CANCER OVERVIEW

These cancers affect the male genital/ reproductive system .

PROSTATE CANCER- Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm.Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal treatment, other types are aggressive and can spread quickly.Prostate cancer that’s detected early — when it’s still confined to the prostate gland— has a better chance of successful treatment.

 

TESTICULAR CANCER –Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction.Younger men are more likely to have this disease and this is the most diagnosed cancer in men from 20 to 34 years of age. Early detection accounts for a 99% treatment success.Testicular cancer is highly treatable, even when cancer has spread beyond the testicle.There are two types: Germ cell tumors which occur in the cells that produce sperm., and stromal tumors which occur in the testicular tissue where hormones are produced.

 

PENILE CANCER – The penis is the male sex organ, reaching its full size during puberty. In addition to its sexual function, the penis acts as a conduit for urine to leave the body.The penis contains several types of cells and  the cancer is classified by the type of cells in which it develops. Almost 9 out of 10 cases of penis cancer are of the form of squamous cell carcinoma. Squamous cells are the kind of cells found mostly on the surface areas of penis and thus. Penis’s head and foreskin are most prone to the cancerous attack.  Tumors have tendency to metastasize and may spread to other parts of the body through the bloodstream or lymph node.

 

The best strategy for these diseases is early diagnosis when cancer is highly treatable. Familiarity with the signs and symptoms of the disease and sensitivity to any physical changes are all helpful towards early detection. Symptoms do not necessarily mean genitourinary cancer, but consulting a specialist is highly recommended.

 

THE RISK FACTORS

Prostate Cancer risk factors

A complete understanding of the causes of prostate cancer remains elusive. The primary risk factors are obesity, age and family history.Prostate cancer is uncommon in men younger than 45, but becomes more common with advancing age, especially after age 50. More than 80% of prostate cancers are diagnosed in men who are 65 or older.Many men never know they have prostate cancer.

  • Family history. Prostate cancer that runs in a family, called familial prostate cancer, occurs about 20% of the time. This type of prostate cancer develops because of a combination of shared genes and shared environmental or lifestyle factors.Men who have first-degree family members with prostate cancer appear to have double the risk of getting the disease compared to men without prostate cancer in the family. This risk appears to be greater for men with an affected brother than for men with an affected father.

 

  • Race/ethnicity- Black men have a higher risk of prostate cancer than white men. They are also more likely to develop prostate cancer at an earlier age and to have aggressive tumors that grow quickly. The exact reasons for these differences are not known and may involve socioeconomic or other factors.

 

 

  • Health Status & Sexuality
  • Obesity and elevated blood levels of testosterone may increase the risk for prostate cancer.Men with high blood pressure are more likely to develop prostate cancer.There is a small increased risk of prostate cancer associated with lack of exercise.Several case-control studies have shown that having many lifetime sexual partners or starting sexual activity early in life substantially increases the risk of prostate cancer.

 

Testicular Cancer risk factors

  • An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are men whose testicles descended normally. The risk remains elevated even if the testicle has been surgically relocated to the scrotum.
    Still, the majority of men who develop testicular cancer don’t have a history of undescended testicles.
  • Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as Klinefelter syndrome, may increase your risk of testicular cancer.
  • Family history. If family members have had testicular cancer, you may have an increased risk.
  • Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and 35. However, it can occur at any age.
  • Race. Testicular cancer is more common in white men than in black men.

 

Penile Cancer risk factors

Infections

  • HIV infection—HIV-positive men have eight-fold increased risk of developing penile cancer than HIV-negative men.
  • Human papillomavirus—HPV is a risk factor in the development of penile cancer.
  • Genital warts—Genital or perianal warts increase the risk of invasive penile cancer by about 3.7 times if they occurred more than two years before the reference date.[ About half of men with penile cancer also have genital warts, which are caused by HPV.

Hygiene and injury

  • Poor hygiene—Poor hygiene can increase a man’s risk of penile cancer.[1
  • Smegma—Smegma, a whitish substance that can accumulate beneath the foreskin, is associated with greater risk of penile cancer.The American Cancer Society suggests that smegma may not be carcinogenic, but may increase the risk by causing irritation and inflammation of the penis.
  • Balanitis and penile injury—Inflammation of the foreskin and/or the glans penis (balanitis) is associated with about 3.1 times increased risk of penile cancer.It is usually caused by poor hygiene, allergic reactions to certain soaps, or an underlying health condition such as reactive arthritis, infection, or diabetes.[ Small tears and abrasions of the penis are associated with about 3.9 times increased risk of cancer.
  • Phimosis—Phimosis is a medical condition where the foreskin cannot be fully retracted over the glans. It is considered a significant risk factor in the development of penile cancer (odds ratio of 38–65). Phimosis may also be a symptom of penile cancer.[4]
  • Paraphimosis—Paraphimosis is a medical condition where the foreskin becomes trapped behind the glans. It is considered a risk factor for the development of penile cancer.[
  • Circumcision—Some studies show that circumcision during infancy or in childhood may provide partial protection against penile cancer, but this is not the case when performed in adulthood. It has been suggested that the reduction in risk may be due to reduced risk of phimosis;other possible mechanisms include reduction in risk of smegma and HPV infection.[

Other

  • Age—Penile cancer is rarely seen in men under the age of 50. About 4 out of 5 men diagnosed with penile cancer are over the age of 55.
  • Lichen sclerosus—Lichen sclerosus is a disease causing white patches on the skin. Lichen sclerosus increases the risk of penile cancer.[As the exact cause of lichen sclerosus is unknown, there is no known way to prevent it.
  • Tobacco—Chewing or smoking tobacco increases the risk of penile cancer by 1.5–6 times depending on the duration smoking and daily number of cigarettes.
  • Ultraviolet light—Men with psoriasis who have been treated using UV light and a drug known as psoralen have an increased risk of penile cancer

 

SIGNS & SYMPTOMS

Symptoms vary and are determined by the area where the disease develops. However, the existence of any of these symptoms does not necessarily signify genital cancer, but a doctor should always be consulted for a correct diagnosis especially if these symptoms last over 2 weeks. If it is genital cancer and symptoms are ignored, it could progress to an advanced stage and less easily treated. The most common symptoms for these genital cancer are:

 

  • Prostate Cancer
  • Inability and difficulty starting urination
  • Painful or burning urination
  • Blood in urine or semen
  • Painful ejaculation
  • Area of back, hips, or upper thighs stiff and painful

 

  • Testes Cancer
  • Pain in the testes or scrotum
  • Scrotum has a heavy feel
  • Lower belly or groin has dull pain or pressure
  • A lump or enlargement in either testicle
  • A sudden collection of fluid in the scrotum
  • Enlargement or tenderness of the breasts
  • Back pain

 

  • Penile Cancer
  • Reddishness and  a rash on penis
  • Small, crusty bumps
  • Open sore that doesn’t heal
  • Swelling or skin change of the penis
  • Groin’s lymph nodes are swollen
  • Wart-like growth or lesion
  • Foul smelling discharge from the penis[
  • Pain in the penis
  • Growth or sore on the penis that doesn’t heal within four weeks (may look like a wart, ulcer, or blister), may or may not be painful
  • Bleeding from the penis or from under the foreskin
  • Change in color of the penis
  • Phimosis

 

If a genital cancer is suspected, a doctor would first conduct a physical examination with a medical history review to detect patient’s risk factors. Depending on the outcome of the physical, next step would be diagnostic tests and/or biopsies of tissue.

 

TREATMENT

Depending on  type of cancer and the stage of the disease and other factors, treatment options can include one and possibly a combination of the following:

  • Surgery
  • Radiation therapy – EBRT, brachytherapy
  • Chemotherapy
  • Targeted therapies

 

It is critical for a patient to first discuss all treatment options as well as possible side effects with the medical team.When developing a treatment plan, we evaluate the stage and grade of the tumor, previous treatments (if any), extent of the cancer, biopsy results, and other unique factors. We develop the most effective multi-modal treatment plans for our patients with the collaboration of pathologists, urologists and radiologists. Dr Ngidi believes in holistic integrated care.Your referring physician is updated of your cancer status and management plan from the beginning  and at completion. This assists in streamlining your care.

Contact our Oncology practice for more Information

If you have been recently diagnosed with  cancer and seek a second opinion, we  dedicated to the best possible solution against your cancer.  We also appreciate and understand the impact that cancer and treatment may have on your life, sexuality, work and emotions and are dedicated to helping you navigate this phase of your life.  If you have questions or would like to know more about treatment options, please contact our center today at 011 2132250 and schedule a consultation with Dr Ngidi

 

The greatest glory in living lies not in never falling, but in rising every time we fall. Nelson Mandela