under the foreskin
Swelling at the end of the penis, especially if the foreskin is constricted
Diagnosis begins with a physical examination of the penis and surrounding lymph nodes to assess the lesion’s appearance, size, and location. A biopsy is then performed, taking a tissue sample for microscopic examination. Imaging tests, such as MRI or CT scans, may determine if the cancer has spread to nearby lymph nodes or other body parts. MRI is helpful for assessing deeper invasion into penile structures.
Treatment Options
Treatment for penile squamous cell carcinoma varies by cancer stage and extent.
Surgical Removal: A common approach to remove cancerous tissue while preserving as much of the penis as possible. Options include local excision (removing the tumor and a margin of healthy tissue) or Mohs micrographic surgery (precisely removing skin layers until no cancer cells remain). For deeper or more extensive cancer, partial or total penectomy (removal of part or all of the penis) may be necessary.
Radiation Therapy: Uses high-energy rays to destroy cancer cells. It can be a primary treatment for some early-stage cancers or combined with surgery, especially if cancer has spread to lymph nodes. This includes external beam radiation or brachytherapy (radioactive sources placed directly into the tumor).
Chemotherapy: Applied topically as a cream for very early-stage, superficial cancers. For advanced or metastatic disease, systemic chemotherapy is administered orally or intravenously to target cancer cells throughout the body.
Immunotherapy: Helps the body’s immune system recognize and attack cancer cells. It is explored, often with chemotherapy, for advanced or recurrent cases.
Prevention Strategies
Strategies can help reduce the risk of developing penile squamous cell carcinoma:
HPV Vaccination: A preventative measure, as certain HPV strains are linked to penile cancer. Most effective before sexual activity, recommended for males and females aged 11-12, and up to age 26 for those not previously vaccinated.
Good Penile Hygiene: Important, especially for uncircumcised individuals, to prevent smegma buildup and reduce inflammation.
Regular Self-Examination: Aids in early detection of unusual changes, allowing for prompt medical evaluation.
Quitting Smoking: Tobacco use is a known risk factor for this cancer.