A vast international survey reveals that one in four men refuses total or partial amputation of the penis, while this intervention is the only one to double its chances of curing penile cancer. In particular, total amputation is a very difficult surgical procedure for men to accept.
Penile cancer is one of the rarest cancers. Every year, about one in 100,000 men contract this disease in the West. However, in recent years, it is affecting more and more men, especially older men.
Researchers from five countries (Italy, Spain, United States, Brazil and Hungary) have conducted an extensive survey of this disease. Presented at the 33rd Congress of the European Association of Urology in Copenhagen, this study reveals that a quarter of men with penile cancer do not receive the ad hoc treatment of partial or complete amputation of the penis. penis.
Choose illness rather than cure
It is very often the patient himself who refuses to benefit from treatment: "Partially or completely removing the penis is often the most effective way to cure cancer, but for many men this cure seems worse than the disease, "says the American Cancer Society.
"No longer have a male attribute and heal", or "keep your penis but stay sick". Cornelian choice for these men according to this study. And this decision can have serious consequences: twice as many patients survived the disease when they had partial or complete penis amputation, according to the study.
To conduct this survey, the researchers retrospectively reviewed the records of 425 patients who had been treated between 2010 and 2016.
Cancer too rare
Sometimes, however, the decision not to operate comes from the doctor. Not by mistake, but because health professionals do not know enough about how to cure this rare cancer. In a way, patients suffering from such a cancer have a loss of luck. Because they are faced with doctors and surgeons who sometimes have never treated this disease.
It would be better for the patient to go to specialized centers. Of course, there are not any street corners. But according to the study, some countries are managing this situation better. For example, in the United Kingdom, penile cancer treatment is centralized in 10 specialized institutions. This increases the chances of survival.
In case of partial amputation, the reconstruction, and various associated techniques, allow to obtain a satisfactory result, at least on the functional level (urination) and for external appearances.
But, it is clear that total or almost total amputation of the penis directly affects urination and sexuality. It is all the more difficult because the reconstructions are a real surgical challenge and are only performed in some very specialized centers. In the absence of reconstruction, the man will have to sit pee. Penile reconstruction from the remaining corpus cavernosum is always attempted as a first intention in partial amputation, otherwise everything has to be reinvented and the process is long and painful.
The transplant was attempted but remains poorly supported, despite anti-rejection and heavy immunosuppressive therapy.