Penile cancer: why cases are increasing worldwide and what can be done to prevent it

In 2018, Joao, a 63-year-old retiree, began noticing a wart on his penis.

“I started visiting clinics to find out what it was, but all the doctors told me it was due to excess skin and prescribed me medication,” the 63-year-old recalls.

Despite the medications the wart continued to grow.

This began to affect the marriage and sex life of João and his wife. “We were like brothers,” he admits.

For this reason, he was determined to find out what was going on.

Over the course of five years, João (not his real name) visited numerous specialists who prescribed him new medications and ordered new biopsies. “Nothing has solved this problem,” he says.

Then in 2023 they were able to make a diagnosis: Joao had penile cancer.

“It was something very unpleasant for my family, especially since they had to amputate part of my penis. “I feel like I’ve been beheaded,” he says.

“This is a type of cancer that you shouldn’t talk about with people because it could become a joke.”

The truth is that penile cancer is rare, but Morbidity and mortality rates are rising throughout the world.

Brazil, where João is from, has one of the highest rates of penile cancer in the world, with 2.1 per 100,000 men, according to recent research.

About 21,000 cases were reported between 2012 and 2022, according to Brazil’s Ministry of Health.

Over the past ten years, this has led to 4,000 deaths and 6,500 amputations: one every two days.

Symptoms of penile cancer often begin with an ulcer that won’t heal and in many cases it has an unpleasant odor.

If the disease is diagnosed early, there is a high chance of recovery through procedures such as surgery, radiation therapy, or chemotherapy.

But if left untreated, it can lead to partial or complete amputation of the penis and possibly other genital organs such as the testicles.

In January last year, João had to undergo a partial amputation. And it was a difficult moment for him.

“I never imagined that I would suffer from the disease. And this is something that cannot be told to everyone,” he explains.

“I was very afraid of the operation, but there was no other alternative. The feeling in the first weeks was sadness. I can’t deny it. “Being without part of your penis is terrible.”

For some patients, the only solution is complete amputation of the penis. And this is something that changes lives forever.

Thiago Camelo Murao from the Department of Urology at the Sao Paulo Cancer Center notes that “in the case of partial amputation, urine continues to come out of the penis.”

“In the case of a complete amputation, the urethral opening may be moved into the perineum, between the scrotum and anus, resulting in the patient having to urinate while sitting on the toilet.”

According to experts, there are several risk factors that can lead to penile cancer, such as phimosis (a condition in which the foreskin cannot be removed) or smoking.

Mauricio Dener Cordeiro, a urologist specializing in this topic, notes that personal hygiene plays an important role in the development of this disease.

“When a man does not expose the head of the penis and clean the skin around it properly, discharge occurs and accumulates. This is ideal for bacterial infections,” he says.

“If this happens repeatedly, it becomes a risk factor for tumor development,” he adds.

But beyond hygiene, Cordeiro says persistent exposure to the human papillomavirus could be one of the “major risk factors.”

In some cases, human papillomavirus can cause cancer of the mouth and penis.

“Mass vaccination against human papillomavirus is necessary because of its high effectiveness in preventing injuries associated with this type of disease,” Cordeiro says.

He believes a lack of information about the vaccine, doubts about its effectiveness and few vaccination campaigns have contributed to low immunization rates.

According to recent studies, the number of cases in the world has increased significantly.

In 2022, the public health journal JMIR published the results of a large-scale analysis that included information from at least 43 countries.

The highest incidence of penile cancer between 2008 and 2012 was observed in Uganda (2.2 per 100,000 men), followed by Brazil (2.1 per 100,000) and Thailand (1.4 per 100,000).

The country with the lowest incidence was Kuwait (0.1 per 100,000).

“Although developing countries account for the majority of cases, the largest increase in incidence in recent years has been seen in European countries,” concludes the Chinese University study, led by researchers Leiwen Fu and Tian Tian.

For example, the report notes that the United Kingdom saw an increase in cases over 30 years from 1.1 cases per 100,000 men to 1.3 per 100,000 men.

Between 1961 and 2012, Germany saw a 50% increase in cases.

The truth is that the numbers are rising, and if this continues, by 2050 there will be 70% more cases than current numbers.

This change can largely be explained by the aging population, according to experts, who note that the highest incidence occurs in men over 60 years of age.

“Penile cancer is a rare disease, but it is easily preventable. It is important that men of all ages wash their penis with soap and water every day and after sex,” says Cordeiro.

He also advised using a condom during intercourse and having surgery to remove the foreskin, which in the case of phimosis can help reduce the risk of penile cancer.

João is currently awaiting the results of his final tests, which he will receive later this year. “I am confident that these tests will show that I will be cured,” he says.

According to Cancer Research UK, more than 90% of men diagnosed with penile cancer that has not spread to nearby lymph nodes survive five years or more.

“Now, after the amputation, the pain is gone and I feel much better. But I will have to face partial amputation of my penis for the rest of my life.”

*Additional reporting by Rone Carvalho, BBC Brazil.

And remember that you can receive notifications in our application. Download the latest version and activate them.