NCCN Guidelines for Penile Cancer from Version 1.2019 Include

Total Page:16

File Type:pdf, Size:1020Kb

NCCN Guidelines for Penile Cancer from Version 1.2019 Include NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Penile Cancer Version 2.2019 — May 13, 2019 NCCN.org Continue Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion *Thomas W. Flaig, MD †/Chair Harry W. Herr, MD ϖ Sumanta K. Pal, MD † University of Colorado Cancer Center Memorial Sloan Kettering Cancer Center City of Hope National Medical Center *Philippe E. Spiess, MD, MS ϖ/Vice Chair Christopher Hoimes, MD † Anthony Patterson, MD ϖ Moffitt Cancer Center Case Comprehensive Cancer Center/ St. Jude Children’s Research Hospital/ University Hospitals Seidman Cancer Center The University of Tennessee Neeraj Agarwal, MD ‡ † and Cleveland Clinic Taussig Cancer Institute Health Science Center Huntsman Cancer Institute at the University of Utah Brant A. Inman, MD, MSc ϖ Elizabeth R. Plimack, MD, MS † Duke Cancer Institute Fox Chase Cancer Center Rick Bangs, MBA Patient Advocate Masahito Jimbo, MD, PhD, MPH Þ Kamal S. Pohar, MD ϖ University of Michigan Rogel Cancer Center The Ohio State University Comprehensive Stephen A. Boorjian, MD ϖ Cancer Center - James Cancer Hospital Mayo Clinic Cancer Center A. Karim Kader, MD, PhD ϖ and Solove Research Institute UC San Diego Moores Cancer Center Mark K. Buyyounouski, MD, MS § Michael P. Porter, MD, MS ϖ Stanford Cancer Institute Subodh M. Lele, MD ≠ Fred Hutchinson Cancer Research Center/ Fred & Pamela Buffett Cancer Center Sam Chang, MD ¶ Seattle Cancer Care Alliance Vanderbilt-Ingram Cancer Center Joshua J. Meeks, MD, PhD ϖ Mark A. Preston, MD, MPH ϖ Robert H. Lurie Comprehensive Cancer Tracy M. Downs, MD ϖ Dana-Farber/Brigham and Women’s Center of Northwestern University University of Wisconsin Cancer Center Carbone Cancer Center Jeff Michalski, MD, MBA § Wade J. Sexton, MD ϖ Siteman Cancer Center at Barnes- Jason A. Efstathiou, MD, DPhil § Moffitt Cancer Center Jewish Hospital and Washington Massachusetts General Hospital University School of Medicine Arlene O. Siefker-Radtke, MD † Cancer Center The University of Texas Jeffrey S. Montgomery, MD, MHSA ϖ Terence Friedlander, MD † MD Anderson Cancer Center University of Michigan Rogel Cancer Center UCSF Helen Diller Family Jonathan Tward, MD, PhD § Comprehensive Cancer Center Lakshminarayanan Nandagopal, MD † Huntsman Cancer Institute O'Neal Comprehensive Cancer Center at UAB Richard E. Greenberg, MD ϖ at the University of Utah Fox Chase Cancer Center Lance C. Pagliaro, MD † NCCN Mayo Clinic Cancer Center Khurshid A. Guru, MD ϖ Lisa Gurski, PhD Roswell Park Comprehensive Cancer Center Alyse Johnson-Chilla, MS ‡ Hematology/Hematology § Radiotherapy/Radiation Continue oncology oncology NCCN Guidelines Panel Disclosures Þ Internal medicine ¶ Surgery/Surgical Oncology † Medical oncology ϖ Urology ≠ Pathology * Discussion writing committee member Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion NCCN Penile Cancer Panel Members Clinical Trials: NCCN believes that Summary of the Guidelines Updates the best management for any patient with cancer is in a clinical trial. Participation in clinical trials is Primary Evaluation, Clinical Diagnosis (PN-1) especially encouraged. Primary Treatment Tis, Ta (PN-1) To find clinical trials online at NCCN Primary Treatment T1, T2 or Greater (PN-2) Member Institutions, click here: Management of Non-Palpable Inguinal Lymph Nodes (PN-3) nccn.org/clinical_trials/clinicians.aspx. Management of Palpable Non-Bulky Inguinal Lymph Nodes (PN-4) NCCN Categories of Evidence and Consensus: All recommendations Management of Palpable Bulky Inguinal Lymph Nodes (PN-5) are category 2A unless otherwise Management of Enlarged Pelvic Lymph Nodes (PN-6) indicated. Surveillance Schedule (PN-7) See NCCN Categories of Evidence Management of Recurrent Disease (PN-8) and Consensus. Management of Metastatic Disease (PN-9) NCCN Categories of Preference: All recommendations are considered appropriate. Principles of Penile Organ-Sparing Approaches (PN-A) See NCCN Categories of Preference Principles of Surgery (PN-B) Principles of Radiotherapy (PN-C) Principles of Systemic Therapy (PN-D) Staging (ST-1) The NCCN Guidelines® are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network® (NCCN®) makes no representations or warranties of any kind regarding their content, use or application and disclaims any responsibility for their application or use in any way. The NCCN Guidelines are copyrighted by National Comprehensive Cancer Network®. All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. ©2019. Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion Updates in Version 2.2019 of the NCCN Guidelines for Penile Cancer from Version 1.2019 include: MS-1 • The discussion section has been updated to reflect the changes in the algorithm. Updates in Version 1.2019 of the NCCN Guidelines for Penile Cancer from Version 2.2018 include: Global Changes • The NCCN Categories of Preference have been applied to all systemic therapy treatment recommendations. INTRO • This is a new page. PN-2 • T1, Grade 1-2 Primary Treatment: "Partial penectomy" added as an option. PN-5 • Top pathway, percutaneous lymph node biopsy positive treatment recommendations updated: " Consider Cisplatin-based neoadjuvant chemotherapy followed by ILND or ILND (in patients not eligible for cisplatin-based chemotherapy)" PN-8 • Top pathway: Invasion of corpora cavernosa absent or present removed and changed to "Noninvasive" or "Invasive" Principles of Penile Organ-Sparing Approaches PN-A (1 of 2) • Laser therapy 3rd bullet updated: "A plume (smoke) evacuator is recommended required during penile laser treatments..." • Spot size in commonly used settings row of the table updated: CO2: "Spot size: 3 mm 1–5 mm" Nd:YAG: "Spot size: 5 mm 1–5 mm" Principles of Systemic Therapy (PN-D) • Name of page was changed from "Principles of Chemotherapy" to "Principles of Systemic Therapy" • These pages were extensively revised to apply the NCCN Categories of Preference. Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. UPDATES NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion INTRODUCTION NCCN and the NCCN Penile Cancer Panel believes that the best management for any patient with cancer is in a clinical trial. Participation in clinical trials is especially encouraged. Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. INTRO NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion PRIMARY EVALUATION CLINICAL PRIMARY TREATMENT DIAGNOSIS See a Management of Topical therapy Non-Palpable or a Inguinal Lymph Wide local excision Nodes (PN-3) or Laser therapya (category 2B) Tis or Ta or H&P Complete glansectomya (category 2B) • Risk factors or See Balanitis, chronic inflammation, Mohs surgery in select casesa Management of penile trauma, lack of neonatal (category 2B) Palpable Inguinal circumcision, tobacco use, Lymph Nodes lichen sclerosus, poor hygiene, (PN-4) sexually transmitted disease • Lesion characteristics Suspicious Diameter, location, number of penile lesion lesions, morphology (papillary, nodular, ulcerous, or flat), relationship to other structures (submucosal, corpora spongiosa, cavernosa, and/or urethra) Cytology or histologic diagnosis • Punch, excisional, or incisional biopsy ≥T1 See Primary Treatment (PN-2) If recurrent disease, see PN-8 or if metastatic disease, see PN-9 a See Principles of Penile Organ-Sparing Approaches (PN-A). Note: All recommendations are category 2A unless otherwise indicated. Clinical Trials: NCCN believes that the best management of any patient with cancer is in a clinical trial. Participation in clinical trials is especially encouraged. Version 2.2019, 05/13/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. PN-1 NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Penile Cancer Discussion PATHOLOGIC DIAGNOSIS PRIMARY TREATMENT Wide local excisiona or
Recommended publications
  • The Male Reproductive System
    Management of Men’s Reproductive 3 Health Problems Men’s Reproductive Health Curriculum Management of Men’s Reproductive 3 Health Problems © 2003 EngenderHealth. All rights reserved. 440 Ninth Avenue New York, NY 10001 U.S.A. Telephone: 212-561-8000 Fax: 212-561-8067 e-mail: [email protected] www.engenderhealth.org This publication was made possible, in part, through support provided by the Office of Population, U.S. Agency for International Development (USAID), under the terms of cooperative agreement HRN-A-00-98-00042-00. The opinions expressed herein are those of the publisher and do not necessarily reflect the views of USAID. Cover design: Virginia Taddoni ISBN 1-885063-45-8 Printed in the United States of America. Printed on recycled paper. Library of Congress Cataloging-in-Publication Data Men’s reproductive health curriculum : management of men’s reproductive health problems. p. ; cm. Companion v. to: Introduction to men’s reproductive health services, and: Counseling and communicating with men. Includes bibliographical references. ISBN 1-885063-45-8 1. Andrology. 2. Human reproduction. 3. Generative organs, Male--Diseases--Treatment. I. EngenderHealth (Firm) II. Counseling and communicating with men. III. Title: Introduction to men’s reproductive health services. [DNLM: 1. Genital Diseases, Male. 2. Physical Examination--methods. 3. Reproductive Health Services. WJ 700 M5483 2003] QP253.M465 2003 616.6’5--dc22 2003063056 Contents Acknowledgments v Introduction vii 1 Disorders of the Male Reproductive System 1.1 The Male
    [Show full text]
  • Genital Ulcers and Swelling in an Adolescent Girl
    PHOTO CHALLENGE Genital Ulcers and Swelling in an Adolescent Girl Meghan E. Ryan, DO; Pui-Ying Iroh Tam, MD A 14-year-old previously healthy, postmenarcheal adolescent girl with a family history of thyroid dis- ease and rheumatoid arthritis presented with vulvar pain and swelling. Vulvar pruritus was noted 6 days prior, which worsened and became associated with vulvar swelling, yellow vaginal discharge, dif- ficulty walking, and a fever (temperature, 39.3°C). Her condition did not improve after a course of cephalexin andcopy trimethoprim-sulfamethoxazole. She denied being sexually active or exposing for- eign objects or chemicals to the vaginal area. not WHAT’S THE DIAGNOSIS? a. Behçet disease Dob. candida c. chlamydia d. Epstein-Barr virus e. herpes simplex virus PLEASE TURN TO PAGE E5 FOR THE DIAGNOSIS CUTIS Dr. Ryan was from Des Moines University College of Osteopathic Medicine, Iowa. Dr. Ryan currently is from and Dr. Iroh Tam is from the University of Minnesota Masonic Children’s Hospital, Minneapolis. Dr. Iroh Tam is from the Department of Pediatric Infectious Diseases and Immunology. The authors report no conflict of interest. Correspondence: Pui-Ying Iroh Tam, MD, 3-210 MTRF, 2001 6th St SE, Minneapolis, MN 55455 ([email protected]). E4 I CUTIS® WWW.CUTIS.COM Copyright Cutis 2017. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. PHOTO CHALLENGE DISCUSSION THE DIAGNOSIS: Epstein-Barr Virus hysical examination revealed bilateral 1-cm ulcer- is the assumed etiology of genital ulcers, especially in ated lesions on the labia minora with vulvar edema sexually active patients, and misdiagnosis in the setting of P(Figure).
    [Show full text]
  • Vaginal and Vulvar Cancer 10.1136/Ijgc-2020-ESGO.178
    Int J Gynecol Cancer: first published as 10.1136/ijgc-2020-ESGO.177 on 4 December 2020. Downloaded from Abstracts 520 LONG TERM FOLLOW UP AFTER DIAGNOSIS OF Introduction/Background Since the introduction of the S2K GESTATIONAL TROPHOBLASTIC DISEASE AWMF guideline-based sentinel node biopsy technique in uni- focal vulvar cancer (diameter of <4 cm) and unsuspicious Pedro Corvelo Freitas, Beatriz Mira, António Guimarães, Ana Opinião, Hugo Nunes, Ana Francisca Jorge, Fátima Vaz, António Moreira. Instituto Português de Oncologia de Lisboa groin lymph nodes, the morbidity rate of patients has signifi- Francisco Gentil cantly decreased in Germany. The groin recurrence rate after IFL is vary from 0% to 5.8%, in contrast to 2.3% (95% CI, 10.1136/ijgc-2020-ESGO.176 0.6% to 5%) in unifocal vulvar cancer vs 3% (95% CI, 1% to 6%) in multifocal vulvar cancer after SLNB only, as sug- Introduction/Background The spectrum of Gestational tropho- gested in the GRoningen INternational Study on Sentinel blastic disease (GTD) ranges from pre-malignant conditions of node in Vulvar cancer (GROINSS-V-I) in 2008. Current guide- complete (CHM) and partial (PHM) hydatidiform moles to the lines suggest that in cases of metastasis of unilateral sentinel malignant invasive mole, choriocarcinoma (CC) and very rare lymph node (SLN) biopsy (B), groin node dissection, namely placental site trophoblastic tumour/epithelioid trophoblastic inguinofemoral lymphadenectomy (IFL), should be performed tumour (PSTT/ETT). Gestational trophoblastic neoplasia (GTN) bilaterally. However, a publication by Woelber et al. in Ger- are highly responsive to chemotherapy (CT) and with appropri- many and and Nica et al.
    [Show full text]
  • Pembrolizumab in Vaginal and Vulvar Squamous Cell Carcinoma: a Case Series from a Phase II Basket Trial Jefrey A
    www.nature.com/scientificreports OPEN Pembrolizumab in vaginal and vulvar squamous cell carcinoma: a case series from a phase II basket trial Jefrey A. How 1, Amir A. Jazaeri 1, Pamela T. Soliman1, Nicole D. Fleming1, Jing Gong2, Sarina A. Piha‑Paul2, Filip Janku 2, Bettzy Stephen 2 & Aung Naing 2* Vaginal and vulvar squamous cell carcinoma (SCC) are rare tumors that can be challenging to treat in the recurrent or metastatic setting. We present a case series of patients with vaginal or vulvar SCC who were treated with single‑agent pembrolizumab as part of a phase II basket clinical trial to evaluate efcacy and safety. Two cases of recurrent and metastatic vaginal SCC, with multiple prior lines of systemic chemotherapy and radiation, received pembrolizumab. One patient had signifcant reduction (81%) in target tumor lesions prior to treatment discontinuation at cycle 10 following confrmed progression of disease with new metastatic lesions (stable disease by irRECIST criteria). In contrast, the other patient with vaginal SCC discontinued treatment after cycle 3 due to disease progression. Both patients had PD‑L1 positive vaginal tumors and tolerated treatment well. One case of recurrent vulvar SCC with multiple surgical resections and prior progression on systemic carboplatin had a 30% reduction in her target tumor lesions following pembrolizumab treatment with a PD‑L1 positive tumor. Treatment was discontinued for grade 3 mucositis after cycle 5. Pembrolizumab may provide some clinical beneft to some patients with vaginal or vulvar SCC and is overall safe to utilize in this population. Future studies are needed to evaluate the efcacy of pembrolizumab in these rare tumor types and to identify predictive biomarkers of response.
    [Show full text]
  • | Tidsskrift for Den Norske Legeforening a Previously Healthy Man in His Late Forties Consulted His Doctor About a Lump in His Anus
    A man in his forties with anal tumour and inguinal lymphadenopathy NOE Å LÆRE AV SVETLANA SHARAPOVA E-mail: [email protected] Department of Gastrointestinal and Paediatric Surgery Oslo University Hospital Svetlana Sharapova, specialty registrar in general surgery and gastrointestinal surgery, and acting consultant. The author has completed the ICMJE form and declares no conflicts of interest. USHA HARTGILL Olafia Clinic Department of Venereology Oslo University Hospital Usha Hartgill, specialist in dermatological and venereal diseases, head of department and senior consultant. The author has completed the ICMJE form and declares no conflicts of interest. PREMNAATH TORAYRAJU Olafia Clinic Department of Venereology Oslo University Hospital Premnaath Torayraju, specialty registrar in the Department of Medicine at Diakonhjemmet Hospital, specialising in dermatological and venereal diseases. The author has completed the ICMJE form and declares no conflicts of interest. BETTINA ANDREA HANEKAMP Department of Radiology Oslo University Hospital Bettina Andrea Hanekamp, specialist in radiology, and senior consultant in the Section for Oncological and Abdominal Imaging. The author has completed the ICMJE form and declares no conflicts of interest. SIGURD FOLKVORD Department of Gastrointestinal and Paediatric Surgery Oslo University Hospital Sigurd Folkvord, PhD, senior consultant and specialist in gastrointestinal surgery. The author has completed the ICMJE form and declares no conflicts of interest. A man in his late forties was examined for suspected cancer of the anal canal with spreading to inguinal lymph nodes. When biopsies failed to confirm malignant disease, other differential diagnoses had to be considered. A man in his forties with anal tumour and inguinal lymphadenopathy | Tidsskrift for Den norske legeforening A previously healthy man in his late forties consulted his doctor about a lump in his anus.
    [Show full text]
  • Case 3.1 X-Linked Agammaglobulinaemia (Bruton’S Disease)
    Case 3.1 X-linked agammaglobulinaemia (Bruton’s disease) Peter was born after an uneventful pregnancy, weighing 3.1 kg. At 3 months, he developed otitis media; at the ages of 5 months and 11 months, he was admitted to hospital with untypable Haemophilus influenzae pneumonia. These infections responded promptly to appropriate antibiotics on each occasion. He is the fourth child of unrelated parents: his three sisters showed no predisposition to infection. Examination at the age of 18 months showed a pale, thin child whose height and weight were below the third centile. There were no other abnormal features. He had been fully immunized as an infant (at 2, 3 and 4 months) with tetanus and diphtheria toxoids, acellular pertussis, Hib and Mening. C conjugate vaccines and polio (Salk). In addition, he had received measles, mumps and rubella vaccine at 15 months. All immunizations were uneventful. Immunological investigations (Table 3.4) into the cause of his recurrent infections showed severe reduction in all three classes of serum immunoglobulins and no specific antibody production. Although there was no family history of agammaglobulinaemia, the lack of mature B lymphocytes in his peripheral blood suggested a failure of B-cell differentiation and strongly supported a diagnosis of infantile X-linked agammaglobulinaemia (Bruton’s disease). This was confirmed by detection of a disease-causing mutation in the Btk gene. The antibody deficiency was treated by 2-weekly intravenous infusions of human normal IgG in a dose of 400 mg/kg body weight/month. Over the following 7 years, his health steadily improved, weight and height are now on the 30th centile, and he has had only one episode of otitis media in the last 4 years.
    [Show full text]
  • Incidence and Cost of Anal, Penile, Vaginal and Vulvar Cancer in Denmark Jens Olsen1*, Tine Rikke Jørgensen2, Kristian Kofoed3 and Helle Kiellberg Larsen3
    Olsen et al. BMC Public Health 2012, 12:1082 http://www.biomedcentral.com/1471-2458/12/1082 RESEARCH ARTICLE Open Access Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark Jens Olsen1*, Tine Rikke Jørgensen2, Kristian Kofoed3 and Helle Kiellberg Larsen3 Abstract Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results: The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively.
    [Show full text]
  • Association of GUTB and Tubercular Inguinal Lymphadenopathy - a Rare Co-Occurrence
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 7 Ver. I (July 2016), PP 109-111 www.iosrjournals.org Association of GUTB and Tubercular inguinal lymphadenopathy - A rare co-occurrence. 1Hemant Kamal, 2Dr. Kirti Kshetrapal, 3Dr. Hans Raj Ranga 1Professor, Department of Urology & reconstructive surgery, PGIMS Rohtak-124001 (Haryana) Mobile- 9215650614 2Prof. Anaesthesia PGIMS Rohtak, 3Associate Prof. Surgery PGIMS Rohtak. Abstract : Here we present a rare combination of GUTB with B/L inguinal lymphadenopathy in a 55y old male patient presented with pain right flank , fever & significant weight loss for the last 3 months. Per abdomen examination revealed non-tender vague lump in right lumber region about 5x4cm dimensions , with B/L inguinal lymphadenopathy, firm, matted . Investigations revealed low haemoglobin count, high leucocytic & ESR count , urine for AFB was positive and ultrasound revealed small right renal & psoas abscess , which on subsequent start of ATT , got resolved and patient was symptomatically improved . I. Introduction Genitourinary tuberculosis (GUTB) is the second most common form of extrapulmonary tuberculosis after lymph node involvement [1]. Most studies in peripheral LNTB have described a female preponderance, while pulmonary TB is more common in adult males [2]. In approximately 28% of patients with GUTB, the involvement is solely genital [3]. However , the combination of GUTB and LNTB is rare condition. Most textbooks mention it only briefly. This report aims to present a case of GUTB with LNTB in a single patient. II. Case Report 55y male with no comorbidities , having pain right flank & fever X 3months.
    [Show full text]
  • Highlighting the Importance of Sexually Transmitted Disease Testing Upon Diagnosis of Penile Cancer: a Case Report
    Case Study Clinical Case Reports International Published: 15 Jun, 2020 Highlighting the Importance of Sexually Transmitted Disease Testing Upon Diagnosis of Penile Cancer: A Case Report Médina Ndoye1, Lissoune Cisse1, Mark LaGreca2, Timothy Phillips2, Mark Siden2* and Matthew Weaver2 1Department of Urology, Idrissa Pouye General Hospital, Senegal 2Department of Medicine, Philadelphia College of Osteopathic Medicine, USA Abstract There is a well-known association between Human Papillomavirus and Human Immunodeficiency Virus with penile cancer. Yet, it is not the standard of care to screen for either of these sexually transmitted diseases upon diagnosis of primary penile cancer. We present a 50 year old male who had a confirmed diagnosis of penile cancer for 2 years prior to his presentation to our clinic in Dakar, Senegal. Outside institutions repeatedly failed to screen the patient for sexually transmitted diseases, namely HPV and HIV. We share this case to emphasize the importance of sexually transmitted disease screening upon diagnosis of penile cancer with hopes to increase awareness in both developed and developing nations. We call for consensus in sexually transmitted disease screening guidelines upon penile cancer diagnoses. Keywords: Penile cancer; HPV; HIV; STD screening Introduction Primary penile cancer is a rare malignant overgrowth of cells, typically located on the glans or the internal prepuce of the penis. It has a worldwide incidence of 1/100,000 and most commonly affects males between the ages of 50 years to 70 years. Delayed diagnosis often yields significant OPEN ACCESS morbidity and mortality [1,2]. While penile cancer is uncommon in Europe and North America, the developing world has much higher rates of incidence up to 8 cases per 100,000 in some countries *Correspondence: [3].
    [Show full text]
  • Penile Cancer
    Guidelines on Penile Cancer O.W. Hakenberg (chair), E. Compérat, S. Minhas, A. Necchi, C. Protzel, N. Watkin © European Association of Urology 2014 TABLE OF CONTENTS PAGE 1. INTRODUCTION 4 1.1 Publication history 4 1.2 Potential conflict of interest statement 4 2. METHODOLOGY 4 2.1 References 5 3. DEFINITION OF PENILE CANCER 5 4. EPIDEMIOLOGY 5 4.1 References 6 5. RISK FACTORS AND PREVENTION 7 5.1 References 8 6. TNM CLASSIFICATION AND PATHOLOGY 9 6.1 TNM classification 9 6.2 Pathology 10 6.2.1 References 13 7. DIAGNOSIS AND STAGING 15 7.1 Primary lesion 15 7.2 Regional lymph nodes 15 7.2.1 Non-palpable inguinal nodes 15 7.2.2 Palpable inguinal nodes 16 7.3 Distant metastases 16 7.4 Recommendations for the diagnosis and staging of penile cancer 16 7.5 References 16 8. TREATMENT 17 8.1 Treatment of the primary tumour 17 8.1.1 Treatment of superficial non-invasive disease (CIS) 18 8.1.2 Treatment of invasive disease confined to the glans (category Ta/T1a) 18 8.1.2.1 Results of different surgical organ-preserving treatment modalities 18 8.1.2.2 Summary of results of surgical techniques 19 8.1.2.3 Results of radiotherapy for T1 and T2 disease 19 8.1.3 Treatment of invasive disease confined to the corpus spongiosum/glans (Category T2) 20 8.1.4 Treatment of disease invading the corpora cavernosa and/or urethra (category T2/T3) 20 8.1.5 Treatment of locally advanced disease invading adjacent structures (category T3/T4) 20 8.1.6 Local recurrence after organ-conserving surgery 20 8.1.7 Recommendations for stage-dependent local treatment of penile carcinoma.
    [Show full text]
  • Vaginal Cancer, Risk Factors, and Prevention Risk Factors for Vaginal
    cancer.org | 1.800.227.2345 Vaginal Cancer, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for vaginal cancer. ● Risk Factors for Vaginal Cancer ● What Causes Vaginal Cancer? Prevention There's no way to completely prevent cancer. But there are things you can do that might help lower your risk. Learn more here. ● Can Vaginal Cancer Be Prevented? Risk Factors for Vaginal Cancer A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. But having a risk factor, or even many, does not mean that you will get the disease. And 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 some people who get the disease may not have any known risk factors. Scientists have found that certain risk factors make a woman more likely to develop vaginal cancer. But many women with vaginal cancer don’t have any clear risk factors. And even if a woman with vaginal cancer has one or more risk factors, it’s impossible to know for sure how much that risk factor contributed to causing the cancer. Age Squamous cell cancer of the vagina occurs mainly in older women. It can happen at any age, but few cases are found in women younger than 40. Almost half of cases occur in women who are 70 years old or older.
    [Show full text]
  • A Current Update on Human Papillomavirus-Associated Head and Neck Cancers
    viruses Review A Current Update on Human Papillomavirus-Associated Head and Neck Cancers Ebenezer Tumban Department of Biological Sciences, Michigan Technological University, 1400 Townsend Dr, Houghton, MI 49931, USA; [email protected]; Tel.: +1-906-487-2256; Fax: +1-906-487-3167 Received: 16 September 2019; Accepted: 4 October 2019; Published: 9 October 2019 Abstract: Human papillomavirus (HPV) infection is the cause of a growing percentage of head and neck cancers (HNC); primarily, a subset of oral squamous cell carcinoma, oropharyngeal squamous cell carcinoma, and laryngeal squamous cell carcinoma. The majority of HPV-associated head and neck cancers (HPV + HNC) are caused by HPV16; additionally, co-factors such as smoking and immunosuppression contribute to the progression of HPV + HNC by interfering with tumor suppressor miRNA and impairing mediators of the immune system. This review summarizes current studies on HPV + HNC, ranging from potential modes of oral transmission of HPV (sexual, self-inoculation, vertical and horizontal transmissions), discrepancy in the distribution of HPV + HNC between anatomical sites in the head and neck region, and to studies showing that HPV vaccines have the potential to protect against oral HPV infection (especially against the HPV types included in the vaccines). The review concludes with a discussion of major challenges in the field and prospects for the future: challenges in diagnosing HPV + HNC at early stages of the disease, measures to reduce discrepancy in the prevalence of HPV + HNC cases between anatomical sites, and suggestions to assess whether fomites/breast milk can transmit HPV to the oral cavity. Keywords: HPV; oral transmission; head and neck cancers; HPV vaccines; HIV and AIDS; head and neck cancer treatment 1.
    [Show full text]