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Radiation therapy uses high-energy rays or particles to
destroy cancer cells. It can be used to treat some early stage penile
cancers instead of surgery. In cases where cancer has reached several
lymph nodes, radiation may be used along with surgery to remove lymph
nodes to try to reduce the risk the cancer will come back. Radiation
may also be used for advanced cancers to try to slow the growth of the
cancer or to relieve symptoms caused by the cancer.
For uncircumcised men who are going to get radiation to the
penis, circumcision is done first to remove the foreskin. This is
because radiation can cause swelling and constriction of the foreskin,
which could lead to other problems.
There are 2 main ways to get radiation therapy.
External beam radiation therapy
The most common way to get radiation therapy is from carefully
focused beams of radiation aimed at the tumor from a machine outside
the body. The treatment is much like getting an x-ray, but the
radiation is more intense. The procedure itself is painless. Each
treatment lasts only a few minutes, but the setup time -- getting you
into place for treatment -- usually takes longer. Treatments are
usually given 5 days a week for a period of 6 weeks or so.
Brachytherapy
For brachytherapy, a radioactive source is placed into or
right next to the penile tumor. The radiation travels only a short
distance, so nearby healthy tissues don't get much radiation. This type
of treatment is done while you are in the hospital. There are 2 ways to
get brachytherapy for penile cancer.
In one method, known as interstitial
radiation, hollow needles are first placed into the penis
in the operating room. Then tiny pellets of radioactive materials are
put into the needles to treat the tumor. The pellets are kept in place
for several days while they release their radiation. After the
treatment is over, the needles are removed.
Another type of brachytherapy involves putting the radiation
source close to (but not into) the tumor. This is called plesiobrachytherapy.
In this method, a plastic cylinder is placed around the penis and then
another cylinder with a radiation source is placed on top of the first
cylinder. Another way to do this is to make a sponge-like mold of the
penis and put the radioactive material into hollowed-out spaces in the
mold. Treatment is usually done for several days in a row.
Possible side effects of radiation therapy
The main drawback of radiation therapy is that it can destroy
or damage nearby healthy tissue along with the cancer cells. Many men
have side effects such as swelling, redness, and sensitivity. The skin
in the treated area may have patches that are oozing and tender. For
some, the skin may even peel. For a while, you may feel a burning
sensation when you urinate.
Patients treated with brachytherapy will find their side
effects tend to be worse 1 to 2 weeks after the treatment is finished.
If external beam radiation is used, the side effects tend to occur
during treatment and then improve after radiation is stopped. Most
symptoms go away in 1 to 2 months. Over time, men treated with
radiation may notice the skin of the penis has become darker or less
elastic. Tiny web-like blood vessels (called telangiectasia) may
be visible. Some more serious side effects can include:
- destruction (necrosis) of some of the skin or tissue at the
end of the penis
- problems urinating due to narrowing (stenosis) of the
urethra from scar tissue
- development of an abnormal opening (fistula) between the
urethra and skin
In many cases, the function and appearance of the penis
gradually return to normal in the months and years after radiation
therapy. In cases where the tumor has not grown beyond the glans,
radiation is directed only at the tip of the penis, so the ability to
achieve erections should not be affected.
Possible side effects of radiation to the pelvic area and
groin lymph nodes include tiredness, nausea, or diarrhea.
Last Medical Review: 10/07/2009
Last Revised: 10/07/2009
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