Penile Cancer

Penile cancer is caused by malignant (cancer) cells within the tissues of the penis.

 

Human papillomavirus (HPV) infection has been shown to increase the risk of developing penile cancer. Signs of penile cancer include visible (and palpable) rash, lesion or sores, foul smelling discharge or bleeding, and thickening of the foreskin or skin of the penis. Penile cancer is a rare disease (1:100,000 men) and accounts for less than 0.5% of all male cancers in Australia.

The management for penile cancer involves accurate diagnosis, grading and staging of the disease, followed by excision of the lesion. While the treatment of primary penile lesion in itself is relatively straight forward, the prognosis of patients with invasive penile cancer requires delineation of the presence and extent of metastatic disease. There is controversy regarding the optimal lymph node surgery, while significant advances have been made in terms of chemotherapy for penile cancer. All attempts should be made to maximise your survival yet maintain your penile function at the same time.

Professor Chung is considered one of the leading surgeon expert in penile cancer and has published extensively in this field (see below). He is the first urologist in Australia to complete a formal fellowship training in Andrology (accredited by the Sexual Medicine Society of North America), and serves as the Chair of Male Lower Urinary Tract section and the past Chair of the Andrology section for the Urological Society of Australia and New Zealand.

Treatment options for penile cancer

Depending on the stage of your penile cancer, different therapeutic options are available

  1. Glans resurfacing (preserving) surgery and glansectomy if the cancer is confined to your glans (head of) penis.
  2. Partial penectomy (allows for adequate residual penile length so that you can urinate standing up and have reasonable sexual function) if the penile cancer involves most of glans and extending onto the shaft penis.
  3. Total radical penectomy (removal of entire shaft penis and creation of neourethra) for cancer on the shaft of penis.
  4. Radiation therapy in selected cases where surgical risks outweigh benefits.
  5. Inguinal (and pelvic lymph) node dissection should be advocated if there is evidence of cancer spread to regional lymph nodes.
  6. Chemotherapy is indicated in advanced metastatic cancer.

Some of the key articles published by Professor Chung

  • Chung E, Yang S, White L, Wood S and Nicol D. Lessons learnt in the management of primary invasive penile cancer in an Australian tertiary referral centre: Clinical outcomes with a minimum 48 months follow-up study. Korean J Urol. 2015;56(2):25-30
  • Zukiwskyj M, Daly P and Chung E. Penile cancer and phallus preservation strategies: a review of current literature. BJU Int. 2013;112(Suppl 2):21-26
  • Teloken P and Chung E. Chapter: Management of locally advanced penile cancer disease (T3-T4). In: Penile Cancer: Challenges and Controversies. Hauppauge, NY: Nova Science Publishers, Inc