Hello and good day Dr. I have a few questions regarding penile cancer. I'm not sure if you are an expert in this field, but if you are, would you mind answering these questions for me. I've read that one of the symptoms of penile cancer is a single ulcer at the glans of the penis. I wonder, does this ulcer come and go or it stays at a spot? Secondly, another symptom related to penile cancer is the thickening of the skin of the penis (that's what they wrote on the internet). What does it mean by thickening of the skin? Is is the foreskin or the penis glans? I mean if it is penis glans then it won't be called skin right? That's all I have for now. I look forward to receive a reply from you Dr. Thank you.
Wai, the majority of cancers of the penis originate from the skin (foreskin or shaft skin). They rarely occur if one is circumcised just after birth. They are by far more common in uncircumcised men especially those who have a tight foreskin (phimosis) which prevents proper cleaning of the area. Constant contact with smegma (a substance produced by the inner foreskin) and chronic infection of the area are probably the 2 most important factors predisposing to cancer of the penis. Other risk factors include AIDs, HPV infection, and tobacco use.
A penile ulcer may be a manifestation of cancer but these typically do NOT heal. A healing ulcer suggests some other pathology. Thickening of the skin usually occurs in the area of the cancer. This is usually involves the foreskin but can occur on the skin of the shaft as well. Other signs include foul smelling discharge, bleeding and a lesion that doesn't heal within a month. Penile cancer usually do not originate on the glans penis but they can.
If you have a tight foreskin and are able to gently retract the foreskin (prepuce) and stretch it, this may help. However, if you develop a fissure (a crack in the foreskin) , retraction will only create more scarring and worsen the tautness. If you can pull it back to expose the glans penis completely, wash thoroughly with soap and water then pat dry. Next apply 3% hydrogen peroxide (available over-the-counter from your local pharmacist) with a cotton tipped applicator to the inner foreskin, glans penis and groove behind the glans. After the bubbling stops, pat dry and pull the foreskin forward. You can do the washing in the shower and apply the hydrogen peroxide once you dry yourself off. Do this on a daily basis. This treatment will not correct the phimosis but will help to prevent infection and further constriction. If the problem worsens, you are best seen by a urologist as a circumcision may be indicated. If you have had recurrent ulcers on the penis, again, you need to see a urologist for evaluation. Good luck.