Tuesday, March 25, 2008

One Painter's Battle Against Penile Cancer

'[S]o, what have you got?'
'Oh, er, men's cancer,' I replied.
'Prostate?'
'No.'
'Testicular?'
'No.'
They dug a bit more until I just came out and said it. 'I've got penile cancer, OK -- cancer of the penis!'
You could have heard a pin drop."

selection from AlterNet’s article ‘Penis Cancer: My Very Private Hell'

British Artist John D Edwards had penile cancer or ‘cancer of the penis’ as he put it.

Penile cancer is rare in North America. Data reported to the Surveillance, Epidemiology and End Results Program (the cancer statistics program of the National Cancer Institute) show that only 1817 men were diagnosed with primary malignant penile cancer in the US between 1973 and 2002.

Given the location of the cancer, it is an especially sensitive topic for patients to speak candidly about.

Unless you’re John D Edwards.

In this interview posted on AlterNet, John D Edwards talks with great candor and humor about his battle with penile cancer. As an artist, he was able to find solace through his paintings, and after treatment he documented his experience on his website, the provocatively titled 'How Cancer Saved My Life' (also the name of his new book).

1. What is penile cancer exactly?
Penile cancer is a cancer of the male external reproductive organ. It usually arises in what are called “squamous cells” or the flat skin cells of the penis, frequently involving the foreskin.

2. What are some risk factors for developing penile cancer?
Because penile cancer is rare, it is hard to define risk factors. However, some observational studies suggest that uncircumcised men are at significantly higher risk of developing penile cancer than circumcised men. Human papillomavirus (HPV) has been linked to the development of penile cancer as well. HPV infection may be less frequent in circumcised men, so these observations may be related (that is, uncircumcised men may be at higher risk for penile cancer because they are more likely to be infected by HPV).

3. What is the treatment for penile cancer?
Treatment is dependent on the local extent of disease and the status of regional lymph nodes. Wide surgical excision is the treatment of choice. For small tumors, this may be quite limited surgery (for example, tumors of the foreskin can be treated by circumcision), but for larger tumors, the surgery can be quite radical, extensive, and mutilating. However, local recurrence after appropriate surgery is very, very rare.

Radiation therapy is also used sometimes, especially if the surgery required to control the tumor is an amputation. Unfortunately, recurrence after radiation is more common than recurrence after surgery, and radiation itself can sometimes cause scarring and blockage of the urethra (the tube that drains urine from the bladder), making the penis nonfunctional.

4. Do men usually retain sexual function after developing penile cancer?
As you might imagine, that depends on the size of the tumor, and therefore on the extent of surgery. For small lesions, retaining normal function is common. For patients who require removal of the penis, obviously sexual function is lost. Fortunately, reconstructive techniques are available, techniques are improving, and preservation of function is the norm.

John D Edwards states that he is still able to urinate normally and has normal sexual function, so anything is possible.

9 comments:

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