According to the National Cancer Institute (Inca), although less frequent than other tumors, such as prostate cancer, penis cancer represents about 2% of all cases of malignant neoplasms diagnosed among men in Brazil, being more frequent in the regions North and Northeast – mainly among people with less education and income.
According to the Ministry of Health, the proportion of hospitalizations has remained relatively stable over the past few years: there were 1,961 in 2016; 2,017 (2017); 2,142 (2018); 2,194 (2019) and 1,951 last year. Between 2014 and 2018, the highest mortality rates from penile cancer were found in three states in the Northeast: Maranhão, Piauí and Sergipe; and in two in the North: Pará and Tocantins. Last year, these five states, in addition to 370 cities across the country, were included in a pilot project that the ministry created to qualify male health care and try to reduce the incidence of penile cancer. The portfolio allocated R $ 20 million to the project, still in the experimental phase.
According to urologist Felipe de Paula, member of the board of the Brazilian Society of Urology (SBU) of São Paulo, many cases of the disease could be avoided only with basic care with intimate hygiene, since carelessness with cleaning the organ male sexuality is identified as the main risk factor.
“It is necessary to clean the penis very well, but not only its outer part. It is necessary to expose the glans, that is, the head of the penis; put it out of the foreskin [camada de pele retrátil que cobre a extremidade do órgão] and wash it well ”, advises the urologist, pointing out that the presence of phimosis can increase the risk of lesions and make it difficult to wash the glans properly (which should be done only with soap and water), increasing the risk of appearance of a tumor.
Clinical director of the Regional Cancer Hospital of Presidente Prudente (HRCPP), in the interior of São Paulo, Paula also points out that, for various reasons, most patients usually take time to notice the signs that there is something wrong. And even more so to see a doctor.
“Research has shown that, even after perceiving an injury to the penis, half of the men took more than a year to seek health care. Whether due to lack of access, or, most of the time, out of shame ”, declared the urologist to Agência Brasil, alerting to the fact that, in the last year, the early diagnosis of the disease was also hampered by fear of the new coronavirus.
“The situation has worsened, because with the covid-19, people have been seeking less and less health services. This is also reflected in relation to [diagnósticos de] tumors that get worse as a person takes time to seek medical help ”, commented Paula, pointing out that the sooner it starts, the greater the chances of the treatment of any type of cancer being successful. “Unfortunately, when many of these men seek health care, the situation is already serious.”
Paula recommends that men pay attention to the appearance and evolution of wounds and stains on any part of the sexual organ, but mainly on the glans. Wounds that do not heal, the presence of a white discharge and / or an unpleasant smell that does not disappear with the proper washing of the penis can be indications of a tumor.
Another worrying sign may be the presence of inguinal ganglia (ingues) in the groin area. Whatever the case may be, the person should consult a specialist doctor to identify the real cause of the problem and receive the most appropriate treatment.
High cure rate
Diagnosed at an early stage, the treatment of penile cancer has a high cure rate. The detection of cancer cases can be done through clinical, laboratory or radiological exams. Treatment depends on the local extent of the tumor and the involvement of the inguinal ganglia, which can be done through surgery, radiation or chemotherapy, as appropriate. According to the Inca, early diagnosis is essential to prevent the situation from getting worse and it is necessary to amputate the penis partially or totally.
Although it is more common among men over 50 years of age, penile cancer can also affect younger people. Among the factors that increase a person’s risk of developing the disease are smoking and the consequences of mistreated sexually transmitted diseases – a reason for experts to reinforce the recommendation for men to use condoms when having sex.