There is a sharp increase in the incidence of penile cancer worldwide: 6,500 amputations in Brazil

In 2018, a Brazilian pensioner aged 63 went to the doctor after discovering a wart on his penis. He went to different clinics, but doctors prescribed medications and explained that the reason was excess skin. Despite treatment, the wart continued to grow, the disease began to affect the patient’s marital life, but only in 2023 he was diagnosed with genital cancer. The disease was already advanced, and the patient had to have part of his penis amputated. “I feel like I’ve been beheaded,” the patient admits.

Penile cancer is relatively rare, but the incidence and mortality rates of the disease have been rising worldwide in recent years, the BBC reports. Brazil has one of the highest incidence rates in the world: 2.1 cases per 100,000 men. According to Brazil’s Ministry of Health, 21,000 cases were registered between 2012 and 2022, and more than 4,000 men died from the disease. Over the past decade, 6,500 penile amputations have been performed in Brazil – an average of two per day. Maranhão, Brazil’s poorest state, has the highest incidence rate in the world: 6.1 cases per 100,000 men.

Penile cancer often begins with a non-healing sore on the penis and a strong-smelling discharge, and some people experience bleeding and discoloration of the penis. With early diagnosis, the chances of recovery are high, and treatment is carried out using methods such as surgical removal of the affected area and chemotherapy. Left untreated, it can lead to partial or complete amputation of the penis and possibly other nearby organs such as the testicles.

Dr. Thiago Camelo Muran from the urology department of the AC Camargo Cancer Hospital in São Paulo explains that in the case of partial amputation of the penis, urine continues to pass through the penis, but in a complete amputation, the urethral opening is moved to the perineum, between the scrotum and anus, and the patient can produce urinating while sitting on the toilet.

One of the key risk factors is the human papillomavirus (HPV). This virus is transmitted during sexual intercourse, and in some cases can lead to cancer – including cancer of the mouth, larynx or penis. According to Dr. Mauricio Dener Cordeiro from the Brazilian Association of Urology, mass vaccination against HPV is necessary to prevent the disease: the vaccine exists and it is effective, but vaccination must be done in adolescence, before the onset of sexual activity.

Despite the availability of the vaccine, the vaccination rate among girls in Brazil is quite low, only 57%, and among boys it does not exceed 40%. The ideal vaccination coverage to prevent the disease is 90%. According to Dr. Mauricio Dener Cordeiro, unfounded doubts about the effectiveness of the vaccine, misinformation and the lack of information campaigns about the benefits of vaccination are the reasons for its low uptake.