Around 800 men a year are told that they have penile cancer – but experts say more than half of cases are preventable.
Cancer Research UK estimates more than 60 per cent are linked to known risk factors including infection with certain strains of human papillomavirus (HPV), smoking, and chronic inflammatory skin conditions such as lichen sclerosus.
Symptoms include a growth, lump or sore that does not heal within four weeks, a rash, bleeding, abnormal discharge, as well as unexplained weight loss, extreme fatigue and abdominal pain.
But as is the case with many other ‘taboo’ cancers which occur below the belt, many people are too embarrassed about their symptoms to seek medical advice when they first notice them, or simply assume they’re connected to a less serious condition.
The reluctance to speak up means that penile cancer is typically diagnosed at a late stage when treatment is more drastic.
It was the case for Steven Hamill, 33, who made headlines earlier this month when he revealed that he had undergone a partial penis amputation to save his life after some of the warning signs were dismissed as other issues.
In fact, it took him waking up in a pool of his own blood – as well as battling intense pain and an extremely unpleasant odour – before he was handed the devastating diagnosis. But it wasn’t too late for Steven, and today, after treatment, he is cancer-free and the proud dad of a four-year-old boy.
Here, the Daily Mail reveal the warning signs of penile cancer.
Penile cancer is very rare and mostly affects men aged over 50 years old. But experts are concerned that numbers are on the rise
Discolouration and a persistent rash or sores
Penile cancer is typically not seen until middle age, but it can develop much earlier.
And while it is uncommon compared with other cancers, statistically, it kills more than twice as many men as testicular cancer.
Early diagnosis not only improves the chance of a cure, it means treatment can be less invasive, negating the need for amputation.
The first sign of penile cancer is often a change in colour – often red or blue-brown – under the foreskin or on the head of the penis, medically known as the glans, and a rash that lasts longer than a month.
It can also cause abnormal discharge and make the foreskin more difficult to retract.
However, these symptoms do not always point to penile cancer. Colour changes and rashes can develop as a result of infections such as thrush or inflammatory conditions like balanitis and psoriasis.
But, doctors stress, this doesn’t mean it’s okay to procrastinate booking an appointment – early diagnosis can save your penis and your life.
When caught early, more than 90 per cent of men outlive their cancer for five years.
However, for those with the most advanced cancer – diagnosed when it has already spread to other parts of the body – the prognosis is much more bleak.
No men in this group are expected to survive for five years.
Bleeding and foul smelling discharge
An unpleasant smelling discharge can occur due to an infection of because something is irritating the skin of the penis. It can also be due to not washing often or thoroughly enough.
Steven Hamill – now known as ‘Stumpy’ to his friends – was diagnosed with penile cancer in April of 2019
Cancer of the penis is a much less common cause, but something to be aware of.
Bleeding, including from under the foreskin, can also be a sign of cancer.
Most penile cancers are painless.
A lump in the groin, abdominal pain and unexplained weight loss
These symptoms can be a sign of a more advanced cancer.
At this point, a GP will do tests to decide whether a specialist referral is necessary.
This will involve examining the penis and taking a swab from an sore areas. A doctor may also feel the lymph nodes at the top of a patient’s legs to check for swelling.
Lymph nodes are small glands that make up part of the lymphatic system and are found all over the body, including the pelvis.
If penile cancer spreads it is most likely to be in the lymph nodes close to penis in either groin.
The more established and advanced the tumour is found to be – following a biopsy, MRI and CT or PET-CT scan to show where cells are more active than normal – the more aggressive the treatment required.
This ranges from circumcision of the foreskin, amputating the head of the penis – known as a glansectomy – or total removal.
If the penis has to be removed, and this included the internal ‘root’, then a new outlet for the bladder also has to be made between the anus and scrotum.
This procedure can also make sex difficult, and patients may experience anger, resentment, guilt, anxiety and fear as they come to terms with their illness.
But, according to the NHS, this is now a lot less common because doctors will do everything they can to preserve the penis.
If there are no signs that the cancer has spread, it may be possible to have penile reconstruction after amputation. This requires further surgery and usually involves a flap of skin and muscle from the arm being repurposed.
Boys who receive the HPV vaccine could slash their risk of developing cancer by nearly half
The dangers of HPV
Human papillomavirus (HPV) is the name of a group of 200 viruses – some of which are linked to cancer.
The virus is primarily spread through skin-to-skin contact, often during sex.
It’s linked to almost all cervical cancers, but the sexually transmitted infection (STI), – which rarely causes symptoms – can also cause penile cancer.
Cancers often take years to develop after a person develops HPV.
It may start as genital warts, unusual growths of lumps in the genital area, mouth or throat, as well as sores.
This then may develop into penile cancer – affecting the skin covering the penis or the head or tip.
While there is no treatment for the HPV virus itself, there are ways to lower your chances of getting the virus, and the health problems it can cause.
This included HPV vaccination, which protects against the types of HPV that cause most cases of genital warts and penile cancer.
It is most effective when given before a person is exposed to the virus and is routinely offered to boys and girls from the age of 12 and 13 in the UK through school-based programmes,
Men who have sex with men aged up to 45 can also request the vaccine for free from sexual health and HIV clinics in the UK.
Using condoms, practicing safe sex and not smoking can also significantly reduce your chances of getting HPV and avoiding penile cancer.
