Radiotherapy (also called radiation therapy) is the use of high-energy x-rays to kill cancer cells.
There are two ways that radiotherapy can be used for localised penile cancer (cancer that has not spread beyond the penis). This page describes both external beam radiotherapy and brachytherapy, which can both be used instead of surgery.
External beam radiotherapy can be used instead of surgery on localised penile cancer. It can also be used to treat other areas of the body that may have been affected by penile cancer.
Before radiotherapy, the medical team will take care to identify the precise area to be treated. They will do this using scans such as CT and MRI scans. Once the treatment location has been established, small ink marks will be placed on the target treatment area.
Men will need to have a circumcision (surgery to remove the foreskin) which will reduce the chance of skin swelling and irritation which may affect the penis as a result of treatment.
This treatment involves radiation being beamed at cancer by an external machine. Treatment tends to be given over a six week period in short doses (10-15 minutes).
If the cancer is no more than 4cm in size, brachytherapy may be used. There are two ways to deliver this type of radiotherapy.
Men will be given a general anaesethic. During treatment, radioactive needles are positioned through the penis and small radioactive pellets inserted near to the cancerous areas. The needles need to stay in place for up to seven days and men will need to stay in bed in hospital. Children and pregnant women cannot visit for a while following this treatment. To protect urinary function and allow urination while the needles are in place, a urinary catheter will be inserted.
After seven days, men will be given another general anaesthetic and the needles and catheter will be removed.
A special plastic mould is made in the shape of the penis. This can be fitted over the penis and small radioactive wires attached to the penile tissue around the cancerous area. Radiation is administered through the wires. This type of treatment can be performed on a daily basis over several days.
This may be caused by a combination of both treatment and travel. Getting small, restful naps or taking a mild sedative medication may help. It is best to prepare for this and reduce commitments during treatment.
Radiotherapy can irritate the sensitive skin around the penis and the blood supply to the penis may be reduced. These symptoms tend to occur 2-3 weeks from starting external beam radiotherapy and 2-3 weeks after brachytherapy.
Vitamin E supplements and topical creams can help the healing process 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.
Radiotherapy can sometimes cause the tissue of the penis to become thicker and this can cause a narrowing or ‘stricture’ of the urethra. This might cause the urinary stream to spray. If this occurs, a minor operation can sometimes be performed to widen the urethra.
There are also several types of urinary funnel that can help control the flow of urine.
The following devices are available from Beambridge Medical on prescription.
Male funnel
Male funnel mini
Flexi funnel
Youth funnel
Female funnel
Whiz freedom
Shewee
Other funnels, including disposable ones, can be found on different online shopping channels but these are not available on prescription.
It is also possible to purchase a special key (RADAR Key) which allows anyone who needs to urinate more frequently to access more facilities. These can be purchased from Disability Rights
A toilet card can also be obtained which may allow access otherwise to otherwise private amenities such as toilets in shops. Further information can be found here.
