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Chemotherapy (often called "chemo") is the use of drugs for
treating cancer. Two types of chemotherapy that may be used in treating
penile cancer are topical chemotherapy and systemic chemotherapy.
Topical chemotherapy
Topical chemotherapy means that an anticancer medicine is
placed directly onto the skin instead of being given by mouth or
injected into a vein. The drug most often used in topical treatment of
penile cancer is 5-fluorouracil (5-FU).
When applied directly onto the skin in the form of a topical
cream, 5-FU is not absorbed. It reaches cancer cells near the skin
surface but cannot reach cancer cells that have invaded deeply into the
skin or spread to other organs. For this reason, treatment with 5-FU
generally is used only for premalignant conditions or carcinoma in situ
(Tis, stage 0).
One of its main advantages is that the drug does not spread
throughout the body. This means that the side effects that often occur
with systemic chemotherapy do not occur with topical chemotherapy.
After treatment, a biopsy is done. If cancer remains, surgery is
recommended.
Treatment with 5-FU cream causes the treated skin to be red
and sensitive for a few weeks. Use of other topical medicines or creams
can help relieve these side effects.
Systemic chemotherapy
Systemic chemotherapy uses anticancer drugs that are injected
into a vein or given by mouth. These drugs enter the bloodstream to
reach cancer cells in all areas of the body. This treatment is useful
for cancers that have spread (metastasized) to lymph nodes or distant
organs.
One or more chemotherapy drugs may be used to treat penile
cancer that has spread to other organs. The following combinations of
chemotherapy drugs have been used:
- cisplatin and fluorouracil (5-FU)
- vincristine, methotrexate, and bleomycin
- carboplatin and paclitaxel (Taxol)
Chemotherapy can shrink cancers before surgery to make them
easier to remove. It's also used for advanced penile cancers to shrink
tumors and relieve some symptoms. These drugs are also being studied to
see if giving them after surgery will keep the cancer from coming back
and improve survival.
Chemotherapy drugs kill cancer cells but also damage some
normal cells. So it's important to avoid or minimize side effects,
which depend on the specific drugs, the amount taken, and the length of
treatment. Temporary side effects might include nausea and vomiting,
loss of appetite, loss of hair, and mouth sores. The drug cisplatin can
cause nerve damage (neuropathy) and kidney damage (nephropathy). The
nerve damage can cause problems with numbness and tingling in the hands
and feet. Doctors give a lot of intravenous (IV) fluid with cisplatin
to help prevent the kidney damage. Fluorouracil can cause sores in the
mouth (mucositis) that can make it hard to eat. This drug can also
cause diarrhea. Vincristine and paclitaxel also can cause nerve damage.
A rare side effect of bleomycin is lung damage, which can lead to
problems breathing. Be sure to tell your cancer care team if you are
having side effects because they can be prevented or managed.
Because chemotherapy can damage the blood-producing cells of
the bone marrow, patients may have low blood cell counts that can
result in:
- increased chance of infection (due to a shortage of white
blood cells)
- bleeding or bruising after minor cuts or injuries (due to a
shortage of blood platelets)
- fatigue or shortness of breath (due to low red blood cell
counts)
Most side effects disappear once treatment is stopped. Hair
will grow back after treatment ends. There are remedies for many of the
temporary side effects of chemotherapy, so you should not hesitate to
discuss them with your cancer care team. For example, anti-nausea drugs
can be given to prevent or reduce nausea and vomiting. Other drugs can
be given to boost the blood cells.
Last Medical Review: 07/11/2008
Last Revised: 05/13/2009
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