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Why is Phimosis a risk factor for Penile Cancer

June 26 2012 at 10:55 PM
matt  (Login johndoe805)

After looking at various sites on the internet , i have come to understand that there are 3 main risk factors for Penile Cancer - Phimois , smoking and HPV infection (in that order of priority). It has been proven that the smegma of a human is non-carcinogenic. Then why is Phimosis a Risk Factor ? Is it because the carcinogens from tobacco and HPV can accumulate under the foreskin ? Or is it because the action of bacteria on smegama can render it Carcinogenic ?
In this posthttp://www.network54.com/Forum/244184/thread/1174627540/last-1177845390/Phimosis
Paul has said that there is not much risk from Phimosis.
But in this post
, he identifies Phimosis to be the number one risk factor. I find these two to be contradictory to each other. Please clarify whether Phimosis complements the actions of tobacco and HPV infection or is Phimosis a risk factor in itself ?
I also want to congratulate you people for the wonderful job that you are doing on this forum. Thanks a lot.

Paul B.
(no login)

Good research there.

June 27 2012, 7:10 AM 

The fact is - both things you discern me as having said, would appear to be true not only back in 2007, but five years later as well.

But they are by no means contradictory!

The American Cancer Society statement now appears on this page but still contains a peculiarly American bias towards circumcision. In particular, there seems to still be a fixation with smegma despite the declaration that no evidence exists to suggest this is involved.

My take on this is (presently) that the connection between phimosis (and smegma) and cancer is probably inverted. Phimosis in this situation is more likely to be secondary to chronic irritation such as from - as we so often discuss here - Candida or other genital infections including interestingly (because in the female equivalent, HPV is a known cause of chronic vulvodynia), HPV and possibly, tobacco usage. The connection with "poor hygiene" generally relates not to washing - as we point out, the penis as with the vagina is largely self-cleaning and rinsing with water is not only sufficient, but the only safe option - but to poor "sexual hygiene" which is to say, multiple partners and lack of condom use.

Smegma production to any disturbing extent, is generally also the result of chronic irritation more often due to soap (by any pseudonym) and in either gender, a self-perpetuating cycle frequently develops with the use of ever more soap attempting to "clean out" the ever more prolific smegma which the soap causes.

It then remains - there is indeed, "not much risk from Phimosis" because there is little risk overall. As long as your phimosis is not the result of unsafe practices. The risk is in failing to avoid or treat the phimosis by treating the cause. In a sense, "phimosis" is so easy to resolve whether by coming here or simply realising by oneself that it just needs to be stretched, that failing to search for a solution is actually an indicator of a "social" risk factor which category certainly includes the other two.

I'm not sure of the exact frame of mind in which I wrote those postings because I suspect I meant to say that having a foreskin is the most obvious risk factor because circumcision removes at least half and more commonly two thirds of the total (mobile) skin of the penis and almost all of the mucous membrane so it must reduce the risk of cancer by at least this proportion - skin you do not have simply cannot develop cancer (nor in the same proportion, can it collect tobacco tars or HPV).

(You don't get breast cancer if you do not have breasts, though in fact men still do have breasts to some extent, some more so than others and do have a small risk.) For that very same argument, it might be expected that circumcised men will have a slightly higher risk of HPV carriage though not much higher simply since the virus is so highly infectious.

And incidentally, HPV is generally considered to be responsible for virtually all cervical cancer (potentiated by tobacco use) as well as the others nominated in those articles, and has even been found as an association with breast cancer.

(Login johndoe805)

Thanks for your response

June 27 2012, 11:07 PM 

Hi Paul,
Thanks for your response. What exactly did you mean by the statement "the connection between phimosis (and smegma) and cancer is probably inverted" ? Am i to take it that you mean the primary cause of penile cancer is genital infection and this coupled with phimosis is a potential risk factor ? Do you mean to say that abstaining from tobacco and not having multiple sexual partners significantly reduces the risk of penile cancer irrespective of whether you have phimosis ?
Is phimosis fairly common among the uncircumcised male population ?
I would also like to know whether there is anyway of cleansing the area under the foreskin for people with Phimosis. I understand that stretching is an effective way to achieve retraction , but in the meanwhile is there any way to maintain hygiene underneath the non-retractile foreskin ?

Paul B.
(Login Paul_B.)


June 28 2012, 6:10 AM 

What I specifically meant to suggest is that phimosis is associated with the development of cancer without being causative, a critical distinction. I am suggesting that the factors which actually cause the cancer - primarily HPV and smoking - cause inflammation which itself frequently results in the phimosis, and that in advance of the much longer progress to cancer.

The real connection with cancer is generally agreed to be chronic inflammation. The error in the argument is to assert that phimosis and smegma cause chronic inflammation when in fact it is the reverse - that is why I also hasten to explain that it is inflammation that results in excess smegma, the smegma in itself being the product.

Hygiene under the foreskin is simple. Wash with water only (How? Just do the "funnel" under the shower) for a start but simply do not smoke - that factor is absolutely simple to avoid (but remember - by far the simplest way to give up smoking is always at the start of the very first cigarette) and practice genuine "safe sex" (something that can certainly be rather controversial at times).

{And some Interesting news just in!}

(Login johndoe805)


July 1 2012, 10:12 PM 

Thanks Paul. I learnt a lot about phimosis after discussing with you. Thanks a lot.

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