Penile cancer warning

Penile cancer, a rare but serious disease often linked to the human papillomavirus (HPV), is leaving some Jamaican men facing devastating consequences, including the loss of their penis and the end of their ability to father children.

Consultant urologist Dr Elon Thompson told The Sunday Gleaner that while penile cancer is not as common as prostate cancer in men or cervical cancer in women, local cases have been recorded, with some requiring complete surgical removal of the organ.

“Penile cancer is one of those cancers that initially was thought to be affecting persons at the lower socio-economic status, who are a lot of times, smokers as well. And definitely there is an involvement with HPV. So, we would a lot of times describe it as the homologue for cervical cancer. Even though it’s not as common in men as cervical cancer is in women, but it certainly can be one of those very bad cancers in men,” he said.

Although once associated with lower socio-economic groups, Thompson said penile cancer occurs across all social strata. He noted that the disease can have severe physical and emotional consequences, particularly when diagnosed at an advanced stage.

A man as young as 40

He has treated patients who required amputation due to the disease, including a man as young as 40. The condition not only ends sexual function but also the possibility of having children if patients had none prior to diagnosis.

Thompson is urging men to be vigilant and monitor their penises for any unusual changes.

“The most important thing with penile cancer, I guess, is to really look at the penis and see if there is something abnormal there,” he said, pointing to the foreskin or the head of the penis as particular areas to check.

“A lot of times we find some big lesions on the penis and you wonder, like, ‘You didn’t see this before?’, and you’re very concerned that persons could allow it to get to this size. And you wonder, ‘How many persons are taking note of what is happening to their bodies?’” Thompson explained.

He also warned that engaging in oral sex with a cancerous lesion may increase the risk of transmitting HPV, potentially exposing partners to throat cancer.

Thompson, who is also a legislator in the Upper House, told The Sunday Gleaner that as a surgeon, he has removed the penises of patients with penile cancer.

He noted that the psychological trauma associated with the disease can be significant and is one of the reasons why some patients die a short time after diagnosis, depending on the stage at which it is detected

“It is a very serious consideration, and it is one of those psychologically traumatic [and] impactful conditions that I don’t know if we even understand fully how much trauma that can cause. ... It’s one of those cancers that really can be ... really fatal if you leave it. And I have seen cases where persons have decided not to follow through with treatment or have not treated their primary lesion on the penis, and, you know, within months [or a few] years, they are gone,” he said.

Early detection is critical

Thompson stressed that early detection is critical and pointed to prevention through vaccination.

“Initially when the [HPV] vaccine was only being given to girls, it was seen as an ethical consideration. Why are we giving it only to girls? Yes, it was because the alert was sounded with regard to cervical cancer, and [it] being more common in terms of affecting women more commonly than, per se, penile cancer in men. But, to basically create that balance, it was also included in advice for boys. So, [it is now recommended for] both girls and boys, preferably prior to first sexual encounter,” he explained.

The recommended age for vaccination is generally between nine and 12 years, with the expectation that it should be administered by age 15. However, Thompson noted that uptake remains sub-optimal. Given that the cost of cancer care is very expensive to both the government and patients, he is calling for greater advocacy among parents, schools, churches and community groups.

“Putting on the policy hat now, ... I would absolutely want to re-engage the public with regards to vaccination [against] HPV,” he told The Sunday Gleaner.

PROSTATE CANCER

Thompson also highlighted prostate cancer as a major concern, noting that it remains one of the leading causes of death among Jamaican men.

“It is detected through screening. A lot of the time, though, what we are finding is that we detect it at an advanced stage. And the reason why we detect it at an advanced stage is because we are not screening enough persons to pick it up early,” he explained.

He said advanced prostate cancer can spread to other organs, including the bones, sometimes leaving patients unable to walk. In some cases, this is the first symptom that leads to diagnosis.

Screening involves a prostate-specific antigen (PSA) blood test, often combined with a physical prostate examination.

“PSA is a blood test that is used for screening in prostate cancer. It is used along with the prostate examination, which has been a common topic of discussion for men in our country. The narrative, however, is if it is that you are uncomfortable for any reason with doing the prostate examination, then at least you must do the PSA. The recommendation, however, is still a PSA blood test and a prostate examination,” he told The Sunday Gleaner.

He explained that PSA results typically range from zero to four and may require follow-up testing to monitor trends.

Thompson added that men of African descent, including the majority of Jamaica’s population, are at higher risk for prostate cancer, particularly those with a family history of the disease or whose mothers had breast cancer.

He is encouraging men, especially those nearing or above the age of 40, to prioritise screening, noting that early detection can significantly improve outcomes.

erica.virtue@gleanerjm.com