What is Prostate Cancer
Penile cancer occurs when abnormal cells in the penis begin to grow and multiply uncontrollably.
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.
The Penis
The penis is the male sex organ, playing a key role in both the urinary and reproductive systems. It contains a tube called the urethra, which carries urine from the bladder and semen (sperm) from the testicles out of the body. The base of the penis, known as the root, is inside the body and extends outward, hanging in front of the scrotum—a pouch of skin that holds the testicles.
The penis is made up of several parts:
– Head (glans): The tip of the penis.
– Body (shaft): The main part of the penis.
– Foreskin: A movable layer of skin covering the glans.
– Frenulum: A small tag of skin on the underside, connecting the foreskin to the shaft.
Some men undergo circumcision, a procedure to remove the foreskin.
The penis consists of various tissues, including skin, muscle, and nerves, with a rich blood supply. During sexual arousal, blood flow to the penis increases, causing the erectile tissue in the shaft to fill with blood, leading to an erection.
This diagram shows the parts of the penis
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.
The Lymph nodes
Lymph nodes, also known as lymph glands, are small, bean-shaped structures that are part of the lymphatic system. They are found throughout the body, including in the pelvis. If penile cancer spreads, it often moves first to the lymph nodes near the penis, particularly in the groin area.
Where penile cancer starts
Penile cancer can begin in various parts of the penis but most often starts under the foreskin in men who are not circumcised or on the head of the penis (glans). The specific type of penile cancer is determined by the type of cell where it originates.
Risks and causes of Penile cancer:
The exact cause of most penile cancers is unknown, but certain factors may increase the risk of developing the disease.
Human Papilloma virus (HPV)
HPV (Human Papillomavirus) is a common infection that spreads through close skin-to-skin contact, typically during sexual activity, including oral sex. Most sexually active people will encounter HPV at some point, but in most cases, the virus causes no harm and clears up on its own.
There are many types of HPV, with some causing genital warts and others leading to changes that may develop into cancer. HPV is responsible for about 60% of penile cancer cases, with types 16 and 18 being the most common in these cases.
Research, such as a Danish study, suggests that men who have never used condoms are at more than double the risk of developing penile cancer compared to those who have used them. This is likely because condoms help reduce the risk of HPV infection. Additionally, circumcision may lower the risk of HPV infection on the penis.
Age
Penile cancer is more likely to occur in men aged 50 or older, and it is relatively rare in men under the age of 40.
Having a weakened immune system
A weakened immune system can increase the risk of developing penile cancer. Conditions like HIV or AIDS, and certain medications taken after an organ transplant, may reduce the immune system’s ability to fight infections and diseases, including cancer.
Phimosis in uncircumcised men
Circumcision is a minor surgical procedure to remove part or all of the foreskin from the penis. Uncircumcised men may experience difficulty retracting their foreskin, a condition known as phimosis. Men with phimosis have a higher risk of developing penile cancer, although the exact reason is not fully understood.
Phimosis may contribute to this increased risk due to factors such as smegma—a cheese-like substance of dead skin cells that can accumulate under the foreskin and cause irritation and inflammation if not cleaned regularly.
Circumcision in infancy often reduces the risk of penile cancer, while circumcision in adolescence provides some protection. However, circumcision in adulthood does not seem to significantly impact the risk of developing penile cancer.
Psoriasis treatment
Psoriasis is a long-term skin condition that isn’t contagious. It’s sometimes treated with a combination of a drug called psoralen and light therapy, known as PUVA. While PUVA is effective for treating psoriasis, it can also be used in cancer treatment. However, men who have undergone PUVA therapy may have an increased risk of developing penile cancer.
Other possible causes
Stories about potential causes of penile cancer often appear in the media, but the evidence supporting these ideas can vary. Some factors you might have heard about may not be included here due to a lack of clear evidence or because the research is not definitive.
Daignosis
If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,
Treatment options
A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected