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Follow-up care after treatment of penile cancer

Intervals

Conservative treatment

Patients having conservative treatment of the primary tumor either by surgery, YAG laser, or radiation therapy, and have remaining epithelial tissue on the glans or inner fold of the prepuce, have a high rate of recurrence.

These patients must have regular follow-up:

  • every 2 months for the first 2 years.
  • every 3 months for the 3rd year and thereafter every 6 months.

It is also very important that the patient learns how to perform self examinations (inspection and inguinal examinations ).

Amputation

Patients treated with a partial or total amputation rarely have local recurrence. During the first 2 years, the risk is greater for developing nodal metastasis.

These patients must have regular follow-up:

  • Every 4 months for the first 2 years.
  • Twice a year in the 3rd year. 
  • Thereafter, yearly.

Positive nodes and metastasis

Patients with positive nodes and metastases when the primary tumor is removed should be monitored:

  • Every 2 months for the first 2 years.
  • Every 3 months the 3rd year. 
  • Every 6 months for the 2 following years.

Inguinal lymphadenectomy

If an inguinal lymphadenectomy has been performed (pN0), a physical examination should be performed:

  • Every 4 years for 2 years.
  • Every 6 months during the 3rd year.
  • Further follow-up is not necessary after the 3rd year.

Inguinal metastasis

Patients having inguinal metastasis at presentation or found during the follow-up period should have a CT of the pelvis/avdomen. Other cases must have follow-up that is individualized.

Local physical examination

  • Anamnesis
  • Inspection of the organ (description, photos, meatus).
  • Palpation of the groins.

Supplementary tests

  • Pelvic and abdominal CT for positive nodes.
  • Chest X-ray for distant metastasis.

Delayed effects

Many patients experience problems pertaining to sexual life after treatment, however, most patients describe their quality of life as satisfactory, according to a study on tumor-free patients in Norway (18, 19).

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