Mr. Liu is 45 years old this year, and he had the problem of long foreskin when he was young, but he has not dealt with it. Especially after getting married and having children, he felt that there was no need to deal with it, so he kept it like this.
About three months ago, when he was taking a shower, he noticed a hard lump on his genitals, but it didn't hurt or itch, so he didn't take it seriously. Unexpectedly, after a while, the lump grew bigger and bigger, almost covering the top of the genitals.
Only then did he start to panic, and he hurriedly went to the hospital for an examination, which was found to be penile cancer, and he also needed to undergo penile resection, which was difficult for him to accept, how could it be like this?
The doctor said that Mr. Liu had not dealt with the problem of long foreskin for many years, so much so that the genitals became inflamed, chronic irritation, and eventually developed into cancer.
1. Penile cancer: is phimosis mostly to blame?
Penile cancer, as the name suggests, refers to malignant tumors that occur in the penis, and the most common pathological type is penile squamous cell carcinoma, accounting for more than 95%. It is more common in men over the age of 40, with a long foreskin, and who do not pay attention to local cleaning.
Du Yuejun, attending physician of the Department of Urology of Nanfang Hospital of Southern Medical University, published an article introducing that poor local penile hygiene can lead to recurrent infections, which is currently recognized as a risk factor for penile cancer. In particular, men with foreskin and phimosis can easily accumulate a large amount of smegma everywhere, leading to repeated infections of the penis and eventually cancer.
Should the foreskin be cut off or not? Children under the age of 6 years who do not have recurrent infections or urinary disorders can not rush to deal with phimosis of the foreskin; However, if you are older than 6 years old and still cannot turn up to reveal the glans, especially if you have recurrent infections, you must have surgery as soon as possible.
In addition, the onset of penile cancer may also be related to the following factors.
HPV infection: After HPV infection occurs in men, it will cause genital warts on the external genitalia, and cancerous changes of the penis, perianal area, and anus may also occur. Studies in Europe have found that HPV16 subtype infection is detectable in 84.2% of penile cancer patients.
Smoking: In a Brazilian study of 230 patients with penile cancer, about 50% of patients were smokers, and there was a clear association between smoking and penile cancer.
Unclean sex: Unclean sex can easily lead to the spread of sexually transmitted diseases, such as syphilis, gonorrhea, AIDS, etc., which are also related to the occurrence of penile cancer. Infection can lead to an inflammatory response in the penis, causing tissue damage, abnormal cell growth, and increased risk of cancer.
2. Ding Ding has 4 abnormalities, or signs of penile cancer
Yang Ke, director of the Fourth Department of Urology of Hunan Provincial People's Hospital, said that the cure rate of early penile cancer can reach 70~80%. However, if it is accompanied by lymph node metastasis, the survival rate will drop to 20~30% in 5 years after surgery, and the mortality rate of patients will be higher if there is no timely treatment.
Therefore, when Ding Ding has the following 4 abnormal manifestations, it is recommended that male friends should check it as soon as possible, so as not to delay the best period of treatment.
1. glans/coronal sulcus mass
The most common symptom of penile cancer is the appearance of lumps and masses on the external genitalia, among which the glans is the most common, and some will appear in the coronal sulcus below the glans. It is usually a hard lump or cauliflower-like bump that appears as a pimple, and it is necessary to seek medical attention as soon as it is found. Other patients develop ulcerative masses that are locally hard.
2. Erythema/papules or masses
The lump inside the foreskin grows larger, puncturing the foreskin and creating a purulent discharge that erodes, stings, or burns around it.
3. Difficulty urinating
Patients may experience urinary discomfort such as urinary frequency, urgency, and dysuria, but these symptoms can easily be mistaken for a benign condition, and purulent hematuria may occur as the disease progresses.
4. The lower body is erosive and smelly
Penile cancer can cause erosions in the glans area of men, and purulent discharge may be attached to the surface, which is often accompanied by a foul odor.
3. If I unfortunately have penile cancer, do I have to have it removed?
Penile cancer does not have to be removed, and the principle of penile cancer treatment is to remove the tumor while preserving the function of the organ as much as possible. Treatment for penile cancer generally includes surgery, radiotherapy and chemotherapy.
1. Surgery
Among them, the surgical treatment of penile cancer can be divided into three types according to the grade and stage of the tumor.
Penile preservation: For early, localized penile cancer, circumcision, local lesion excision, and laser treatment can be performed to preserve the penis.
Partial resection: It is generally used when the tumor differentiation degree is low and at least 1cm away from the surrounding tissues of the tumor, and the probability of local recurrence after surgery is less than 8%, and the 5-year survival rate is more than 90%.
Total excision: suitable for patients with intermediate and advanced stages, if the tumor has spread to the scrotum, the scrotum and testicles need to be removed.
2. Radiotherapy
Indicated for superficial, ulcerative cancers that do not metastasize to lymph nodes and have not invaded the corpora cavernosum of the penis, especially in younger patients, radiation therapy can control tumor growth and preserve sexual function.
3. Chemotherapy
Chemotherapy alone has a general effect on penile cancer, so it is generally used for adjuvant therapy and combination therapy.
4. Can I still enjoy my married life after the removal of the dingding?
After the genital excision, it will definitely have a certain impact on the sex life, especially for some patients who have had a long resection, and it is difficult to even stand up and urinate normally after surgery, and naturally they cannot have intercourse.
In addition, the absence of the genital head can also affect normal access to intercourse; Some men will have a great psychological burden because of the surgery, and even refuse to have sex outright after the surgery.
Will the removal of the part affect normal fertility?
If sexual intercourse and ejaculation can occur normally after surgery, fertility will not be affected, and men can still get pregnant and have children. However, if the "eggs" are removed, the parts that produce sperm are gone, and it is naturally impossible to have children.
Penile cancer is a completely preventable and treatable disease, men must pay enough attention to it, observe the physical performance and regular physical examination, and seek medical attention in time if abnormalities are found.
Resources:
[1] Understanding Penile Cancer. Dr Zhang, Urologist 2022-07-14
[2] "A 54-year-old man with penile cancer and a total genital organ removal, can he still have sex?" 》. Guangdong, Zhejiang and Shanghai Platform 2022-08-31
[3] "Tintin cuts off a part, can it still be "sexually blissful"? 》. Clinic 11 2020-01-28
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