Penile cancer prognosis is closely related to the natural history of the neoplasm. The primary cancer progressively infiltrates penile structures, initially in a horizontal and superficial pattern of spread, followed by a stepwise vertical invasion through the penile fascia and tunica albuginea1 . However, the main characteristic of this uncommon malignancy is the high tendency to metastasize through the lymphatic vasculature to superficial inguinal, deep inguinal, and pelvic lymph nodes. The majority of patients eventually die as a result of complications related to regional lymph nodes before developing distant metastases (Fig. 10.1 a, b).

Distant metastases to lung, liver, bone, or brain are present in only 1-10% of patients with advanced lymph node involvement and these unfortunate individuals have an unfavorable prognosis with a mean survival of approximately 7-10 months.2,3

Dealing With Erectile Dysfunction

Dealing With Erectile Dysfunction

Whether you call it erectile dysfunction, ED, impotence, or any number of slang terms, erection problems are something many men have to face during the course of their lifetimes.

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