An international study suggests a quarter of penis cancer sufferers do not get the recommended treatment.

The survey also found that these patients have about half the survival rate of those who were treated according to guidelines.

The study finds that non-adherence is partly due to patients refusing treatment, or doctors being reluctant to treat appropriately or being unfamiliar with the best procedures.

Cancer of the penis is a frightening prospect. Partially or completely removing the penis is often the most effective way to cure penile cancer, but for many men, this cure seems worse than the disease.

Researchers from 12 centres in Italy, Spain, the USA, Brazil, and Hungary, looked at adherence to the European Association of Urology (EAU) guidelines on the treatment of penile cancer.

They retrospectively examined the records of 425 patients who had been treated in the 2010-2016 period.

“We found that most patients were treated in accordance with the gold-standard EAU recommendations, but around 25 per cent of patients had not received appropriate treatment,” said lead author, Dr Luca Cindolo.

“From our work, we see that around twice as many patients survive if they have been treated according to recommended guidelines.

“In around half of those patients not treated according to guidelines, the decision was made by the doctor, and we suspect that this is because many doctors are unfamiliar with treating this rare, but devastating cancer.

“In one in 6 cases, the patient, or the patient’s carers, made the decision not to be treated according to guidelines. We often find that patients don’t want to be treated, or that the patients’ carers are unwilling to take the decision to treat.

“These are often difficult treatment decisions to take, and so they need to be arrived at after open discussion between the patient and the medical team.

“It’s a condition which most urologists don’t see very often, so it’s best if the medical team is experienced in dealing with the condition. This may mean that the treatment in national or international centres of excellence is the best way to proceed." 

The latest EAU guidelines on penile cancer are accessible here.