Procedure
For penile cancer, radiotherapy is either an alternative to surgery or is used when surgery is not possible. Sometimes radiotherapy is also recommended as an additional treatment before or after surgery. Radiotherapy is often combined with chemotherapy to improve its effectiveness.
So-called curative radiotherapy is used to cure penile cancer, either alone or in combination with surgery and drug therapy. If the cancer has already spread, so-called palliative radiotherapy can prevent or alleviate the symptoms caused by local tumor growth or metastases.
Each patient is discussed in detail by a panel of experts from all relevant specialist areas. After this discussion, the optimal treatment choice is presented to the patient and their wishes and opinions are taken into account. Personal support is a matter of course for us.
Types of radiotherapy for penile cancer
Two types of radiotherapy can be used for penile cancer: external and internal.
In external radiotherapy, a linear accelerator is used to send high-energy X-rays to the tumor or remaining tumor cells in order to kill them in a targeted manner. External radiation therapy is carried out as an outpatient treatment, does not require anesthesia and can be easily integrated into everyday private and professional life. The treatments are not painful and each session only takes a few minutes. As a rule, it is carried out once a day for five weeks. The treatment only takes place on weekdays, therefore five times a week. The treatment only takes place on weekdays, therefore five times a week. Shielding can be used to protect the testicles At the USZ, we use only the latest technology to achieve personalized and precise dose distribution in the tissue.
Internal radiotherapy or brachytherapy can be carried out either on an outpatient basis or during a short admission to our department. Brachytherapy is a clinical and scientific focus of Primoz Petric, an internationally recognized expert in this field, who shares his knowledge at international congresses, courses and through publications. During brachytherapy, the radiation source is inserted in or near the penile cancer. Sometimes a short anesthetic is necessary for this. The rays only travel a short distance, so that the tumor cells are destroyed at close range while the healthy tissue is spared. After treatment, the source is removed. The USZ uses the latest technology of magnetic resonance or computer tomography-guided brachytherapy. This technique enables highly precise and personalized delivery of the radiation dose to the tumor and maximum protection of healthy tissue.
They are supervised by internationally recognized experts. Radiotherapy using modern image-guided technology is a clinical and scientific focus of our team members. We also work closely with our colleagues in urology and medical oncology to guarantee “one-stop” treatment.
The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise and low side-effect radiation treatment of uterine cancer. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.
Operable penile cancer
If the penile cancer has only grown in the upper layers of the skin and has not spread to nearby lymph nodes, then in most cases surgery can be performed to preserve the penis. For these tumors, the choice is between limited surgery with or without additional radiation or radiation therapy alone to preserve penile shape, function or both while curing the cancer.
If the tumor characteristics determined after the surgical procedure are unfavorable, additional postoperative radiotherapy with or without chemotherapy is sometimes required to improve the treatment outcome. In these cases, a five-week course of external radiation therapy is typically used. Preoperative radiotherapy is sometimes recommended before the operation in order to shrink the tumor and enable organ-preserving surgery.
However, surgery can also be avoided in the case of early-stage penile cancer. In this case, instead of surgery, the patient only receives external radiation therapy with simultaneous chemotherapy, followed in certain situations by brachytherapy. This type of radiotherapy is known as definitive radiotherapy. An important advantage of preoperative, postoperative or curative radiotherapy is that it sometimes makes it possible to preserve the penis.
Inoperable penile cancer
In a situation where surgery is not an option, for example because the tumor is too large or there are already large lymph node metastases in the groin, radiotherapy can often be carried out. Radiotherapy can be combined with chemotherapy to improve its effectiveness. This can either be carried out as a definitive treatment or, in selected cases, reduce the size of the tumor to such an extent that surgery is possible.
Metastases of penile cancer, e.g. in the brain or bones
Penile cancer is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.
For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery.
Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic penile cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.
State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee treatment “from a single source”. We also consult with our colleagues in palliative medicine at an early stage.
In clinical trials, we are continuously trying to improve the treatment of penile cancer in order to make it even more effective and tolerable. To the overview of currently open studies.