GP focus with Dr Richard Russell (Prostate, Penile and Testicular cancers)

Our GPs are an important part of Bay Health Care Partners and here our GPs and primary care colleagues have the opportunity to talk about issues and specialties that they are working on or interested in.

To mark Orchid Male Cancer Awareness Week (12-18 September 2022), Dr Richard Russell talks to us about the causes and symptoms of prostate, penile and testicular cancers.

If you are experiencing any of the symptoms mentioned below and you think you may have cancer it’s really important not to ignore them and to contact your GP to make an appointment.

You may feel embarrassed or worried but these are completely normal feelings and your GP is there to support you.
The important thing to remember is that finding cancer early can make it more treatable. If you are experiencing any of the symptoms mentioned below and you think you may have cancer it’s really important not to ignore them and to contact your GP to make an appointment.

You may feel embarrassed or worried but these are completely normal feelings and your GP is there to support you.
The important thing to remember is that finding cancer early can make it more treatable.

Prostate cancer

What are the causes of prostate cancer?

The causes of prostate cancer are largely unknown but there are certain things that can increase your risk of developing the condition. They include:

• Age (men over the age of 50 are more commonly affected).
• Family history (having a father or brother with prostate cancer increases your risk).
• Family history of breast cancer (The risk of prostate cancer increases slightly in men who have a strong family history of female breast cancer).
• Ethnicity (Men of African-Caribbean descent are more likely to develop prostate cancer than Caucasian men and are more likely to die from the condition).
• Diet and exercise (a lack of exercise and a diet high in saturated fats and red meat is thought to lead to an increased risk of developing several cancers and may contribute to the development of prostate cancer).

Symptoms of prostate cancer may include the following:

•  Slow or weak flow of urine.
• Urinating more frequently or urgently than usual.
• Difficulty starting to urinate.
• Pain or burning sensation when urinating.
• Unexplained urinary infection. You can find out more about prostate cancer at Orchid’s website here and the NHS website here.

Penile cancer
What are the causes of penile cancer?
The causes and the way penile cancer develops are not fully understood, however, there are some factors which seem to increase the risk of developing the disease.

• Human Papilloma Virus (HPV) (around 40 types of HPV are transmitted via sexual intercourse and there are several types which are considered high-risk viruses and are linked with the development of cancers in the anus, penis, throat and cervix).
• The presence of foreskin (Penile cancer is virtually unknown in men who have been circumcised as a child, however circumcision in later life does not reduce the risk of penile cancer).
• Phimosis (the inability to pull back or retract the foreskin fully).
• Smoking (Some studies have suggested that smoking may increase the chance of developing penile cancer).
• Psoralen-UV-A Photochemotherapy (PUVA) (used to treat some forms of the skin disease psoriasis, as well as some types of cancer, has been linked to the development of penile cancer).

Possible symptoms of penile cancer

• A growth or ulcer on the penis, especially on the glands or foreskin.
• Changes in the colour of the penis.
• Skin thickening on the penis.
• Persistent discharge with foul odour beneath the foreskin.
• Blood coming from the tip of the penis or under the foreskin.
• Unexplained pain in the shaft or tip of the penis.
• Irregular or growing bluish-brown flat lesions or marks beneath the foreskin or on the body of the penis.
• Reddish, velvety rash beneath the foreskin.
• Small, crusty bumps beneath the foreskin.

Irregular swelling at the end of the penis. You can find out more about penile cancer at Orchid’s website here and the NHS website here.

Testicular cancer
What are the causes of testicular cancer?
Unlike many cancers, there are few known strong risk factors for testicular cancer. While most of these cancers occur in unsuspecting individuals, some risk factors can be traced in a minority of cases.
These include:

• Men born with an undescended testicle (cryptorchidism) where the testicle fails to descend into the scrotum.
• Pre-cancerous cells found inside the testicle known as carcinoma in situ (CIS).
• A brother or father affected by testicular cancer.
• A previous history of testicular cancer.
• Research suggests that testicular cancer is slightly more common in men who have fertility problems resulting in poor or abnormal sperm.
• Caucasian men have a higher risk of testicular cancer than men from other ethnic groups.
• Men with HIV are more likely to develop testicular cancer.

Signs and symptoms of testicular cancer

• A small pea-sized lump can be felt in around 90% of cases and in over 80% of cases, this will be painless.
• Dragging sensation, ache or pain (more common in non-cancerous conditions).
• Recent history of trauma (10%), leading to examination and discovery of a lump.
• Breast swelling or tenderness (called gynaecomastia). This is rare but may be caused by hormones which are produced by some types of testicular cancer. Similar symptoms can be caused simply by body changes during puberty.
• Back pain caused by enlarged lymph nodes in the back.
• You can find out more about testicular cancer and diagrams of how to examine your testicles at Orchid’s website here and the NHS website here.