Penile Cancer
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Table 13.5. Possible side effects of chemotherapy
Penile carcinoma is an uncommon malignancy. Treatment options include surgery, radiotherapy and chemotherapy. Chemotherapy should preferably be given in the context of clinical trials. Adjuvant chemotherapy consisting of two cycles of cisplatin and 5-fluorouracil may be sufficient. The combination chemotherapy regimen with vincristine, methotrexate, and bleomycin given once a week for 12 weeks on an outpatient basis appears to be a promising option. Neoadjuvant chemotherapy may be administered to patients with fixed inguinal nodes and includes three or four cycles of cisplatin and 5-fluorouracil. Chemotherapy for advanced penile cancer has not been widely used. The most commonly used combinations are cisplatin and 5-fluorouracil and cisplatin, bleomycin, and methotrexate. The response rates of both treatment combinations are similar, but the tolerability is much better with no treatment-related deaths in patients treated with cisplatin and 5-fluorouracil.44 An emphasis of future research should be to reduce toxicity. New combinations are currently tested in clinical trials, e.g., taxane-based chemotherapy.
• Pain
• Nausea and vomiting • Diarrhea or constipation • Anemia
• Malnutrition • Hair loss
• Memory loss
• Depression of the immune system, hence (potentially lethal) infections and sepsis
• Weight loss or gain • Hemorrhage
• Secondary neoplasms • Cardiotoxicity
• Hepatotoxicity • Nephrotoxicity • Ototoxicity
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Side Effects of Chemotherapy
Chemotherapy can be physically exhausting for the patient. Side effects mainly affect the fastdividing cells of the body. Table 13.5 presents possible side effects of chemotherapy (dependent on the agent).
Conclusion
Chemotherapy is evolving in the management of urologic malignancies. Urologists and oncologists should work together to optimize patient care. Further investigations and randomized studies are required to clarify the exact role of chemotherapy in urologic oncology.More insight in the molecular biology of the urologic tumors will lead in the future to the development of more effective drugs or combinations with better tolerability profile.
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