Risks and Causes of Penile cancer

The exact cause of penile cancer is not clear, but certain factors can increase the chance of developing it.

The testicles

The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.

Image of the testicles (cruk)

Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.

The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.

Testosterone:

The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:

A deeper voice
Facial hair growth
Increased muscle mass
The ability to achieve an erection
Male sexual drive (libido)

Where does testicular cancer start:

The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins.

Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:

Seminoma
Non-seminoma

Testicular cancer and the lymph nodes:

Lymph nodes are a part of the lymphatic system that spans the entire body. They, along with lymph vessels, contain a yellow fluid known as lymph. This fluid circulates through the lymphatic system, collecting waste products and draining into veins for waste removal.

Cancer can spread to lymph nodes, causing them to enlarge. In testicular cancer, it’s common for the disease to spread to lymph nodes located at the back of the abdomen, known as retroperitoneal lymph nodes.

These retroperitoneal lymph nodes are situated behind the intestines and in front of the spine. They lie next to the main blood vessels in the abdomen, the aorta, and the inferior vena cava.

Image of the lymph nodes with testicles

Who gets it:

Younger men are more likely to get testicular cancer.

Trans women can also develop testicular cancer if they haven’t had an operation to remove their testicles (orchidectomy).

Men in their early 30s are the most likely to get it. It then becomes less common as men get older.

What is a risk factor?

A risk factor is anything that can increase the likelihood of developing a disease.

Different types of cancer have their own unique risk factors. However, having one or more of these factors doesn’t mean you will necessarily develop that cancer.

Phimosis in uncircumcised men:

Circumcision is a simple surgery to remove part or all of the foreskin. Some uncircumcised men may have difficulty pulling back their foreskin, a condition known as phimosis. Phimosis is linked to a higher risk of penile cancer.

The exact cause of this link is unclear, but phimosis can lead to smegma buildup under the foreskin. Smegma, made of dead skin cells, can irritate and inflame the penis if not cleaned properly.

The timing of circumcision can influence the risk of penile cancer:

At Birth: Men circumcised as babies have a lower risk.
In Teenage Years: Circumcision in adolescence offers some protection.
In Adulthood: Circumcision later in life does not seem to reduce the risk significantly.

Circumcision is also commonly performed on newborns for cultural or religious reasons.

Psoriasis treatment:

Psoriasis (pronounced sore-eye-ah-sis) is a long-term skin condition that is not contagious. It is sometimes treated using a drug called psoralen combined with light therapy, known as PUVA. PUVA therapy can also be used for certain types of cancer. However, men who have undergone PUVA therapy may have a higher risk of developing penile cancer.

Other possible causes:

News stories about potential causes of diseases are often shared in the media, but it’s not always clear which are supported by evidence. You might have come across ideas that we haven’t mentioned here. This is because there may not be enough evidence for them, or the information is still uncertain.

Having Weakened immune system:

Circumcision is a minor surgery that removes some or all of the foreskin. Men who are uncircumcised may sometimes have difficulty pulling back the foreskin, a condition called phimosis. Phimosis increases the risk of penile cancer, possibly due to related factors like smegma buildup. Smegma is a substance made of dead skin cells that can collect under a tight foreskin, causing irritation and inflammation if not cleaned regularly.

Circumcision may also influence penile cancer risk based on the timing:

At Birth: Men circumcised as babies have a lower risk of penile cancer.
In Teenage Years: Circumcision during adolescence provides some protection.
In Adulthood: Circumcision in adulthood does not seem to affect the risk of penile cancer.