Penis

Chapter 8d discusses carcinoma of the penis, which is typically a squamous carcinoma arising on the penile shaft or glands in an uncircumcised patient. Management may be by primary surgery, either total amputation or partial amputation with reconstruction, or primary radiotherapy. Primary radiotherapy is indicated for those patients with T1 and T2 tumours <4 cm in diameter, particularly in those unfit for surgery, those with locally advanced disease and fixed inguinal lymph nodes, and for patients in whom surgical treatment may require total amputation and where they choose to have organ preservation by radiotherapy as an alternative. No randomized trial comparison is available to give accurate figures for the relative efficacy of either treatment. Brachytherapy is an alternative means of delivering high-dose radiotherapy to the penis and may be considered where there is local expertise for this instead of external beam treatment.