Penile Cancer
Penile cancer is a rare but serious malignancy that develops in the skin or tissues of the penis, most commonly as squamous cell carcinoma (SCC).
It is strongly associated with human papillomavirus (HPV) infection, chronic inflammation (such as lichen sclerosus), poor hygiene, smoking, and phimosis (tight foreskin). Early signs include a persistent sore, lump, or abnormal growth on the penis, which may be mistaken for an infection. Early detection is crucial, as advanced disease may require more extensive surgery. Diagnosis typically involves a biopsy, imaging studies, and assessment of lymph node involvement, which plays a key role in treatment planning.
Inguinal Lymph Node Dissection and Sentinel Lymph Node Biopsy
Penile cancer can spread to the inguinal (groin) lymph nodes, and assessing these nodes is essential for staging and prognosis. Sentinel lymph node biopsy (SLNB) is a minimally invasive technique used to identify and remove the first lymph nodes to which cancer may have spread. If sentinel nodes contain cancer, or if there is clinically evident lymph node involvement, a full inguinal lymph node dissection (ILND) may be necessary. ILND involves removing multiple lymph nodes to improve cancer control and reduce the risk of recurrence.
Dr Dewar has training and experience in these procedures. He performs sentinel lymph node biopsy together with an experienced breast cancer surgeon. When lymph node positive disease is present, open inguinal lymph node dissection is necessary. Techniques such as saphenous vein sparing, flap quilting, and vacuum-assisted closure help to minimise post-operative complications.