The number of men being diagnosed with cancer of the penis has soared by 20 per cent in the last 30 years, according to new figures.
Experts believe the main reasons for the increase may be changes in sexual behaviour, greater exposure to sexually transmitted HPV (human papilloma virus) and decreasing rates of childhood circumcision.
HPV-related genital warts are associated with a six-fold risk of penile cancer and the incidence of them has rapidly increased in men between 1970 to 2009, with a 30 per cent rise during 2000–2009.
Cancer charities are now urging men to be aware of symptoms of the disease – which are often confused with signs of a sexually transmitted infection.
Penile cancer has a high cure rate if detected early, but some men, such as Nigel Smith, from Wolverhampton, are misdiagnosed.
He was told at a sexual health clinic that he had a genital wart that would go away in time.
It didn’t, but rather than seek help, Nigel hid his symptoms from his wife for 12 months by sleeping in their spare bedroom, using his snoring as an excuse.
He was eventually diagnosed with penile cancer in 2011, aged 58, and last year underwent a partial penectomy (partial removal of the penis). He is currently considering reconstructive surgery.
He said: ‘If my GP had sent me to a urologist rather than a sex clinic, the cancer could have been diagnosed at stage 1 and treated.
‘By the time I saw a urologist, the cancer was stage 3 – one stage away from terminal. I’m now in temporary remission but there’s a 50/50 chance that the disease will return as a secondary cancer – maybe in my lungs or liver.
‘Every time I go to the toilet I have a painful reminder of what’s happened, so it’s hard to put things behind me.
‘The sexual side of my marriage has ended. I’m 60 but I’m a young 60! It shouldn’t be the end yet.
‘The psychological impact of it all is massive. It’s more traumatic than anyone who hasn’t been through this can know.’I didn’t talk about my symptoms for so long and hid them from my wife. It’s a man thing; we ignore things and hope they’ll go away. If you find something, you need to get it looked at.’
The new research, published in the journal Cancer Causes Control, was supported by the male cancer charity Orchid.
The charity’s chief executive, Rebecca Porta, said: ‘The research shows that the incidence of this devastating cancer, which currently receives little recognition, is on the increase.
‘Unlike other more common cancers, penile cancer is rare and many men feel embarrassed and unable to talk openly about it.
‘This can lead to feelings of isolation at a time when support is vital. It is very important that men are aware of the warning signs and symptoms of the disease and that those with worrying symptoms seek medical advice as soon as possible.’
Cancer can develop anywhere in the penis, but the most common places are under the foreskin and on the head (the glans).
The exact cause of penile cancer is unknown, but various factors have been linked to an increased risk.
HPV-related genital warts are associated with a six-fold risk of penile cancer. There are over 100 types of HPV virus and only two strains have been linked with penile cancer. However both these strains are also linked to throat, cervical and anal cancer.A man’s risk of developing cancer of the penis is greater if he smokes. It has been suggested that smoking may act as a co-factor that modulates the risk of progression from HPV infection to premalignant lesions and invasive penile cancer.
Furthermore, the toxic chemicals found in tobabcco are excreted in the urine. A build up of these substances under the foreskin may cause changes in the normal healthy cells of the skin, which may lead to cancerous cells developing.
Men who are uncircumcised are also at greater risk. This is because they may find it more difficult to pull back the foreskin enough to clean thoroughly underneath, resulting in poor hygiene.
This may lead to a build up of chemical substances that may cause irritation of the skin and lead to cancerous changes.
For more information: http://www.orchid-cancer.org.uk/Penile-Cancer