NAIROBI, Kenya -Despite its rarity, penile cancer is witnessing a concerning rise in incidence, with experts predicting a 77pc increase in cases by 2050.
The trend is particularly notable in Europe, driven by an aging population and other contributing factors.
While penile cancer rates have traditionally been higher in developing countries, a surge in cases is now being observed across Europe.
As the continent’s population ages, the prevalence of penile cancer is expected to climb, given that being over 50 is one of the primary risk factors.
Additional risk factors include phimosis (a condition where the foreskin is too tight), poor genital hygiene, and smoking. Interestingly, penile cancer is rare among men circumcised at birth.
Over 90% of penile cancers originate from squamous cells in the skin of the penis. Other types of malignancies, such as melanoma, basal cell carcinoma, or sarcoma, are less common.
Human papillomavirus (HPV) infection is identified in about half of squamous cell carcinoma cases.
HPV is likely the most prevalent sexually transmitted infection globally, with over 70% of sexually active adults contracting it at some point, usually during adolescence.
While most HPV infections are asymptomatic and resolve on their own, some can persist and cause pre-malignant changes in the penile skin, potentially leading to cancer.
HPV 16, a high-risk type of the virus, is especially notorious for causing malignant changes in various tissues, including the penis, cervix, mouth, throat, vulva, vagina, and anus.
While HPV vaccines have significantly reduced cervical cancer rates, their impact on penile cancer is expected to take longer to manifest due to the typically extended period between HPV infection and cancer development.
Diagnosis of penile cancer is often delayed due to patient embarrassment or guilt, leading many men to self-medicate with antimicrobial or steroid creams rather than seek professional medical advice.
This delay is exacerbated by healthcare providers occasionally misclassifying lesions as benign.
Timely diagnosis and treatment are crucial, as the chances of a cure diminish significantly if malignant cells spread to the groin lymph nodes.
Treatments for penile cancer include laser or microsurgery to remove cancerous tissue, sometimes combined with chemotherapy or radiotherapy.
In severe cases where tumors are unresponsive, amputation of the penis may be necessary, though this is always considered a last resort.
Brazil, one of the countries with the highest rates of penile amputation, sees nearly two such surgeries performed daily.
However, new treatment approaches are offering hope. These include engineered T cells that target HPV-infected cells and immunotherapies like tislelizumab, which enhance immune responses to squamous cell tumors.
These innovative treatments have shown promise in several cases, paving the way for improved outcomes.
