Treatment

Radiotherapy is used to treat early stage disease and for palliation. It is given either by radio-active implants, by external X-rays, or as a radio-active mould fitted around the shaft of the penis. Interstitial brachytherapy appears to be superior to external beam (1). The estimated 5-year control rate with brachytherapy has been reported as 82%, with an overall 5-year survival of 79%. (2) Radiotherapy may also be used to treat fixed malignant inguinal nodes, or be given as the treatment of first choice to young patients.

Surgical excision is indicated if:(3)

• radiotherapy has been ineffective
• the corpus cavernosum is involved

Amputation will not interfere with micturition since both the internal and the external sphincters are preserved.

If the inguinal lymph nodes remain enlarged 1 month after surgery, deep X-ray therapy or a block dissection is given.

Reference

1. Crook J, Ma C, Grimard L. Radiation therapy in the management of the primary penile tumor: an update. World J Urol. 2009 Apr;27(2):189-96
2. Escande A et al. Brachytherapy for Conservative Treatment of Invasive Penile Carcinoma: Prognostic Factors and Long-Term Analysis of Outcome. Int J Radiat Oncol Biol Phys. 2017 Nov 01;99(3):563-570
3. Issa A et al. Treatment Options and Outcomes for Men with Penile Intraepithelial Neoplasia: A Systematic Review. Eur Urol Focus. 2022 May;8(3):829-832