The treatment regimen consists of:
Surgery: Surgery involves the removal of the primary penile tumour with a margin of normal tissue and can be executed with multiple procedures depending on the size of the penile cancer.
- Moh’s micrographic surgery: In case of very small tumours, the tumour is removed layer by layer, preserving a sizeable portion of normal penile tissues as possible.
- Circumcision:In small tumours affecting the preputial skin (foreskin) only a circumcision is executed.
- Glansectomy: For small tumours affecting the glans penis, only the glans is removed and called glansectomy.
- Partial penectomy:For tumours involving the distal part of the penile shaft, a partial penectomy is executed, and the residual penile stump is adequate for passing urine in upright posture and for sexual intercourse with his partner.
- Total penectomy with perineal urethrostomy:For large tumours, wherein an adequate penile stump cannot be left behind, a total penectomy is executed with perineal urethrostomy (creating a new opening for urethra in the perineum for passing urine).
- Groin lymph node dissection: Unilateral or bilateral groin lymph node dissection may be performed for patients with proven or suspicious groin lymph nodal spread.
Non-surgical treatment options: In very old or frail patients who cannot withstand any surgery or in very early cancers, specialists suggest non-surgical options like the use of topical agents, cryosurgery, cryotherapy or laser.
Chemotherapy: Chemotherapy in the form of injections or tablets may be suggested depending on the stage of the disease, comprising 6 cycles, with each cycle consisting of 2- 3 weeks. In some cases, radiation therapy is also given simultaneously and is called concurrent chemo-radiotherapy.
Radiotherapy: Radiotherapy uses high-energy rays to target and destroy cancer cells and may be used as an alternative to surgery or after surgery as adjuvant treatment.
Chemotherapy - Drugs to treat cancer cells are injected into the body, these drugs have tolerable side effects, and the side effects have been minimized with new forms of chemotherapy drugs with the evolving changes in medical and treatment approaches. Chemotherapy is crucial to contain the cancer cells circulating in the blood.
Radiation therapy: Intense energy usually X-rays or proton radiation is aimed directly at the operated area to kill cancer cells to minimize recurrence.