Cancer of the penis warrants surgery

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: I have a deviated septum and chronic seasonal allergies. I’m glad I read your recent column on oxymetazoline in nasal sprays.

I promptly discarded my nasal spray, which contained that active ingredient.

I’ve used a different spray that has phenylephrine hydrochloride 1%. Is this safe to use?

J.N.

Answer: Phenylephrine is a nasal decongestant, and all of these may cause the same problem, called rhinitis medicamentosa, if used too long or too frequently. They are safe and effective only if used for no more than a few days.

Nasal steroids are the most effective treatment for chronic seasonal allergies, but there are alternatives available from your family physician or ENT specialist.

Readers may email questions to: ToYourGoodHealth@med .cornell.edu or mail questions to 628 Virginia Dr., Orlando, FL 32803.