Appointment sheet
Localised penile cancer (organ-confined, node-negative)
Prepared with OnCo (onco.cc/prep/localised-penile-cancer/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
16 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example p16 immunohistochemistry and HPV DNA, Grade and lymphovascular invasion of the primary, Depth and stageof the primary, Surgical margin status, Dynamic sentinel node biopsy result), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Penile intraepithelial neoplasia
- 5.For my situation (penile intraepithelial neoplasia), which of the standard options do you recommend and why?
- 6.Am I a candidate for Fluorouracil (5-FU), and what side effects should I expect?
T1 to T2 tumours
- 7.For my situation (t1 to t2 tumours), which of the standard options do you recommend and why?
Clinically negative groins
- 8.For my situation (clinically negative groins), which of the standard options do you recommend and why?
Prevention
- 9.For my situation (prevention), which of the standard options do you recommend and why?
- 10.Am I a candidate for Nonavalent HPV vaccine, and what side effects should I expect?
- 11.How do the results of A Phase III Study to Evaluate the Efficacy, Immunogenicity and Safety of the 9-valent HPV Vaccine in Chinese Males apply to someone like me?
Any stage
- 12.Are there clinical trials I could join, for example of HPV & HBV vaccination, A Phase III Study to Evaluate the Efficacy, Immunogenicity and Safety of the 9-valent HPV Vaccine in Chinese Males?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “Local recurrence after organ-sparing surgery is common and needs long follow-up”. How does that affect my plan?
- 16.I read that “Sentinel node biopsy misses some metastases, and the false-negative rate depends on centre experience”. How does that affect my plan?
The words I may hear
- Mohs surgery: Skin cancer surgery in which the tumour is removed in thin layers, each checked under the microscope on the spot, until the edges are clear; it spares the most normal skin.
- HPV status (HPV-positive / HPV-negative): Whether a cancer is caused by human papillomavirus.
- HPV-positive (p16) head and neck cancer: Throat cancers caused by the human papillomavirus, identified by a p16 stain.
- Lymphadenectomy (lymph node dissection): Surgically removing the lymph nodes that drain a tumour, both to stage the cancer and to clear any spread.
Tests and results to bring
Biomarker results to ask for: p16 immunohistochemistry and HPV DNA, Grade and lymphovascular invasion of the primary (decide sentinel node biopsy), Depth and stage (Ta, T1, T2) of the primary, Surgical margin status, Dynamic sentinel node biopsy result.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Prevention: HPV vaccination (now offered to boys in many countries and being tested in Chinese men) and treatment of phimosis and lichen sclerosus. (HPV & HBV vaccination, Nonavalent HPV vaccine, A Phase III Study to Evaluate the Efficacy, Immunogenicity and Safety of the 9-valent HPV Vaccine in Chinese Males)
- Penile intraepithelial neoplasia: Circumcision if the foreskin is involved; topical fluorouracil or imiquimod, laser ablation or glans resurfacing; close follow-up because recurrence is common. (Fluorouracil (5-FU), Thermal ablation and cryotherapy for cervical precancer)
- T1 to T2 tumours: Organ-sparing surgery (wide local excision, glansectomy, partial penectomy) with narrow margins; brachytherapy for small distal tumours; total penectomy only for large or proximal disease. (Mohs surgery, Brachytherapy)
- Clinically negative groins: Surveillance for low-risk tumours (Ta, T1 grade 1 without lymphovascular invasion); dynamic sentinel node biopsy for intermediate- and high-risk tumours, with inguinal lymphadenectomy if positive. (Sentinel lymph node biopsy, Lymphadenectomy (lymph node dissection))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call