Penile Cancer on the Rise: 6,500 Amputations Seen in Brazil in the Past Decade

Penile cancer cases have been rising across the globe, with Brazil recording one of the highest incidence rates.

In fact, the country has seen 6,500 penis amputations in the past decade.

Penile Cancer

Penile cancer happens when cells uncontrollably grow over or in the penis of a man. While the cancer may form in any part of the penis, it typically begins in the head or in the foreskin for those who are not circumcised.

Symptoms typically begin when a sore over the reproductive organ does not heal and when it discharges with a strong smell. Some men may also experience color changes and bleeding in the penis.

When penile cancer is detected earlier, the recovery rate is high via treatments such as removing the lesion surgically, chemotherapy, and radiotherapy.

However, if the condition is not treated, a total or partial penile amputation could be necessary. This may possibly even cover other genital organs nearby, such as the testicles, if it is necessary.

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Penile Cancer Cases on the Rise

Though penile cancer is actually rare, its incidence and rates of mortality have been rising all over the world. In fact, rates are expected to go up by a whopping 77% in the coming 26 years.

In Germany, rates saw a 50% increase between 1961 and 2012. A significant spike was also observed in the UK.

For Brazil, between the years 2012 and 2022, a total of 21,000 cases were reported. This was according to the Ministry of Health of the country. Because of this, more than 4,000 deaths and over 6,500 penile amputations have been seen in the past decade.

The penile amputation rate is equivalent to an average of two per day.

The highest incident rate was observed in Brazil's poorest state, Maranhão, which was equivalent to 6.1 men per 100,000.

When it comes to amputation, a partial amputation may still allow urine to exit the penis. However, for total amputation, the patient's urethral orifice would get moved to the perineum in between the anus and scrotum. Because of this, the patient would need to sit down in order to urinate.

Behind the Rise of Penile Cancer Cases

According to Mauricio Dener Cordeiro from the Brazilian Society of Urology, persistent HPV (human papillomavirus) infection is a primary risk factor.

This infection could be transmitted via sex. It could also result in penis and mouth cancers in some cases.

Dr. Cordeiro shared that mass HPV vaccination is crucial, as it has been seen to be highly effective in preventing such lesions. However, he adds that Brazil has vaccination rates that do not meet the required level for effectiveness.

In Brazil, even though the vaccine is available, the rate of vaccination is still low. For boys, the level does not go beyond 40%. For girls, the rate has just reached 57%.

Ideally, the ideal vaccination rate for preventing infection is 90%.

He thinks that misinformation regarding the vaccine, a lack of campaigns, and ungrounded doubts regarding effectiveness could have contributed to the low rates.

The National Health Service also says that smoking could also increase penile cancer risk. One may also have a higher likelihood of getting penile cancer if they experience problems pulling back the foreskin to maintain the cleanliness of the penis. This condition is known as phimosis.

Neil Barber, the Clinical Urology Lead at the Frimley Health NHS Foundation Trust, also explains that in the population of circumcised individuals, penile cancer is nearly unheard of. Infections under the foreskin, poor hygiene, and conditions such as phimosis are risk factors.

Other established risk factors for penile cancer include unprotected sex (which specifically involves not using condoms). Poor hygiene could also exacerbate the risks of such a route.

Dr. Cordeiro noted that penile cancer is a rare condition that can be highly prevented. He recommends the use of condoms during sexual intercourse. He also advises going through surgery for foreskin removal in phimosis cases in order to reduce penile cancer risk.