Surgical Removal of Penile Cancer: Description, Healing Process, and Potential Issues
Penile cancer is a relatively rare condition, affecting fewer than 1 male in 100,000 each year in North America, as stated by the American Cancer Society (ACS). This article aims to provide a clear and straightforward guide to the various treatment options available for penile cancer, including penectomies and alternative approaches.
When a penectomy is necessary, it involves the removal of part or all of a person's penis. The surgery is typically performed under general anesthetic, and antibiotics may be administered to reduce the risk of infection. During recovery, swelling, bruising, and pain are common, and a person may be prescribed antibiotics or pain medication.
There are different types of penectomies: partial, total, and radical. In a partial penectomy, only the affected portion of the penis is removed, leaving some shaft remaining. A total penectomy involves the removal of the entire penis, and in a radical penectomy, the surgeon also removes parts of the penis that are inside a person's body. In some cases, a doctor may perform a glansectomy, where the tip of the penis is removed if cancer is only present in that area, and the area is then repaired using a skin graft.
Alternative treatments for penile cancer besides penectomy include partial penectomy, organ-preserving surgery, radiation therapy, and laser therapy. These treatments aim to control cancer while preserving as much of the penile tissue and function as possible.
Organ-preserving surgery can involve techniques like wide local excision or glans resurfacing, which preserve penile structure for early-stage or smaller tumors. Radiation therapy, both external beam radiation and brachytherapy (internal radiation), can be used to treat penile cancer, especially in early stages or as an adjunct to surgery. Laser ablation may be considered for very early superficial lesions.
In some cases, topical chemotherapy or immunotherapy might be options, though less common. Other conservative treatments depend on staging and patient specifics.
Lymph node dissection is important in treatment planning to address potential cancer spread. If necessary, lymph nodes near the penis may be surgically removed and examined for signs of cancer.
While total penectomy remains a standard for advanced cases, these alternative options focus on balance between oncologic control and quality of life by preserving penile tissue and function where feasible. Surgeons typically try other treatment options before performing a penectomy to treat penile cancer.
The BAUS (British Association of Urological Surgeons) provides valuable information on penectomy recovery and potential complications. After the surgery, a surgeon places a catheter inside a person's urethra to allow urination while the wounds heal. If a person has a skin graft during their penectomy, a healthcare professional will remove their dressing after 5-10 days and remove their catheter once their wounds have healed or the skin graft has "taken."
Complications that may occur after a penectomy include a degree of impotence, a shorter penis, spraying urine during urination, skin graft failure, reoccurrence of cancer in the penis, narrowing of the urethra opening, infection, and other potential issues. It is crucial for individuals to discuss their treatment options with their healthcare provider to make informed decisions about their care.
