Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.
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Why Total Penectomy is Still Necessary for Advanced Penis Cancer: Understanding When It’s the Best Option

12 Apr
By Dr. Anup Ramani

Penis cancer is a rare yet serious condition that can significantly impact a patient’s health and quality of life. In its early stages, penis cancer may be managed with less invasive treatments, such as local excision or partial penectomy. However, in more advanced cases, Total Penectomy remains a necessary and life-saving procedure. Understanding why this surgery is still necessary for advanced penis cancer – and when it is considered the best option – can provide clarity for both patients and their families.

In cities like Mumbai, where some of the best medical professionals’ practice, it’s essential to consult a penis cancer surgeon who can provide expert advice on treatment options. This article will explore the reasons why total penectomy remains a vital option for advanced cases of penis cancer and why, in some situations, it may be the best choice for patient survival and overall well-being.

What is Total Penectomy Surgery?

Total penectomy refers to the complete surgical removal of the penis. This procedure is typically performed when cancer has spread extensively and other treatment options are no longer effective. Unlike partial penectomy, which involves removing only part of the penis, total penectomy removes the entire organ, including its tissue and structures.

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Why is Total Penectomy Performed?

  • Advanced Penile Cancer: When cancer has progressed too far to be treated by other means, total penectomy may be necessary to ensure all cancerous tissue is removed.
  • Control of Spread: If the cancer has spread deeply into the tissue or surrounding structures, removing the penis may prevent the cancer from spreading further and protect other organs.
  • Improving Prognosis: In some cases, removing the entire penis offers the best chance of preventing the cancer from returning or metastasizing.
Penectomy Surgery

Though this procedure is emotionally and physically challenging, it remains one of the most effective ways to treat aggressive or advanced penis cancer.

The Role of Total Penectomy Surgery in Advanced Penis Cancer Treatment

Advanced penis cancer surgery occurs when the tumor has grown deeply into the tissue, spread to nearby lymph nodes or reached other parts of the body. In these cases, local treatments like radiation or chemotherapy may not be enough to control the disease. This is where total penectomy becomes a crucial part of the treatment plan.

When is Total Penectomy Necessary?

  • Large or Deep Tumors: If the tumor has become too large or is deeply invasive into the penile tissues, partial penectomy may not be enough to ensure complete removal of the cancer.
  • Lymph Node Involvement: If the cancer has spread to the lymph nodes in the groin or pelvis, removing the penis can help eliminate the main tumor source, preventing further cancer spread.
  • No Other Viable Treatment Options: When the cancer is too advanced for radiation or chemotherapy to be effective, total penectomy is sometimes the only option for controlling the disease.

By removing all the cancerous tissue, total penectomy offers the best chance of survival in these severe cases.

How Total Penectomy Treatment Improves Patient Survival?

While total penectomy is a significant and difficult procedure, it can dramatically improve the survival rates of patients diagnosed with penis cancer treatment. Understanding the procedure’s impact on survival involves considering how it removes all affected tissue and reduces the risk of further cancer spread.

Survival Benefits of Total Penectomy Surgery

  • Prevention of Metastasis: By completely removing the tumor, total penectomy can stop the cancer from spreading to other organs, which is crucial for extending the patient’s life.
  • Lower Recurrence Rates: In some advanced cases, when the cancer is fully removed, the risk of recurrence is significantly lowered, giving patients a better chance of long-term survival.
  • Improved Quality of Life: While the loss of the penis can impact a patient’s emotional and psychological health, removing the cancerous tissue provides a clear path for recovery and future treatments, improving overall life expectancy.
In advanced cases where other treatment options might not offer significant results, total penectomy can be life-saving.

Total Penectomy vs. Partial Penectomy: What’s the Difference?

In some cases, partial penectomy may be sufficient for treating early or less aggressive forms of penis cancer. However, for more advanced cases, total penectomy is often preferred. Here’s how the two procedures differ:

  • Partial Penectomy: Involves the removal of part of the penis, typically done when the cancer is localized and has not spread deeply into surrounding tissues. This option preserves some sexual function but may not be sufficient for larger or more aggressive tumors.
  • Total Penectomy: Involves the removal of the entire penis and any surrounding tissue where cancer may have spread. This option is typically recommended for advanced cancer cases where the tumor has deeply invaded surrounding tissues.

The choice between the two procedures is determined by the extent of the cancer, its location and how far it has spread.

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Psychological and Emotional Impact of Total Penectomy

The decision to undergo total penectomy is life-altering, not only physically but also emotionally. Losing the penis can cause significant emotional distress, including feelings of loss, depression and anxiety. It is crucial for patients to receive adequate psychological support before, during and after the procedure.

Psychosocial Support during Treatment

  • Preoperative Counseling: Patients should have access to mental health support before surgery to address concerns and expectations. Counseling can help patients process the emotional aspects of the surgery and prepare for the changes in their lives.
  • Postoperative Therapy: After surgery, patients may benefit from continued counseling or support groups to help them cope with the physical and psychological changes following total penectomy.
Having access to a support system and professional mental health care can greatly help patients adjust to life after surgery.

Penis Cancer Treatment Options in Mumbai

Mumbai is home to some of the best penis cancer surgeons in India, offering a variety of treatment options for patients diagnosed with penis cancer. Treatment plans may include:

  • Surgical Options: In addition to total penectomy, other surgical treatments include partial penectomy and lymph node removal if cancer has spread.
  • Radiation Therapy: For smaller, localized tumors, radiation can be used as a non-invasive treatment to shrink the tumor.
  • Chemotherapy: Chemotherapy may be used in conjunction with surgery to treat more advanced cases and prevent recurrence.

Dr Anup Ramani, Penis cancer specialists in Mumbai can provide patients with personalized treatment plans tailored to the stage of the cancer and the patient’s overall health.

FAQs About Penis Cancer Treatment

Total penectomy is a surgical procedure where the entire penis is removed, typically in cases of advanced or aggressive penis cancer.

Total penectomy is necessary when the cancer has spread too deeply into the tissue, has affected nearby lymph nodes or is unresponsive to other treatments like radiation or chemotherapy.

By removing all cancerous tissue, total penectomy prevents the spread of cancer and reduces the chances of recurrence, improving the patient’s long-term survival prospects.

Losing the penis can have significant emotional effects, such as depression and anxiety. Psychological counseling and support are essential for patients to cope with these changes.

Alternatives include partial penectomy for less advanced cancers, as well as non-surgical treatments like radiation or chemotherapy, depending on the cancer’s stage.

Conclusion

While the loss of the penis due to total penectomy is a daunting reality, it remains one of the most effective options for treating advanced penis cancer. When other treatments fail or when the cancer has spread, total penectomy offers the best chance of survival and disease control. Dr. Anup Ramani offers best Penis Cancer treatment in Mumbai which can have access to medical care, ensuring that they receive the best possible treatment for their condition.

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Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.

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PARTIAL PENECTOMY
  • Partial penectomy is done in cases where glans and distal penis is involved with carcinoma. 
  • Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
  • Patients who develop stones in the kidney or ureter, often experience severe pain.
  • This condition usually needs a procedure to remove the kidney stones.
  • This procedure is called ureteroscopy and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
  • The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
  • The procedure takes about 40-50 minutes. 
  • A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is one night and patient is discharged the next day after removal of the catheter.
  • Patient has to come back after six weeks to remove the stent in the kidney.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
  • Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
  • This procedure is called TURP and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
  • The overgrown prostate is dissolved with a laser bloodlessly.
  • The procedure takes about 40 minutes.
  • A catheter (urine pipe) is kept after the procedure to drain the bladder.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR

  • Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.

  • Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.

  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).

  • Dr. Ramani then sits in the controlling console to perform the surgery.

  • On an average, a robotic adrenalectomy takes one hour.

  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.

  • A urine catheter and bag to drain the bladder is inserted during surgery.

  • A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.

  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.

  • The drain pipe, if kept, is removed in the room on day 2 after surgery.

  • The catheter is removed on day two after surgery.

  • Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).

  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.

RETURN TO ACTIVITY

  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.

  • Heavy activities like running, weight lifting can be resumed after a month

FOLLOW UP AFTER SURGERY

  • Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
    Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consultation.

ROBOTIC SURGERY FOR BLADDER CANCER
  • Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
  • Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
  • Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the new bladder is inserted during surgery.
  • Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
  • The drain pipes are removed in the room on day 3-5 after surgery.
  • Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
  • Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY

  • Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.

  • Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.

  • If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.

ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
  • Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
  • relatively easier but still requires significant experience to consistently deliver results.
  • Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the bladder is inserted during surgery.
  • A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
  • The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
  • Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self- sufficient. 
  • They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. 
  • Almost all patients are back to work within 2-3 weeks of surgery.
  • Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
  • Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
  • Local patients usually meet Dr. Ramani after two weeks to discuss report. 
  • Outstation patients are counselled on a phone consultation.