Despite being a preventable disease, penile cancer was responsible for 2,900 amputations between 2021 and 2025 in Brazil, according to data from the Ministry of Health (MS) raised by the Brazilian Society of Urology (SBU). In this same period, the condition was responsible for 2,300 deaths.
Penile cancer can lead to amputation of the organ if diagnosed at an advanced stage Photo: Game/Adobe Stock
The entity understands that the lack of information and prejudice are the main obstacles to prevention, which involves measures such as adequate hygiene, vaccination against the virus HPV and surgery to correct phimosis, called postectomy.
Records are not restricted to a single group, but the incidence is higher in men over 50 years of age. According to urologist Roni de Carvalho Fernandes, president of the SBU, the initial signs are usually local and often painless.
These include the appearance of wounds or ulcers on the penis that do not heal, as well as changes in the color of the skin, which may become reddish, whitish or darker, especially on the foreskin (the skin that covers the head of the penis) or on the glans (the head of the organ).
Thickening of the skin or the appearance of nodules may also occur, as well as secretions with a strong odor under the foreskin and episodes of bleeding. “In advanced stages, the patient may feel pain and enlarged groin nodes”, highlights the doctor.
What causes penile cancer?
The disease is caused by a chronic infection of the foreskin, which initially manifests as a wound that does not heal and evolves into an ulcer or serious injury. One of the most common causes is not adequately cleaning the area, where fungi and bacteria can proliferate.
Therefore, hygiene must be carried out daily during the bath, with the foreskin retracted to expose the glans and washed with soap and water. People with phimosis, a condition that makes it difficult to expose the glans, are at greater risk of developing the disease and may resort to surgical removal of the foreskin to facilitate cleaning.
Furthermore, penile cancer can arise as a result of HPV infection, a sexually transmitted virus that, in women, causes cervical cancer. To avoid contamination, it is recommended to use condoms during sexual intercourse, in addition to vaccination against the virus – available at THEIR for the population aged 9 to 14 and immunosuppressed up to 45 years of age.
Diagnosis and treatment
When diagnosed at an early stage, penile cancer has a high chance of cure and can be treated less aggressively. At this stage, the tumor remains restricted to the superficial layers of the skin, without reaching deeper structures. This allows removal of only the affected area, avoiding the need to remove the penis.
Amputation is only indicated in extreme situations. It can be done partially or completely on the organ, depending on the extent of the injury. In these cases, the urethra is repositioned in the perineum, which causes the patient to urinate sitting down. This change can bring difficulties in everyday life, in addition to directly affecting the individual’s self-esteem.
It is worth mentioning that, unlike other types of cancer, there is no standardized population screening for penile cancer. “The diagnosis is based mainly on a physical examination performed by the urologist, clinical evaluation of the patient’s history, including intimate hygiene, phimosis, smoking and HPV infection. A biopsy of the lesion confirms the diagnosis when a tumor is suspected”, highlights Fernandes.
North and Northeast deserve attention
The highest records of amputations occurred in São Paulo, with 542 procedures, followed by Minas Gerais, with 476, and Rio de Janeiro, with 442. Although most of the absolute records are concentrated in the Southeast region, the SBU highlights that the North and Northeast regions need more attention. According to Fernandes, proportionally they are the most impacted places.
The doctor mentions that this happens due to structural, social and access to healthcare factors. “Among them, the following stand out: greater socioeconomic vulnerability; difficulty in accessing specialized health services, which favors late diagnosis; greater frequency of inadequate intimate hygiene; high prevalence of untreated phimosis; greater exposure to HPV infection; in addition to the lack of health information, which contributes to many men seeking care only in advanced stages of the disease”, he describes.
