Radiotherapy and Chemotherapy for Non Localised Penile Cancer

If penile cancer has spread beyond the penis and has affected other areas of the body such as your lymph nodes, surgery to remove the lymph nodes followed by external beam radiotherapy and/or chemotherapy may be reccomended

Radiotherapy and chemotherapy can also be used without surgery in cases of more advanced penile cancer.

External beam radiotherapy (radiotherapy applied from outside the body) directs radiation at the cancer. It can shrink areas of cancer which are affecting specific areas of the body. It can also provide relief from symptoms such as pain or discomfort.

For general advice on radiotherapy from NHS Choices please click here.

Fatigue

This may be caused by a combination of both treatment and travel. Getting small restful naps or taking a prescribed mild sedative medication may help. It is best to prepare for this and reduce commitments during treatment.

Skin Reactions

Radiotherapy can irritate the sensitive skin around the penis delaying the healing process.

Vitamin E supplements and topical creams can help and these may be prescribed by the  healthcare team. Men should keep areas that have been exposed to radiotherapy covered and protected from direct sunlight.

For more information on the possible side effects of radiotherapy from NHS Choices, please click here

Lymphoedema

Lymphoedema occurs when lymph fluid (which flows around the body in one direction) accumulates in the groin area and prevents adequate drainage to the lower extremities (usually the legs). This can cause the leg(s) to swell and can sometimes also affect the penis and scrotum.

There is more detailed information on the lymph system here, and how lymphoedema is treated here.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy used for non localised penile cancer is administered directly into the blood stream and is called systemic chemotherapy.

The most common chemotherapy drugs are Cisplatin, 5-Fluorouracil (infusion) and Docataxel. They will usually be administered in ‘cycles’. Cycles are periods when you will be given certain drugs which are then repeated over weeks or months.

Like all medical treatments, chemotherapy can have side effects. These will differ from individual to individual and not everyone will experience the same symptoms. For more information on chemotherapy in general, visit NHS Choices, here.

While chemotherapy drugs are treating cancer cells, they may temporarily reduce the number of normal healthy blood cells. When these become reduced, people will be more at risk of infection and will tire easily.

It is important to let the medical team know if you begin to feel unwell or develop a temperature at any time during treatment. If necessary, antibiotics may be given to treat an infection.

Before starting chemotherapy,men may need to have a hearing test (audiogram) as chemotherapy can affect hearing. A  breathing test may also be performed as some chemotherapy can reduce lung function. While  receiving chemotherapy, blood tests will be taken on a regular basis to monitor general health.

For more information on the possible side effects of chemotherapy from NHS Choices, please click here.

The effects of chemotherapy may take some time to reduce after treatment, perhaps a year or more. Men may feel tired and should take this into account when planning any return to work or other commitments.

Following radiotherapy or chemotherapy treatment, further scans will be performed to see how well the cancer has responded to treatment. These results will help determine whether any further treatment is needed. 

If cancer has spread to other areas or organs of the body, it is called metastatic disease.

Unfortunately, in some cases it is not possible to cure metastatic penile cancer but it may be possible to hold it back to some degree using radiotherapy or chemotherapy. In this situation, care and treatment will be managed by a number of health professionals who will work together to ensure the best possible quality of life.

Some people may be asked to take part in a clinical trial. Some men do this to improve their own situation and some just want to help others. There is more information about clinic trials here.

For information on the type of services that may be available from the NHS to support people going through treatment, please click here.

At Orchid, we are here to support you too. Contact our team of nurses who can answer your questions and listen to your concerns.