Prognosis and survival for penile cancer
Men with penile cancer may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a man’s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect a person, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for penile cancer.
The most reliable prognostic factor for penile cancer is the stage of the tumour at the time of diagnosis. As with most cancers, the lower the stage of penile cancer, the better the outcome. Tumours that are on the surface of the skin of the penis have a more favourable prognosis than those that have grown through the skin to underlying tissues or those that have spread to lymph nodes and other organs. When diagnosed at an early stage, penile cancer is usually curable.
Lymph node involvement
Lymph node involvement is related to the stage of the tumour and is an important prognostic factor. Penile cancer that has not spread to lymph nodes has a better prognosis than penile cancer that has spread to lymph nodes.
Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood vessels.
Penile cancers that have a lower grade have a better prognosis than those with a higher grade.
- Well-differentiated and moderately differentiated tumours have a better prognosis than poorly differentiated tumours.
- Low-grade tumours usually occur on the foreskin or glans of the penis. Most tumours that affect the shaft of the penis tend to be higher grade.
- Lymph node metastasis is often related to the grade of the penile tumour. The higher the grade of the tumour, the higher the chance that the lymph nodes contain cancer.
Type of penile cancer
Some types of penile cancer have a better prognosis.
- Warty carcinoma (verruciform), verrucous carcinoma and basal cell carcinoma are usually low grade, rarely spread to other parts of the body and have a good prognosis.
- Basaloid carcinoma, sarcomatoid carcinoma and melanoma of the penis tend to grow and spread more quickly and are often at an advanced stage when diagnosed.
Clinical trial discovery improves quality of life
A clinical trial led by the Society’s NCIC Clinical Trials group found that men with prostate cancer who are treated with intermittent courses of hormone therapy live as long as those receiving continuous therapy.