Radiation therapy for penile cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation may be used for penile cancer:
- as the primary treatment to destroy cancer cells
- Radiation therapy may be offered to men who wish to preserve the penis, who don’t want to have surgery or who are not eligible for surgery.
- Although radiation therapy allows a man to preserve his penis, the risk of recurrence is higher than if the penis was removed by surgery.
- Radiation therapy appears to be most effective in men who have tumours less than 4 cm in size.
- before surgery to shrink a tumour (neoadjuvant radiation therapy)
- Neoadjuvant radiation therapy may be used in men who have advanced penile cancer involving the lymph nodes or who have a large mass of cancerous lymph nodes in the groin.
- after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant radiation therapy)
- to relieve pain or to control the symptoms of advanced penile cancer (palliative radiation therapy)
- Radiation therapy may be given with chemotherapy.
The amount of radiation given during treatment, and when and how it is given, is often different for each person because it is based on the extent of the tumour. A lead shield may be used to minimize radiation exposure to the testicles in men who wish to preserve their fertility.
External beam radiation therapy
Penile cancer may be treated with external beam radiation therapy. A machine directs radiation to the tumour and some of the surrounding tissue.
External beam radiation therapy usually involves having treatments once a day, 5 days a week. The number of treatments will depend on the size of the tumour and type of penile cancer. Generally, treatment is given for about 4-6 weeks. A mould or special device is often used to keep the penis in place during each treatment.
Men who are not already circumcised should have the procedure done before having external beam radiation. External beam radiation therapy can cause the head of the penis (glans) to become inflamed, which can lead to phimosis (foreskin that does not pull back [retract] fully).
Brachytherapy is internal radiation therapy. Radioactive material (radioactive isotope) is inserted right into, or very close to, the tumour. Radioactive materials can also be placed in the area from where the tumour was removed. The radiation kills the cancer cells over time. Brachytherapy is usually given over 4-7 days. The man remains in bed at the hospital while the radiation is delivered.
Men who are not already circumcised should have the procedure done before having brachytherapy. Circumcision allows the tumour to be fully exposed to the radiation treatment. Like external beam radiation therapy, brachytherapy can cause phimosis (foreskin that does not pull back [retract] fully) in men who are not circumcised.
A catheter will be inserted into the urethra before brachytherapy is given. This helps the doctor to feel exactly where the urethra is while inserting the radioactive material. The catheter is left in place until the treatment is finished to allow the urine to drain.
Interstitial brachytherapy for penile cancer uses hollow, thin needles. A radioactive source is placed into the needles, which deliver radiation directly to the tumour.
Treatment given to shrink a tumour before the first-line therapy (the first or standard treatment), which is usually surgery.
Neoadjuvant therapy may be given if a tumour is too large to be removed by surgery. It may include chemotherapy, radiation therapy or hormone therapy.
Treatment given in addition to the first-line therapy (the first or standard treatment) to help reduce the risk of a disease (such as cancer) coming back (recurring).
Adjuvant therapy is often given when doctors do not know for sure if any cancer cells remain in the body after the first-line therapy.
The tube that carries urine from the bladder to the outside of the body.
In males, the urethra passes through the prostate and penis and carries semen as well as urine. In females, the urethra opens above the vaginal opening.