Cleanliness is manliness

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Doctors perform a penis operation at a Ho Chi Minh City hospital. Photo by Thanh Tung

The incidence of penile cancer in Vietnam has increased in recent years, and doctors say it is the result of poor hygiene as well as a shyness that prevents timely treatment.

Medical research shows that the condition, rarely heard about in Vietnam, has become the 17th most prevalent cancer in men.

It occurs in 2.1 men per 100,000 in Hanoi, and 3.4 percent of men in Ho Chi Minh City, according to a Nguoi Lao Dong report last month.

A 45-year-old man from Long An Province, only identified by his initials N.V.S., got to the hospital more than a month after he started feeling itchy in his penis and treated it on his own with antibiotics.

He only went to the hospital when ulcers had already developed and it was oozing pus. Doctors had to remove his penis to stop malignant cells from metastasizing in other parts of the body.

Doctors said the disease was previously seen more among manual workers, but of late, white collar patients have increased in number. 

Many victims are between 30 and 40 years of age, but some are in the early 20s, they added.

One such young victim sought treatment at the Binh Dan Hospital in Ho Chi Minh City a year ago, after his penis became severely infected.

It started with scabs that he treated himself with external creams.

The 24-year-old college student was luckier than the other man as doctors only needed to remove the infected part and his potential fatherhood was not affected.

Dr Mai Ba Tien Dung, head of the men's health department at the hospital, said penile cancer accounts for between 6 and 8 percent of cancer cases in the world.

Doctors at the Ho Chi Minh City Oncology Hospital said more than 90 percent of penile cancer cases are related to phimosis the narrowing of the opening of the foreskin that prevents it from drawing back over the penis, while most of the remaining 10 percent were caused by HPV virus type 16. 

Dr Bui Chi Viet, a specialist at the hospital, said there are many things that lead to the disease, including poor penis hygiene that causes bacterial infections, inflammation and ulceration.

If these conditions are allowed to prolong, the cell structure is altered and becomes cancerous, Viet said.

Doctors said the disease develops slowly and in the early stages, looks like a normal infection, but people would never know whether there is anything more serious if they do not seek proper medical attention.

They said people should be alert and seek a specialist when they feel mild pains in the penis, notice abnormal skin color, or swelling at its head.

The cancer does not stop at stripping men off one of their primary male functions. It can prove fatal, as it could travel first to lymph nodes in the groin and thus compromise the body's immune system.

Lymph nodes are distributed widely throughout the body and help filter microorganisms and other particles.

Early treatment can save the penis or part of it and give the patients between 65 and 80 percent of chances of surviving, doctors said.

Otherwise, they can lose their entire organ, and have their survival chances fall to between 20 and 50 percent.

A recent survey of nearly 200 penile cancer patients at the Ho Chi Minh City Oncology Hospital showed that 86 percent of them came to the hospital late, between nine to 13 months after the first signs appeared.

Among the victims, 66 percent managed to keep parts of their penis while 18 percent had to have it removed. Nine percent lost their entire genitals (penis and testicles).

Doctors said they know that no man wants to lose such a "precious part" of his body, but in certain cases, they need to remove it to save the man's life. A tube would be inserted to keep the urethra open for urination.

The patients can seek implantation of the organ using muscle and skin grafted from another part of the body like the forearm, they added.

A reconstructed penis can help with standing during urination but studies have shown that it would either not be able to ejaculate or ejaculate with less force.

Without a penis reconstruction, the man would have to squat in order to urinate since doctors reroute the entrance of the urethra to below the scrotum.

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