In 2018, a Brazilian pensioner named João sought medical attention after discovering a wart on his penis.
Despite visiting numerous doctors, who attributed the wart to excess skin and prescribed medication, the wart continued to grow. Over the next five years, João’s condition persisted, straining his marriage and significantly affecting his sex life.
Despite multiple visits to specialists and various medications, João’s wart did not improve. In 2023, he was finally diagnosed with penile cancer.
The news was a shock to his family, and João had to undergo a partial penectomy, which he described as feeling “decapitated.” The stigma surrounding penile cancer made it difficult for João to discuss his condition with others.
Penile cancer, though rare, is increasing in incidence and mortality worldwide. Brazil, João’s home country, has one of the highest incidence rates at 2.1 per 100,000 men. Between 2012 and 2022, Brazil reported 21,000 cases of penile cancer, resulting in over 4,000 deaths and more than 6,500 amputations, averaging two per day.
Maranhão, Brazil’s poorest state, has the highest global incidence rate at 6.1 per 100,000 men.
Symptoms of penile cancer include persistent sores on the penis, strong-smelling discharge, bleeding, and color changes. Early detection can lead to successful treatment through surgical removal of the lesion, radiotherapy, or chemotherapy.
However, if left untreated, partial or total penectomy, and possibly the removal of other nearby genital organs, may be necessary.
João underwent a partial amputation in January, which was a difficult and terrifying experience for him. He described the initial weeks post-surgery as filled with sadness and acknowledged the challenge of living without part of his penis.
In cases of partial amputation, urination continues through the penis. However, in total amputation, the urethral opening is relocated to the perineum, requiring the patient to urinate while seated. Persistent human papillomavirus (HPV) infection is a major risk factor for penile cancer.
HPV, transmitted through sexual contact, can lead to various cancers, including penile cancer. Despite the availability of an effective HPV vaccine in Brazil, vaccination rates are low, with only 57% of girls and less than 40% of boys vaccinated, far below the 90% coverage needed to prevent the disease.
Dr. Mauricio Dener Cordeiro emphasized the importance of HPV vaccination and proper hygiene to reduce the risk of penile cancer. Conditions like phimosis, which hinder foreskin retraction and cleaning, create an environment conducive to bacterial infections and increase cancer risk. Smoking and poor hygiene further elevate the risk.
Globally, penile cancer cases are rising, especially in developing countries. A study published in JMIR Public Health and Surveillance analyzed data from 43 countries and found the highest incidence rates in Uganda, Brazil, and Thailand. Developed countries like England and Germany have also seen increases in incidence rates.
By 2050, the global incidence of penile cancer is projected to rise by over 77%, primarily due to an ageing population. Experts emphasize that penile cancer, though rare, is highly preventable.
Using condoms, maintaining proper hygiene, and circumcision in cases of phimosis can significantly reduce the risk.
João remains hopeful as he awaits his latest test results, confident that they will show he is cured. Despite living with a partial amputation, he reports feeling much better post-surgery.
According to Cancer Research UK, over 90% of men diagnosed with localized penile cancer survive for five years or more.
