Showing posts with label penile cancer. Show all posts
Showing posts with label penile cancer. Show all posts

Wednesday, April 9, 2014

WELLINGTON, NZ: Morris's latest claim "extremely worrying" - Paediatric Prof.

MSN Health NZ
April 3, 2014

NZ academic questions circumcision study

A New Zealand academic says the authors of a study suggesting male circumcision has major health benefits have confused cleanliness with godliness.

The study of American data suggested half of uncircumcised men would contract an adverse medical condition caused by their foreskin during their life, and that the benefits of circumcision exceeded the risks by 100 to one.

Professor Brian Morris of the University of Sydney said infant circumcision should be regarded as equivalent to childhood vaccination, and as such it would be unethical not to routinely offer parents circumcision for their baby boy.

But Professor Kevin Pringle, the Professor of Paediatrics and Head of Obstetrics and Gynaecology at the University of Otago in Wellington, says he found the paper extremely worrying.

Prof Pringle says the report quotes a more than 20-fold increase in the risk of penile cancer for uncircumcised men, but the figures didn't agree.

"In fact, the incidence of penile cancer in Israel (almost 100 per cent of males circumcised) is about the same as that in Scandinavia (circumcision the exception), suggesting that it is cleanliness, rather than godliness that is important," he said.

Prof Pringle said the authors overestimated the level of cases of two other conditions, phimosis and balanitis, and said 80 per cent of children with phimosis respond to the application of a steroid cream. Only a small percentage needed a circumcision.

Prof Pringle said the comparison with vaccination was inappropriate as most of the diseases for which infants are vaccinated are potentially lethal or produce significant handicap.

"Circumcision is an intervention with significant risks (ignored or minimised by the authors of this paper) to prevent problems that will not develop in the vast majority of males."

Monday, March 17, 2014

BRITAIN: Penile cancer rises

"Soared" from 1.10 to 1.33 per 100,000/yr, and the mortality rate fell by 20%

Daily Mail
February 18, 2014

The rise of PENIS cancer: Cases soar by 20% amidst fears that symptoms are being misdiagnosed as STDs

  • Number of men diagnosed with disease has risen dramatically in 30 years
  • May be due to changes in sexual behaviour, greater exposure to the human papilloma virus and[/or] decreasing rates of childhood circumcision
  • Men who smoke are also more likely to get penile cancer
by Anna Hodgekiss
The number of men being diagnosed with cancer of the penis has soared by 20 per cent in the last 30 years, according to new figures.

Experts believe the main reasons for the increase may be changes in sexual behaviour, greater exposure to sexually transmitted HPV (human papilloma virus) and[/or] decreasing rates of childhood circumcision.

HPV-related genital warts are associated with a six-fold risk of penile cancer and the incidence of them has rapidly increased in men between 1970 to 2009, with a 30 per cent rise during 2000–2009.

Cancer charities are now urging men to be aware of symptoms of the disease - which are often confused with signs of a sexually transmitted infection.

Penile cancer has a high cure rate if detected early, but some men, such as Nigel Smith, from Wolverhampton, are misdiagnosed.

He was told at a sexual health clinic that he had a genital wart that would go away in time.

It didn't, but rather than seek help, Nigel hid his symptoms from his wife for 12 months by sleeping in their spare bedroom, using his snoring as an excuse.

He was eventually diagnosed with penile cancer in 2011, aged 58, and last year underwent a partial penectomy (partial removal of the penis). He is currently considering reconstructive surgery.

...
PENILE CANCER SYMPTOMS
  • A painless lump or ulcer on the penis that doesn't heal
  • Bleeding
  • A red rash under the foreskin
  • Flat growths of brownish colour
  • Difficulty in drawing back the foreskin
  • Unusual smelling discharge from under the foreskin
  • Unexplained change in colour of the skin
  • Swollen lymph nodes in your groin area
...

The new research, published in the journal Cancer Causes Control, was supported by the male cancer charity Orchid.

Cancer Causes Control. 2013 Dec;24(12):2169-76. doi: 10.1007/s10552-013-0293-y. Epub 2013 Oct 8.
Long-term trends in incidence, survival and mortality of primary penile cancer in England.
Arya M, Li R, Pegler K, Sangar V, Kelly JD, Minhas S, Muneer A, Coleman MP.
PURPOSE:
Few population-based studies exist of long-term trends in penile cancer. We report incidence and mortality trends in England over the 31 years 1979-2009 and survival trends over the 40 years 1971-2010.
METHODS:
We calculated annual incidence and mortality rates per 100,000 by age and calendar period. We estimated incidence and mortality rate ratios for cohorts born since 1890, and one- and five-year relative survival (%) by age and deprivation category.
RESULTS:
A total of 9,690 men were diagnosed with penile cancer during 1979-2009. Age-standardized incidence rates increased by 21 %, from 1.10 to 1.33 per 100,000. Mortality rates fell by 20 % after 1994, from 0.39 to 0.31 per 100,000. Survival analyses included 11,478 men diagnosed during 1971-2010. Five-year relative survival increased from 61.4 to 70.2 %. Five-year survival for men diagnosed 2006-2010 was 77 % for men aged under 60 years and 53 % for men aged 80-99 years. The 8 % difference in five-year survival (66-74 %) between men in the most affluent and most deprived groups was not statistically significant.
CONCLUSIONS:
The 21 % increase in penile cancer incidence in England since the 1970s may be explained by changes in sexual practice, greater exposure to sexually transmitted oncogenic human papilloma viruses, and[/or] decreasing rates of childhood circumcision. Improvement in survival is likely due to advances in diagnostic, staging and surgical techniques. There is a need for public health education and potential preventative strategies to address the increasing incidence.
PMID: 24101363 [PubMed - in process]

The charity's chief executive, Rebecca Porta, said: 'The research shows that the incidence of this devastating cancer, which currently receives little recognition, is on the increase.

'Unlike other more common cancers, penile cancer is rare and many men feel embarrassed and unable to talk openly about it.

...

Cancer can develop anywhere in the penis, but the most common places are under the foreskin and on the head (the glans).

The exact cause of penile cancer is unknown, but various factors have been linked to an increased risk.

HPV-related genital warts are associated with a six-fold risk of penile cancer. There are over 100 types of HPV virus and only two strains have been linked with penile cancer. However both these strains are also linked to throat, cervical and anal cancer.

rates of childhood circumcision

A man’s risk of developing cancer of the penis is greater if he smokes. It has been suggested that smoking may act as a co-factor that modulates the risk of progression from HPV infection to premalignant lesions and invasive penile cancer.

Furthermore, the toxic chemicals found in tobacco are excreted in the urine. A build up of these substances under the foreskin may cause changes in the normal healthy cells of the skin, which may lead to cancerous cells developing.

Men who are uncircumcised are also at greater risk. This is because they may find it more difficult to pull back the foreskin enough to clean thoroughly underneath, resulting in poor hygiene. [Or they may just not bother.]

This may lead to a build up of chemical substances that may cause irritation of the skin and lead to cancerous changes.

Saturday, November 16, 2013

FRANKFORT, KENTUCKY: Doctor failed to check under foreskin for cancer, gets off

Fox17
November 15, 2013

Ky. high court turns away penis amputation lawsuit

FRANKFORT, Ky. (AP) -- A Kentucky man who sought damages from a doctor who removed a cancer-riddled section of his penis during what was scheduled to be a simple circumcision has lost his final appeal.

The Kentucky Supreme Court opted not to take up the case of Phillip Seaton of Waddy. The court did not comment on its reasons for turning down the case.
 
Seaton sued Dr. John Patterson over the amputation.

A jury in Shelby County ruled in favor of Patterson at trial. The Kentucky Court of Appeals upheld that decision, finding that the jury correctly concluded that Seaton consented to allow Patterson to perform any procedure deemed necessary during the Oct. 19, 2007, surgery.

The Seatons also sued Jewish Hospital, where the surgery took place. The hospital settled with the couple for an undisclosed amount.

Earlier story

Saturday, January 5, 2013

LOUISVILLE, KY: Court finds for doctor who amputated penis during circumcision

NBC News
December 21, 2012

Court backs doctor in penis amputation case

by Brett Barrouquere
LOUISVILLE, Ky. — A Kentucky man lost his bid Friday to force a doctor to pay damages for removing a cancer-riddled section of his penis during what was scheduled to be a simple circumcision.

The Kentucky Court of Appeals found that a jury correctly concluded that 66-year-old Phillip Seaton of Waddy consented to allow Dr. John Patterson to perform any procedure deemed necessary during the Oct. 19, 2007, surgery.

Patterson, a Kentucky-based urologist, maintains he found cancer in the man's penis during surgery and that it had to be removed. The patient claims the surgery was supposed to be a circumcision and he never authorized the amputation, nor was he given a chance to seek a second opinion.
[Why was the cancer not found well before the circumcision had begun? Did nobody look under his foreskin earlier?]

"Additionally, there is uncontroverted testimony in the record that if Mr. Seaton were not treated for the penile cancer, it would prove fatal in the future," Judge Janet Stumbo wrote for the court.

Judge Michael Caperton dissented, but did not issue a written opinion.

Clay Robinson, a Lexington-based attorney for Patterson, said the opinion was "very well-reasoned" and fact-based. [Would the attorney for the doctor have been so laudatory if the decision had gone the other way?]

"You always appreciate when you see judges at any level go into that amount of detail," Robinson said.

Seaton and his wife, Deborah, sued Patterson, a Kentucky-based urologist, in Shelby County Circuit Court in 2008. Seaton was having the procedure to better treat inflammation. The Seatons also sued Jewish Hospital, where the surgery took place. The hospital settled with the couple for an undisclosed amount.
Both sides agree that Seaton had squamous cell carcinoma, a type of skin cancer, in his penis. Patterson concluded that a tumor had overtaken much of the top of the organ, which made it impossible to insert a catheter.

"He also opined that serious complications and additional surgery could result if he did not insert the catheter," Stumbo wrote.

The main point of contention is whether Patterson acted reasonably in removing the organ immediately or if amputation could have been delayed to let Seaton seek other medical options.

Stumbo and Judge Donna Dixon concluded that, even though Seaton had limited ability to read and write, he never informed the doctor of that fact and signed the consent form in the presence of a witness. The Seatons claimed that the waiver didn't give Patterson authority to conduct an amputation without further consent.

"They maintain that no harm would have resulted if Dr. Patterson has consulted with either of them before proceeding, or if he had allowed them to consult with another physician to get a second opinion or other treatment options," Stumbo wrote.

Stumbo wrote that Patterson acted properly because the tumor had consumed such a large section of the organ.
...