Around a quarter of men diagnosed with penile cancer are not receiving the recommended surgical treatment, which typically involves partial or total amputation of the penis, according to an international study. The research, led by Dr Luca Cindolo from Chieti, Italy, will be presented at the European Association of Urologists (EAU) Congress this week.
The study analysed data from 425 patients across 12 treatment centres in the US, Brazil, Italy, Spain, and Hungary. It found that while most patients were treated according to gold-standard EAU guidelines, approximately 25 per cent did not receive appropriate treatment. Among those who did not undergo amputation, about one in six cases was due to patient refusal, with the procedure often perceived as “worse than the disease”.
Dr Cindolo noted that in 52 per cent of cases, doctors did not offer the recommended treatment, partly because many clinicians are unfamiliar with this rare but devastating cancer. “We often find that patients don’t want to be treated, or that the patients’ carers are unwilling to take the decision to treat,” he said.
Penile cancers are rare, affecting about one in 100,000 men. In the UK, there are around 640 diagnoses each year, while the US sees approximately 2,300 cases. Diagnosis rates have increased by up to 25 per cent in the last 30 years, partly due to an ageing population.
The study highlighted disparities in treatment outcomes between countries. Dr Vijay Sangar, director of surgery at the Christie cancer hospital in Manchester, who was not involved in the study, emphasised the importance of centralising treatment in specialist centres. “In some countries such as Hungary, Spain, and Italy, these rare urological cancers are still treated locally, which may reflect the lower survival rates,” he said. “Generally, the more penile cancer a team sees the better they become at managing the disease.”
