DEAR DR. ROACH: What can you tell me about cancer of the penis? I can’t seem to find information. — S.S.
ANSWER: Cancer of the penis is quite rare in industrialized nations, accounting for less than 1% of all cancers in men. By contrast, it is quite common in parts of Africa, Asia and South America, where it can account for 10% to 20% of all cancers.
One risk factor is phimosis, an inability to retract the foreskin. Circumcision decreases risk of penile cancer, but careful lifelong hygiene (thus avoiding phimosis) reduces the risk of penile cancer to the same level as seen in circumcised men. Human papillomavirus is another risk factor, found in 30% to 50% of penile cancers. HIV infection and tobacco use are other risk factors.
Surgery is the standard treatment for cancer of the penis. The goal of treatment is to preserve as much of the penis as possible in order to maintain sexual and urinary function. There are alternative treatments, including topical medications, radiation and laser treatment. Finding a cancer center with experience in treating penile cancer would be ideal. With only about 2,000 cases per year in the U.S., even many urologists have limited experience.
DEAR DR. ROACH: As a person suffering from celiac disease, I must be careful with every morsel I put into my mouth. That includes medications, and I am having difficulty finding a list of gluten-free drug manufacturers. I called my pharmacist and was told to ask my doctor. My doctor didn’t seem to have the answers, either. I even consulted a Physicians Desk Reference but could not locate gluten-free medications or manufacturers. Surely someone has the information handy. Can you help me? — L.N.