Penis Cancer (cont.)
Treatment option overview
There are different types of treatment for patients with penile cancer.
Different types of treatments are available for patients with penile cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
Surgery
Surgery is the most common treatment for all stages of penile cancer. A
doctor may remove the cancer using one of the following operations:
- Mohs microsurgery: A procedure in which the tumor is cut from the skin in
thin layers. During the surgery, the edges of the tumor and each layer of tumor
removed are viewed through a microscope to check for cancer cells. Layers
continue to be removed until no more cancer cells are seen. This type of surgery
removes as little normal tissue as possible and is often used to remove cancer
on the skin. It is also called Mohs surgery.
- Laser surgery: A surgical procedure
that uses a laser beam (a narrow beam of intense light) as a knife to make
bloodless cuts in tissue or to remove a surface lesion such as a tumor.
- Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal
tissue. This type of treatment is also called cryotherapy.
- Circumcision: Surgery
to remove part or all of the foreskin of the penis.
- Wide local excision: Surgery
to remove only the cancer and some normal tissue around it.
- Amputation of the
penis: Surgery to remove part or all of the penis. If part of the penis is
removed, it is a partial penectomy. If all of the penis is removed, it is a
total penectomy.
Lymph nodes in the groin may be taken out during surgery.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other
types of radiation to kill cancer cells or keep them from growing. There are two
types of radiation therapy. External radiation therapy uses a machine outside
the body to send radiation toward the cancer. Internal radiation therapy uses a
radioactive substance sealed in needles, seeds, wires, or catheters that are
placed directly into or near the cancer. The way the radiation therapy is given
depends on the type and stage of the cancer being treated.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of
cancer cells, either by killing the cells or by stopping them from dividing.
When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs
enter the bloodstream and can reach cancer cells throughout the body (systemic
chemotherapy). When chemotherapy is placed directly onto the skin (topical
chemotherapy) or into the spinal column, an organ, or a body cavity such as the
abdomen, the drugs mainly affect cancer cells in those areas (regional
chemotherapy). The way the chemotherapy is given depends on the type and stage
of the cancer being treated.
Topical chemotherapy may be used to treat stage 0 penile cancer.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied.
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to
fight cancer. Substances made by the body or made in a laboratory are used to
boost, direct, or restore the body's natural defenses against cancer. This type
of cancer treatment is also called biotherapy or immunotherapy. Topical biologic
therapy may be used to treat stage 0 penile cancer.
Radiosensitizers
Radiosensitizers are drugs that make tumor cells more sensitive to radiation
therapy. Combining radiation therapy with radiosensitizers helps kill more tumor
cells.
Sentinel lymph node biopsy followed by surgery
Sentinel lymph node biopsy is the removal of the sentinel lymph node during
surgery. The sentinel lymph node is the first lymph node to receive lymphatic
drainage from a tumor. It is the first lymph node the cancer is likely to spread
to from the tumor. A radioactive substance and/or blue dye is injected near the
tumor. The substance or dye flows through the lymph ducts to the lymph nodes.
The first lymph node to receive the substance or dye is removed. A pathologist
views the tissue under a microscope to look for cancer cells. If cancer cells
are not found, it may not be necessary to remove more lymph nodes. After the
sentinel lymph node biopsy, the surgeon removes the cancer.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
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