PENILE CANCER – risk factors and prevention (with captions) (low audio) #9

PENILE CANCER – risk factors and prevention (with captions) (low audio) #9


Penile cancer is considered a rare malignancy. According to the International Agency for
Research on Cancer, approximately 0.8 new cases per 100 000 persons were documented
in 2018. This number is far lower than the age-standardized
incidence of lung cancer, which was estimated at 22.5 per 100 000. It is most common in India, China, Brazil,
and the United States, and usually appears between ages 50 and 70. Because cancers are not all the same, since
tumors arise in different tissues and present different cellular abnormalities and behaviors,
they are classified in various types and subtypes. This applies to cancers of the penis. 95% of the malignant tumors of the penis are
squamous cell carcinomas. This name just indicates the aggressive behavior
of the tumor, which we can also call a neoplasia, and what the precursor cells were. A carcinoma is a malignant tumor of epithelial
tissues, which cover exterior surfaces of the body, internal cavities and tubes, and
also form the main, secretory part of glands. If the width of the epithelial cells is greater
than their height, then they are described as squamous. These squamous cell carcinomas can be further
classified into subtypes, such as usual SCC, basaloid, verrucous, and adenosquamous. Melanomas, basal cell carcinomas, and other
cancers comprise the remaining 5%. Melanomas, also called malignant melanomas,
and basal cell carcinomas are typical cancers of the skin, although the former may rarely
be a primary cancer of other sites, for example, the eyes, the central nervous system, and
mucus membranes, which line gastrointestinal, respiratory, and genitourinary tracts. It is estimated that about one third of cases
is associated with human papilloma virus (or HPV). HPV is known to be an oncogenic virus, which
means it can cause genetic abnormalities that make cellular proliferation go awry. Other oncogenic viruses include the Epstein-Barr
virus (related to some lymphomas, cancers of smooth muscle cells, and gastric and nasopharyngeal
cancers), hepatitis B and C viruses (which can lead to liver cancer), and human T-lymphotropic
virus (or HTLV)-1 (associated with adult T-cell leukemia). Penile cancers have also been associated with
chronic inflammatory conditions, such as lichen sclerosus and inflammation induced by phimosis. Lichen sclerosus is a disease of unknown cause
that predominantly affects genitalia and commonly produces white itchy patches, which may progress
with scarring and eventually cause secondary phimosis. Phimosis is an inability to retract the foreskin
(also known as prepuce) and this hinders adequate hygiene. Consequently, the accumulation of microorganisms
and smegma (a mixture of shed skin cells and sebum) may cause balanoposthitis, that is,
the inflammation of the glans and the preputial skin. It should be noted that phimosis is a normal
finding at birth, when it is considered “physiological” or “primary”, meaning not caused by other
conditions. And most cases of primary phimosis resolve
during childhood without complications. Other risk factors for penile cancer are smoking
and PUVA (psoralen UV-A phototherapy). This treatment, known to increase the risk
of squamous cell carcinoma of the skin) is used in some cases of psoriasis and employs
ultraviolet radiation, subtype A, associated with psoralen, a substance that sensitizes
the skin to UVA. So what can be done to prevent penile cancer? It’s important not to smoke, not only to
prevent penile cancer, but also many other diseases. Smegma is not carcinogenic, but maintaining
a good hygiene should ward off causes of inflammation and also accumulation of HPV virions. Condoms may help prevent HPV infection and
vaccination could also be beneficial, although this is not clear according to current evidence,
as it is for cancer of the uterine cervix.

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