DISEASES OF THE PENIS: PREMALIGNANT AND MALIGNANT LUMPS
Cancer of the penis is virtually unheard of in men who have been circumcised in childhood. In uncircumcised men, it is thought that irritation under the foreskin, as a result of poor hygiene, infection or an inability to retract the foreskin, can ultimately lead to malignant cell changes.
Some premalignant conditions cause easily detected colour changes on the penis. If there are bright red- or orange-coloured velvety plaques on the glans, the man has a condition called erythroplasia of Queyrat. These plaques are usually painless, moist and slightly elevated, and have sharply defined edges. They appear singly or in groups and require prompt attention, because they can progress to frank cancer.
Another premalignant condition, called leukoplakia, manifests itself as a white, boggy area of thickened skin on the glans. It looks like a splotch of grey-white paint, is usually painless and can be removed with surgery or laser treatment.
Fortunately, cancer of the urethra is very rare in Australia. Kaposi’s sarcoma, a cancer that shows up in red-blue patches, is also rare in healthy Australian men but is commonly found on the genitals of those infected with HIV.
Frank squamous cell carcinoma of the penis is a rare cancer that starts as a lump on or right near the glans. The lump is painless and firm. Eventually it spreads like a cauliflower and becomes ulcerated. The earlier it is treated, the better the outcome. Treatment options include radiotherapy, chemotherapy and surgery.
If the cancer becomes invasive, a partial or total amputation of the penis may be necessary.
One well-known urologist says that on more than one occasion he has seen ‘a man of means, immaculately groomed, accompanied by a loving wife, pull back his uncircumcised foreskin and reveal an advanced cancer with its foul dead tissue. Imagine a rotting cauliflower: that is what it is like – and the groin is filled with enormous matted nodes.’ He has always been astounded that it could have been ignored until it had reached such an advanced degree.
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