penile cancer
The close association that exists socially between sexual capacity and self-esteem leads to this disease having a high psychological impact on men
The prevalence is small: less than 500 cases per year in Spain. And this cancer is rarely talked about, also surrounded by a strong stigma due to the great psychological impact that the disease adds to the men who suffer from it. We are talking about penile cancer, a tumor that “originates from an uncontrolled growth, in the tissues of this member, of cells with malignant potential (cancerous) that divide abnormally and subsequently move to another part of the body ( metastasis) causing serious problems and even death”, explain doctors Javier Romero-Otero –director of the Department of Urology at HM Hospitales de Madrid and medical director of the ROC Clinic– and Félix Guerrero Ramos –responsible for the Uro Unit- ROC Clinic Oncology–. “Depending on the cells that originate it and its growth, there are different types of penile cancer, but the most common is squamous cell carcinoma and the highest incidence of this pathology in the world is found in Brazil,” they add.
One of its main risk factors is chronic infection by the human papillomavirus (HPV). In addition, some studies maintain that people with multiple sexual partners and who have unprotected relationships have a higher risk of developing it; as well as single men (probably related to the above) and those who start sexual relations at an early age, who reside in rural areas and have a low socioeconomic level. Other related reasons are: age, habitual or chronic infections in the area of the glans or foreskin and phimosis – a problem that occurs when the hole in the foreskin, the skin that covers the penis, is too narrow to let the glans out. – which is not operated.
Reluctance to go to the doctor
The symptoms of the disease appear very early. The most common is to find lesions around the glans or foreskin, but they can manifest in any part of the penis. “Sometimes it is a lesion with redness in the glans area that did not exist previously, or a small wart, or a scaly area. For this reason, before any type of alteration, it is key to consult with the urologist, ”the doctors advise.
First, to rule out other possible mild injuries that are easy to diagnose and treat, such as folliculitis due to ingrown pubic hair. Secondly, because penile cancer can start with a premalignant lesion that, without being initially malignant, can become cancer if it is allowed to progress. In advanced cases, lumps or ulcers (wounds) may appear in the groin area because the tumor has already spread to the nodes in the groin area.
«The social context does not help men to express their sexual problems in a natural way»
Pink GOALKEEPER
clinical psychologist
In order to make a diagnosis, the patient must undergo a physical examination in which the urologist examines the penis and groin. The problem is that, given the area in which it occurs, sometimes men have a certain reluctance to consult a doctor about these discomforts, which can mean that, when they decide to do so, it is already too late.
The most common treatment is surgery and there are different options depending on where the tumor is. “If it is in the foreskin, for example, with a circumcision the margins remain clean. Other times, only the glans is removed, while in the most serious cases, partial or total amputation of the penis (penectomy) is considered, ”the urologists report. Total penectomy is the intervention that has the most aesthetic, functional and psychological consequences, since the man is left without a penis and has to urinate sitting down.
misunderstood masculinity
Beyond the physical effects, the emotional condition that accompanies this disease is important. “The appearance of psychological problems associated with these cases has several explanations. It is known that one of the main concerns of adolescent boys revolves around the size and deviation of the penis, the asymmetry of the testicles, the shape of the glans and the absence or presence of body hair. They experience it as a stage in which a ‘countdown’ begins for their first sexual relationship, which is perceived as an initial rite to acquire social prestige and belonging to the peer group. Therefore, self-esteem is closely related to the occurrence of this adjustment, which leads the male sex to define themselves as ‘more valid or fit’ based on their ‘sexual ability’. That is one of the reasons why any problem or difficulty in adult life in this area is experienced with rejection, fear, shame and stigma”, explains Rosa Portero, a health psychologist at the Clinical Psychology Center in Madrid.
Added to this circumstance is the ‘taboo’. “Historically, the sociocultural context has not favored the natural treatment of issues related to sexuality and sexual organs, and there is also a great lack of knowledge of these pathologies, which explains the difficulty of men to ‘open up’ about related problems with their genitals, as well as their reluctance to consult a doctor, “the specialist develops.
In his opinion, the solution lies in promoting «an essential cultural change for the evolution of the current model of misunderstood masculinity. It is necessary to stop identifying masculinity with power, physical strength, toughness and emotional repression and to enhance values such as authentic expressiveness, honesty, empathy or kindness. Only through values-based education will we be able to tackle this problem.”
Not related to testicular cancer
Testicular cancer has nothing to do with penile cancer. The only thing in which they are similar is that they are rare diseases. “A patient with testicular cancer is not at increased risk of penile cancer, and vice versa. In fact, penile cancer risk factors do not affect and do not cause testicular cancer. The latter is more typical of young men, while penile cancer generally affects older men”, explain the ROC Clinic specialists.
The symptoms that characterize testicular cancer are: increased testicular size, a feeling of heaviness in the scrotum, abdominal or groin pain or discomfort in a testicle or in the scrotum.