Treatment of Penis Cancer in Germany
Best hospitals and doctors for penis cancer treatment in Germany
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Penis cancer is a rare malignant tumor usually curable before it reaches the metastatic stage. In Germany, the surgical technique is most often used to treat this disease. In the early stages, doctors resort to minimally invasive procedures. In Germany, the treatment for penis cancer involves external beam radiation therapy and interstitial radiation therapy. At the metastatic stage, chemotherapy can be used.
Content
- What is penis cancer?
- Treatment of early-stage penile cancer
- Surgical treatment of penile cancer
- Radiation therapy
- Systemic chemotherapy
- Why is it worth undergoing treatment in Germany?
Penis cancer is development of the malignant neoplasm from the penile tissues. Treatment options in Germany include surgery, radiation therapy, and chemotherapy.
These are laser therapy, cryosurgery, crcumcision, Mohs surgery, penectomy, and lymph node dissection.
Radiation therapy may be recommended instead of surgery, after surgery, as chemoradiotherapy or to treat the affected lymph nodes.
Topical and systemic chemotherapy are used for penile cancer. It is usually administered before or after surgery.
Treatment of penile cancer in Germany with Booking Health includes access to sparing surgeries, novel medicines and advanced equipment. The average cost of penectomy with the subsequent plasty is 14,900 EUR, the minimum price is 11,900 EUR, and the maximum price is 19,200 EUR.
What is penis cancer?
Penis cancer is a malignant tumor of the corresponding organ. Most often, it develops on the glans penis. In 50% of cases, the tumor is associated with papillomavirus infection, which is sexually transmitted. 95% of cases are squamous cell carcinoma. Less commonly, basal cell carcinoma or melanoma develops on the penis.
The development of the disease is often preceded by long-term precancerous processes: Bowenoid papulosis, Bowen's disease, cutaneous horn, and other pathologies.
The patients usually go to the doctor with the following symptoms:
- red spots on the penis;
- erosion or ulcers;
- painful cracks;
- lump;
- wart-like growths.
The symptoms are nonspecific. The rash on the penis looks the same as many other diseases: precancerous or not at all associated with oncology.
In patients with phimosis, symptoms often go unnoticed for a long time. This nature is because the tumor develops under the tight foreskin. In the early stages, it does not cause pain or other discomforts. The disease is often detected in such patients only after the appearance of metastases in the groin.
Diagnostic methods:
- biopsy – since the tumor is located on the surface of the body and is available for visual examination, it is enough to obtain a tissue fragment and examines it in the laboratory for diagnosis confirmation;
- CT, MRI, and ultrasound scanning are used to determine the depth of tumor invasion and search for metastases in regional lymph nodes and distant organs and tissues.
According to the tissue sample testing results, the histological type of the tumor and its grade are determined.
Treatment of early-stage penile cancer
At an early stage of penile cancer, doctors use sparing surgical interventions and non-surgical techniques to fully preserve the size of the penis, its function, and aesthetics.
Circumcision is sometimes the only treatment the patient needs. This is an effective operation if the tumor is located on the foreskin. It is removed along with the nearby part of the skin, and then a histological examination of the material is carried out. With clean resection margins, the resection scope is considered adequate. The risk of recurrence after surgery is low.
Laser ablation is the destruction of a small tumor with a laser. The laser vaporises the tissues, leaving a thick scab on their site. Laser ablation is a more sparing technique than surgery and is safer. The laser destroys bacteria in the wound and coagulates the vessels, and the scab formed due to the procedure reliably protecting the wound from traumatic injury and secondary infection. But only cancer in situ or stage 1 basalioma can be treated using this technique. In addition, the laser is offered to men who refuse surgery as an alternative to operation. The risk of recurrence after laser treatment is higher than after surgery. But in case of recurrence, the recurrent tumor on the penis can be destroyed again with the laser or surgically removed.
Cryodestruction is rarely used in hospitals in Germany. The procedure involves freezing the penile tumor with liquid nitrogen. When thawed, the cells die. But there are drawbacks: it is difficult for a doctor to control the depth of exposure so that the procedure may leave large scars. After the procedure, an inflammatory reaction develops in the affected area, so patients experience pain in the first few days. Cryodestruction can be used for the verrucous form of penis cancer and carcinoma in situ of the glans penis.
Topical chemotherapy involves the application of a cream with cytostatics for several weeks, which destroys small tumors. But the cream does not penetrate as deeply into the tissues as a laser or other physical methods. Therefore, topical chemotherapy is effective only at the in situ stages of penile cancer. The treatment is sparing and provides good aesthetic outcomes. Scars do not appear in the affected area, but skin redness and increased sensitivity are possible, which persists during the treatment.
Topical immunotherapy is the application of a cream that activates the immune response against the tumor. The drug is applied to the skin for 3-7 weeks. Some patients develop systemic side effects: flu-like symptoms. Topical immunotherapy is used only for penis cancer in situ, like topical chemotherapy.
Photodynamic therapy is used in German hospitals for superficially located tumors. The therapy is not suitable for wart-like growths, as it can only destroy growths of minimal thickness. The patient receives a photosensitizer, a drug that accumulates in cancer cells. The penis tumor is then exposed to a specific light that activates the sensitizer. This then results in toxic substances that destroy cancer cells from the inside.
Surgical treatment of penile cancer
The scope of the operation depends on the location, size of the tumor, and its histological type.
Wide excision is a standard operation for small tumors. The doctor removes the neoplasm on the penis to capture healthy tissue. The surgical intervention provides a minimal risk of cancer recurrence. However, a significant defect is formed at the site of removal, which doctors have to close with skin grafts from other parts of the patient's body. The plastic stage of the operation provides a good aesthetic outcome.
Mohs surgery is a treatment option that removes less of the healthy tissue around the tumor. This is a complex and lengthy operation. It is performed in specialized hospitals in Germany. The doctor removes cancer with a minimum of healthy tissue. The material is then sent to the laboratory. The resection margins are examined, and some show signs of cancer. After that, the surgical intervention continues: the wound is expanded in the direction where cancer cells are detected. The doctor cuts off thin pieces of skin. The material is then examined again. This is repeated several times, and the wound is expanded until all resection margins become clean. With this approach, the doctor can not remove tissue with a margin, which improves the aesthetic result of treatment and reduces the risk of developing functional disorders. Mohs surgery is used only for small tumors that have not invaded the deep tissues of the penis.
Glansectomy is the removal of the glans penis, complete or partial. After this operation, a reconstructive stage is required. The glans penis is repaired with skin grafts.
Partial penectomy is the removal of part of the penis. As a result, its length is reduced. It is the most commonly used treatment for penis cancer. The surgeon strives to save as much of the organ as possible, but he still has to move back from the margin of the tumor to avoid recurrence.
Total penectomy involves the removal of the entire penis, including the part that is inside the pelvis. This operation is complemented by perineal urethrostomy. The doctor creates a hole in the skin of the perineum to drain urine. A man can still control urination, but now he is forced to urinate while sitting. For locally advanced cancer and the penis, the doctor may also remove the scrotum with testicles. After that, testosterone production stops, so the patient must receive lifelong replacement therapy with this hormone.
Lymphadenectomy is the removal of lymph nodes: inguinal and pelvic. It is performed when there are signs of metastatic spread to the lymph nodes. This is a traumatic operation, after which lymphatic oedema of the lower extremities often develops. The inguinal lymph nodes are removed through an incision in the groin and the pelvic lymph nodes through an incision in the lower abdomen.
Sentinel lymph node biopsy is a procedure that avoids lymph node dissection at an early stage of cancer. It is performed in specialized hospitals in Germany. When performing surgery to remove penile cancer, the doctor injects a radioactive substance into the area of the tumor. Then, with a gamma camera, he checks which lymph nodes this substance accumulates. They are considered signal (sentinel). These few lymph nodes are removed and examined. If there are no cancer cells, there are no metastatic foci in the lymph nodes located farther from the tumor. Therefore, there is no need to remove them. If metastases are detected in the sentinel lymph nodes, doctors perform lymph node dissection in a standard scope.
Radiation therapy
For penis cancer, both external beam and contact radiation therapy (brachytherapy) can be used.
Here are the situations when radiation therapy can be used for this disease:
- early-stage penis cancer – instead of surgery;
- irradiation of the lymph nodes after surgery – treatment for reducing the risk of recurrence;
- the main method of local tumor control in patients with medical contraindications to surgery;
- jointly with chemotherapy before surgery – to reduce the tumor in size and make the operation less traumatic;
- Metastatic penis cancer – as a palliative treatment method to control the symptoms of the disease and reduce the risk of complications.
External beam radiation therapy is carried out five days a week for six weeks. Protective shields are used to protect the groin and testicles.
Doctors in Germany treat penile neoplasms with interstitial brachytherapy, which involves the administration of needles into the penis, through which radioactive seeds are then delivered. The patient spends several days in the hospital. At the end of the course of treatment, the needles are removed. Although this irradiation option is invasive, it has two advantages: the course can be completed faster, and healthy tissue is practically not irradiated. But brachytherapy is not used to irradiate the lymph nodes, so the possibilities of the method are limited. The procedure is used only at the early stage of the disease.
Systemic chemotherapy
Chemotherapy can be used in Germany in the following situations:
- before surgery (rarely) – chemotherapy helps to reduce the size of the tumor before its removal (combination with radiation therapy is possible);
- after surgery to reduce the risk of recurrence (rarely used since convincing evidence of the effect of adjuvant chemotherapy on patient survival has not yet been obtained);
- metastatic form of the disease.
Why is it worth undergoing treatment in Germany?
For penis cancer treatment, you can go to one of the hospitals in Germany. Here are a few reasons for you to undergo treatment in this country:
- Sparing minimally invasive procedures for the early stages of penile cancer that can cure the disease without surgery in most patients.
- When performing the surgical intervention, doctors seek not only to cure cancer, but also to preserve sexual function, the aesthetics of the penis, and the ability to urinate while standing.
- To treat small tumours at the early stage, the specialists perform the Mohs surgery, which provides patients with the best aesthetic and functional outcomes.
- After tumor removal surgery in Germany, doctors perform skin grafting to close the resulting defects.
- A Sentinel lymph node biopsy is performed, allowing many patients to avoid surgery to remove the inguinal and pelvic lymph nodes.
- Doctors in Germany use innovative methods of radiation therapy, which provide a minimal risk of complications from the healthy tissues surrounding the tumor.
To undergo penis cancer treatment in Germany, you are welcome to use the Booking Health service. On our website, you can get up-to-date and accurate information about the cost of treatment in Germany, compare prices in different German hospitals and book a medical care program at a favorable price. The cost of surgical treatment for penis cancer with the subsequent plastic reconstruction is between 11,900 EUR and 19,200 EUR. The treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.
The average price of rehabilitation after penis cancer treatment is 1,190 EUR per day, the minimum price is 1,041 EUR per day, and the maximum price is 1,553 EUR per day.
Please leave your request on the website of the Booking Health medical tourism facilitator. Our employee will contact you, consult, and answer all your questions. We will take care of the organization of your trip abroad. We will provide the following benefits for you:
- We will select the best German hospital, whose doctors specialize in penis cancer treatment and achieve the best results.
- We will help overcome the language barrier and establish communication with the doctor at the German hospital.
- The waiting period for medical diagnosis and treatment for patients will be reduced, and you will receive medical care on the most suitable dates.
- We will reduce the price. The cost of treatment in Germany will be lower than usual due to eliminating overpricing and additional coefficients for foreign patients.
- Our specialists will solve any organizational issues: paperwork, transfer from the airport to the German hospital and back, hotel booking, and interpreting services.
- We will prepare your documents and translate them into English or German. You will not have to repeat the previously performed diagnostic procedures.
- We provide communication of patients with the German hospital after the completion of treatment.
- We will arrange additional medical examinations and treatment, if required.
- We will buy medicines in another country and forward them to your native country.
While the best specialists in the world take care of your health, the Booking Health staff will help reduce the cost of treatment in Germany and take care of all the travel arrangements.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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