Talk:Penile cancer

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Broadcast media have never presented a story about penile cancer[edit]

Prove me wrong. Is is it due to some sort of fear that it will upset a predominantly female audience?Godofredo29 (talk) 00:49, 15 May 2013 (UTC)

A place to start would perhaps be the case of Francisco Castaneda, an individual from El Salvador who was detained by by the U.S. Immigration autorities. When it became apparent that he had penile cancer, the autorities began shuttling him around to different facilities so as to avoid treatment of his condition. When they could no longer avoid the issue, it was too late and his penis was amputated--on a Valentine's Day if you can believe it. Before Mr. Castaneda died he was able to testify before a House committee, telling his wrenching story. After his death, his family was awarded about $1.5 million dollars.99.109.50.48 (talk) 23:50, 15 May 2013 (UTC)

AMA and RACP on circumcision and penile cancer[edit]

The American Medical Association and the Royal Australasian College of Physicians say the use of infant circumcision to prevent penile cancer in adult men is not justified.

  • "Nevertheless, because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified." -- American Medical Association. Neonatal Circumcision. Dec 1999.
  • "Penile cancer is a rare disease with an incidence of around 1 per 100,000 in developed countries. Even though the evidence suggests neonatal circumcision may reduce the risk ten-fold, the rarity of the condition is such that universal circumcision is clearly not justified on these grounds." -- The Royal Australasian College of Physicians. Policy Statement On Circumcision. Sep 2002.

DanBlackham 08:54, 30 Sep 2004 (UTC)

So? Williamb 09:00, 30 Sep 2004 (UTC)

The fact that the AMA and RACP say circumcision is not justified to prevent penile cancer helps to put the following sentence from the article in proper perspective. "It is established that childhood circumcision reduces the incidence of penile cancer." -- DanBlackham 09:27, 30 Sep 2004 (UTC)

  • In the US the stats are 1:100,000 across the general population and 1:600 among the uncircumcised. The AMA's opinion was that to address the risk of penile cancer alone circumcision is not justifed. That is fine and should be included. Now why did you tamper with the stats? The next question would be why Theresa aided and abetted this act by reverting to your edit?~It is just gets stranger and stranger. - Friends of Robert 03:39, 1 Oct 2004 (UTC)

" Indeed, the incidence of penile cancer has been reported to be falling in uncircumcised men. In a recent study, a decreasing penile cancer rate of 0.82/100 000 was found in Denmark (where circumcision is uncommon) compared with an incidence of 1/100 000 in the USA " [1] Theresa Knott (The torn steak) 05:23, 1 Oct 2004 (UTC)

Penile cancer is rare[edit]

Penile cancer is rare according to the following organizations:

  • American Cancer Society: "Penile cancer is very rare in North America and Europe."
  • American Academy of Pediatrics: "Cancer of the penis is a rare disease; the annual age-adjusted incidence of penile cancer is 0.9 to 1.0 per 100 000 males in the United States. In countries where the overwhelming majority of men are uncircumcised, the rate of penile cancer varies from 0.82 per 100 000 in Denmark to 2.9 to 6.8 per 100 000 in Brazil93 and 2.0 to 10.5 per 100 000 in India."
  • American Medical Association: "Penile cancer is a rare disease in the United States (0.9 to 1 per 100,000)."
  • The Royal Australasian College of Physicians: "Carcinoma of the penis is a rare condition, with an annual incidence of approximately 1:100,000 men in developed countries, regardless of whether there is a high or a low circumcision rate."

In my opinioin article should include a sentence that says penile cancer is rare in developed countries. -- DanBlackham 22:53, 30 Sep 2004 (UTC)

    • Show us the cite then we can see if it deserves to be included. - Friends of Robert 03:39, 1 Oct 2004 (UTC)

The above quotes from the American Cancer Society, American Academy of Pediatrics, American Medical Association, and The Royal Australasian College of Physicians all say that penile cancer is rare. Statements made by those organizations deserve to be included in the article, especially when they all agree. -- DanBlackham 09:10, 1 Oct 2004 (UTC)

Citation [6] is not valid, it should be removed. The American Cancer Society simply states that the incidence of penile cancer in developing countries is much higher without offering any sources of evidence. Mohammed Azeem of England (talk) 13:41, 17 March 2013 (UTC)

The Royal Australasian College of Physicians policy on circumcision[edit]

Robert added the word "alone" to the following sentence.

"The American Medical Association and the Royal Australasian College of Physicians say the use of infant circumcision to prevent penile cancer alone in adult men is not justified."

However in my opinion the following quotes from The Royal Australasian College of Physicians Policy Statement On Circumcision do not support that addition.

  • "After extensive review of the literature the RACP reaffirms that there is no medical indication for routine male circumcision." (emphasis in original document)
  • "The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit."
  • "Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure."

DanBlackham 09:10, 1 Oct 2004 (UTC)

Incidence rate in uncircumcised men[edit]

Both the American Medical Association and the Canadian Paediatric Society say the annual incidence rate of penile cancer in uncircumcised men in the United States is 2.2 in 100,000 not 1 in 600.

Both the AMA and CPS cite the article by Kochen and McCurdy to support the 2.2 in 100,000 figure.

  • Kochen M, McCurdy S. Circumcision and the risk of cancer of the penis. A life-table analysis. Am J Dis Child. 1980;134:484-486.

DanBlackham 09:52, 1 Oct 2004 (UTC)

In February 1996, representatives of the American Cancer Society stated in a letter to the American Academy of Pediatrics:
"The American Cancer Society does not consider routine circumcision to be a valid or effective measure to prevent such [genital] cancers. Research suggesting a pattern in the circumcision status of partners of women with cervical cancer is methodologically flawed, outdated and has not been taken seriously in the medical community for decades."
Due to dozens of such statements, I removed the inaccurate statement that the ACS says lack of circumcision is a cause.Mzmadmike 18:45, 11 May 2007 (UTC)
    • Did you read the abstract of Kochen/McCurdy? [2] Seeing is believing. Then a brain teaser for you. The CPS gives the hint. What is the difference between 1:100,000 and 1:100,000 per year? - Friends of Robert 17:08, 1 Oct 2004 (UTC)

Why I removed the 1 in 600 quote[edit]

We can't put a one in 600 whole of lifetime figure next to an annual incidence rate in the article. It is misleading in the extreme because to a casual reader who may well not pick up on Robert Brooke's little brainteaser above it looks as if circumcising drastically reduced the incidence of penile cancer. I've removed it from the article for now. If someone wants to add it back in in such a way as to make it crystal clear that the two figures cannot be directly compared then I won't redelete it. Theresa Knott (The torn steak) 17:30, 1 Oct 2004 (UTC)

  • Boy, am I glad that you are starting to show some sensitivity towards how information may be interpreted by laymen readers who can not pick up the nuances. How I wish that you would apply that to other articles where you insist upon inserting or allowing the insertion of POV pushing material. I would like you to now reconsider your pushing of the link to NORM (as a sort of free advert) in the Frenulum article (and much more). You have now proved that you have this sensitivity and to fail to apply this elsewhere will serve to prove your bias. - Friends of Robert 03:59, 2 Oct 2004 (UTC)
  • As to the edit. I am not happy that you wish to delete a fact from Wikipedia. This is tantamount to deliberately concealing the truth. This is naughty. If you are are worried about (as you obviously are) that the lack of circumcision is recognised as increasing the risk of Invasive Penile Cancer (IPC) that is not grounds for censoring an article. I will relook at the word order to make sure the facts are clearly stated but take into account your horror at the the thought that people may find out the the presence of a foreskin is a specific health risk. - Friends of Robert 03:59, 2 Oct 2004 (UTC)

"Specifically in the United States the lifetime risk of an uncircumcised man for developing invasive penile cancer (IPC) is one in 600, which is several times higher than for males neonatally circumcised"

This isn't good enough. We need the actual lifetime risk for a circumcised man. I can't see it in the source Robert Brookes cited. Theresa Knott (The torn steak) 07:33, 2 Oct 2004 (UTC)
  • Isn't good enough for whom? I sincerely hope that this heralds a change in approach from you in so far as you will now start to show similar consistency to the "other" side of the debate. Now if you don't ... what would that tell us? - Friends of Robert 09:08, 2 Oct 2004 (UTC)
Just cite the source for circumcised men and it'll stay. How hard is that? (No pun intended) Mike H 09:14, Oct 2, 2004 (UTC)
  • Hi Mike. Congrats on your recent appointment as an admin. Do us a favour and keep an eye on Theresa will you? There appears to be a genuine problem with bias there. Hard work is needed to knock these circumcision related articles into shape. Oh yes ... added a few cites. - Friends of Robert 09:27, 2 Oct 2004 (UTC)

Keeping things in perspective[edit]

In my opinion the fact that the American Cancer Society estimates that in 2003 twice as many men in the United States died from male breast cancer (400) as died from penile cancer (200) helps the article to keep things in perspective. -- DanBlackham 10:36, 2 Oct 2004 (UTC)

Objectively, it makes it sound like penile cancer is less important than male breast cancer. Mike H 10:45, Oct 2, 2004 (UTC)
  • Is the insertion of this gem of information designed to make the 200 or so uncircumcised men who are to die in the US every year feel better? Or is it a desperate attempt to play down the fact that there is an increased risk for uncircumcised men of developing invasive penile cancer? The test will no doubt be the content of other cancer related articles inserted before this issue arose here where it was "found" necessary to place the incidence of a particular cancer in context with others as is being suggested here. - Friends of Robert 11:28, 2 Oct 2004 (UTC)

evidence[edit]

There should be a list of signs and symptoms associated with penile cancer on this page. Scorpionman 12:51, 5 October 2005 (UTC)

In particular, is a freckle on the glans a cancer symptom? —Preceding unsigned comment added by 69.3.11.167 (talk) 20:00, 12 April 2009 (UTC)
More along the lines of sores and redness...are they necessarily a symptom or could they be something else too? Scorpionman (talk) 14:58, 29 August 2009 (UTC)

Cleanup[edit]

This article is messy, particularly the Risk section. It looks ridiculous to have 6 or 7 sources cited for one sentence, and to have sentences contradicting each other and with the same information being repeated several times. This article should not be a verbatim record of a debate. It should represent a synthesis of the available reliable sources, presenting opposing arguments without undue weight. -- Donald Albury 11:47, 19 October 2006 (UTC)

Risk[edit]

The risk section should be changed as it devotes all of the space to circumcision then ends with a statement saying that circumcision isn't the main factor.Tremello22 (talk) 23:30, 20 June 2008 (UTC)

An alternative staging system has been proposed[edit]

Heyns CF, van Vollenhoven P, Steenkamp JW, Allen FJ, van Velden DJ. Carcinoma of the penis--appraisal of a modified tumour-staging system. Br J Urol. 1997 Aug;80(2):307-12.Links

PMID 9284207

Department of Urology, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa.

OBJECTIVE: To evaluate variables for the prediction of lymph node metastases in carcinoma of the penis, using a recently proposed modified tumour-staging system that combines the histological degree of differentiation and extent of local invasion of the primary tumour. PATIENTS AND METHODS: Thirty-five patients with squamous carcinoma of the penis and histo- or cytological staging of the inguinal lymph nodes were reviewed. A clinical TNM staging system was used in which the size (diameter) of the primary tumour and the clinical extent of invasion were considered. Subsequently, the tumours were also staged according to a modified T-system in which the histological degree of differentiation and pathological extent of tumour invasion were combined. RESULTS: Penectomy was performed in 34 patients (partial amputation in 20 and radical penectomy in 17). Inguinal lymphadenectomy was performed in 31 patients and in four the presence of lymph node metastases was confirmed by aspiration cytology. Using the clinical TNM staging system, lymph node metastases were histo- or cytologically present in no patients with T1, in five of 19 with T2, in 10 of 13 with T3 and in both patients with T4 tumours. Lymph node metastases were present in two of eight patients without clinically palpable inguinal nodes, in three of 14 with nodes clinically thought to be infective and in 11 of 12 nodes clinically considered to be malignant. Lymph node metastases were present in five of 17 patients with grade 1, in nine of 13 with grade 2 and in three of five with grade 3 tumours. Using the modified histological T-staging system (T1 = grade 1-2, invasive through dermis; T2 = any grade, invasion of corpus spongiosum or cavernosum; T3 = any grade, invasion of urethra; T4 = grade 3, regardless of invasion) lymph node metastases were present in one of nine patients with T1, in eight of 16 with T2, in all five with T3 and in three of five with T4 tumours. CONCLUSION: The modified T-staging system, which combines histological differentiation with pathological extent of invasion, provided the best predictive distinction between T1 and T2-4 tumours, indicating that lymphadenectomy can be avoided in T1 tumours, but should be performed in all patients with T2-4 tumours. We recommend bilateral inguinal lymphadenectomy 6-8 weeks after penectomy in such patients.

Lack of circumcision as a risk factor[edit]

MurasakiSunshine has again removed lack of circumcision as a risk factor, claiming "Promoting lack of circumcision as a risk factor is like promoting lack of mastectomy as a risk factor for breast cancer or lack of appendectomy is a risk factor for appendicitis".

The meaning of this is unclear, but it appears to be that MurasakiSunshine disagrees that it's a risk factor. The important question, though, is what WP:RS say on the subject. I've just searched the PubMed database for "penile cancer risk factor", limiting results to reviews. On the first page alone I found multiple papers identifying lack of circumcision as a risk factor: "the risk factors most strongly associated with penile cancer are lack of neonatal circumcision..."[3] "Men circumcised in childhood/adolescence are at substantially reduced risk of invasive penile cancer"[4] "The author reviews several major investigations from the past 35 years and finds that men with certain risk factors (eg, intact foreskin..."[5] "neonatal circumcision reduces the relative risk for the disease"[6] It is difficult to think of a justification for excluding it. Jakew (talk) 17:04, 22 March 2012 (UTC)

Requested move[edit]

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: page moved by Metropolitan90. As the relister, I was not 100% sure that a title had been agreed upon, other than the fact that the current title needed to be changed. However, since this moved has been performed, consensus must have been clearer than I had originally seen. (non-admin closure) Steel1943 (talk) 04:48, 11 November 2013 (UTC)



Carcinoma of the penisPenile cancerPenile cancer is actually a much more common name for this condition (see http://scholar.google.com), especially in recent publications. I do not understand why it was renamed to the current title in 2006. --Relisted. Steel1943 (talk) 04:26, 7 November 2013 (UTC) Ruslik_Zero 19:04, 30 October 2013 (UTC)

The MeSH term is "Penile Neoplasm", ICD-10 calls it "malignant neoplasm" or "carcinoma in situ" depending, the American Cancer Society's general term is "Penile Cancer". Not sure what the clear direction is here... will notify WP:MEDICINE. Zad68 19:20, 30 October 2013 (UTC)
Wouldn't carcinoma of the penis be a type of penile cancer? Assume there are other types of malignancy that can occur on/in the penis, although probably v rare, sarcomas etc. Having said that, if carcinoma is by far the most common penile cancer, then support rename to the more general term, although a short section delineating other rare types would be then be needed. Lesion (talk) 23:49, 30 October 2013 (UTC)
It appears that practically all penile cancers are carcinomas. Rare exceptions are melanomas and sarcomas. Ruslik_Zero 19:40, 31 October 2013 (UTC)
Agree and per the comment above, the rarer variants of cancer (sarcoma, etc.) should also be noted. LT910001 (talk) 00:16, 2 November 2013 (UTC)
Ruslik0 kindly added some notes about the rarer types I understand. Looks like this move is OK to go ahead now. Lesion (talk) 12:18, 4 November 2013 (UTC)
Agree as long as everybody understands that we're not only just changing the title of the article with this move, but we're actually expanding the scope of this article to no longer cover just carcinoma of the penis but all forms of penile cancer. That's fine. If/when at some point in the future we have enough content covering one of the penile cancer subtypes to break off into its own article, we'll do it at that time in a manner compliant with WP:SUMMARY. Zad68 13:40, 4 November 2013 (UTC)

I know this is not a numbers thing, but I think we have a non controversial move here since 4 (including nominator) have supported, and the other editor involved has not objected... I shall speedy penile cancer in preparation of the move again. Lesion (talk) 22:50, 7 November 2013 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.