Psychological/psychiatric trauma in patients with penile cancer and partial or total penectomy

Abstract

Penile cancer, which is a considerable challenge for countries in the developing world, is a mutilated affection for the patient, considering both the local modifications that are determined by it, as well as from the treatment point of view. In this way, for the more advanced disease phase, aggressive therapy with partial or total penectomy is still the conventional and necessary treatment. There are very few studies about the extent and nature of the psychological effects of penile cancer. Thus, considering that psychological/psychiatric dysfunctions in patients with penectomy are likely to be common and taking into account the current contradictions that exist regarding this area of research, we decided to evaluate the impact of penile cancer and/or partial or total penectomy on levels of anxiety and depression, as studied through some specific scales such as the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). We found increased anxiety and depression, especially in the case of the group with total penectomy, but also in the biopsy group, which comprised patients that had lesions in the terminal stage, such as an inextirpable tumor. The most reduced levels of depression and anxiety were observed in the postectomy group. Our findings presented here and further knowledge about the psychological, social and sexual aspects of these specific patients will help health professionals and organizations to identify treatment options and/or make recommendations for rehabilitation and support services. Additionally, there is a continuous need to identify and assess proper scales to measure the psychological/psychiatric trauma in this group of patients, as well as focusing on the identification of the exact patients that require professional psychological intervention.

Keywords

• HAM-A
• HAM-D
• penectomy
• penile cancer
• postectomy