More than 6,500 men undergo amputation in Brazil as cases of penile cancer increase
It was not until 2023 that he received a definitive diagnosis: penile cancer. The news shocked his family and led to a partial amputation, a traumatic experience that João describes as feeling "decapitated," according to a report on the BBC.
Penile cancer is rare, but recent studies indicate that both incidence and mortality rates are on the rise worldwide. In Brazil, the country with one of the highest incidence rates, there are 2.1 cases per 100,000 men.
Maranhão, the poorest state in Brazil, has the highest global rate at 6.1 per 100,000 men. Between 2012 and 2022, Brazil reported 21,000 cases, resulting in over 4,000 deaths and more than 6,500 amputations, averaging one every two days.
The symptoms of penile cancer often begin with a sore on the penis that does not heal, accompanied by a strong-smelling discharge, bleeding, and color changes.
Early detection is crucial for recovery, with treatments including surgical removal of the lesion, radiotherapy, and chemotherapy. However, if left untreated, partial or total amputation of the penis, and possibly other nearby genital organs, may become necessary.
Dr. Thiago Camelo Mourão of the Department of Urology at AC Camargo Cancer Center in São Paulo explains, "In cases of partial amputation, urine continues to exit through the penis. However, in total amputation, the urethral orifice can be relocated to the perineum, requiring the patient to urinate while sitting on the toilet."
Mauricio Dener Cordeiro of the Brazilian Society of Urology identifies the persistent infection of human papillomavirus (HPV) as a primary risk factor for penile cancer.
HPV, a common sexually transmitted virus, can lead to various cancers, including penile cancer. Despite the availability of the HPV vaccine, vaccination rates in Brazil remain low, with only 57% of girls and less than 40% of boys vaccinated.
Dr. Cordeiro stresses the importance of mass vaccination to prevent related lesions and reduce the risk of cancer.
In addition to HPV, other risk factors include smoking and conditions like phimosis, which hinders proper genital hygiene.
"Poor hygiene and infections beneath the foreskin create a highly favorable environment for bacterial infections, increasing the risk of tumor development," Dr. Cordeiro adds.
Research published in the journal JMIR Public Health and Surveillance indicates rising cases in Europe and other parts of the world. Predictions estimate that by 2050, the global incidence of penile cancer will rise by more than 77%, largely attributed to an ageing population.
Countries like Uganda, Thailand, and Germany have also reported increasing rates, with Germany seeing a 50% rise in cases between 1961 and 2012.
Public health experts advocate for improved awareness, better hygiene practices, safe sex measures such as using condoms, and increased HPV vaccination coverage to combat this trend.
Neil Barber, Clinical Lead for Urology at Frimley Health NHS Foundation Trust, notes, "Penile cancer is almost unheard of in the circumcised population. Established risk factors include unprotected sex and poor hygiene."
As João awaits his latest test results, he remains hopeful for a positive outcome. "Now, following the amputation, the pain has gone away, and I've been feeling much better. But I'll have to live with a partially amputated penis for the rest of my days," he says.
