I always remember my mom’s friends that
they she they also they were always
encouraging me to get in plastic surgery
because of course they was looking for
themselves when they got elder it but I
decide I decided to become a urologist
and when I say you’re always some people
misunderstood I am a neurologist and I
say no I’m your life and when we say
urology’s it’s we’re not only taking
care of this area we also take care of
kidneys bladder stones infection which
we see a lot of things but basically we
see and many people see us because we
see prostate
it’s very important but because when we
are urologist and when we go up party
it’s typically there’s gonna be two
questions the first one is going to be I
have a friend of a friend that have some
kind of erection or some kind of problem
and they will never will recognize out
themselves until the end of the party
and this second is gonna come with all
the jokes about you early that’s when
all the jokes begin and I always
remember when I when I always the
patient have a different funny joke and
the most one that I always remember is
for example I had one that he told me
after I did a rectal exam he told me
who’s gonna call me next are you gonna
call me tomorrow are you gonna send me
flowers tomorrow and I say wow there’s
you can imagine how many jokes you can
get about rectal exam and of course
because they see us as a prostate and of
course prostate has on ribbon and
there’s celebrities that take care and
make their warrants for prostate cancer
same thing happen for testicular cancer
there’s Atlantic’s there’s also a ribbon
and many people are aware about
testicular cancer but I bet you that you
don’t know that also you can get cancer
in the penis
and I always ask did you know the penis
also can get cancer and many people of
course get surprised because they don’t
even know that the penis can also get
cancer and it’s very important because
the good news different that prostate
and testicular cancer is that this type
of cancer we can prevent it and that’s
good news and we’re going to talk today
is that we’re going to give exactly how
we can do on how we can prevent the
penile cancer the penis is a very very
complex organ it’s very difficult to
think that you can transplant a penis
and we’re going to talk that at the end
it’s very important because it’s not
only for urination it has to be with
reproduction because this this sperms
this Simmons goes out through the
urethra it has to be with intercourse
relations and it has to be with identity
and that’s why it’s so difficult that if
we section some of the penis what we’re
going to do to preserve the function and
and when we see the s I was trying to
illustrate that the treatment can be
dramatically sometimes if we don’t make
the diagnosed on time that we can give
some local treatment that we can freeze
we can burn this small tumor if it’s too
deep of to extensive sometime we need to
make sections and sometimes we need to
do a complete excision of the penis and
the scrotum it calls complete valet to
me open ectomy and then I always ask
this question how many men could live a
full life without penis and that’s why
it’s very important then when we see a
patient that has penile cancer we have
to really create a very good relation
with the patient because when we give
that bad news
the first thing they wanna go is run
away and when they come back and they
found that you was right it’s gonna be
too late and then you have to spend your
time to sprain him exactly what you have
to do and you need to convince him that
you need to do some specific treatment
sometimes you need to resect some of the
penis but if you don’t play them on time
they will get upset they will deny what
they have and they run away and when
they come back they will have metastases
and they will they will die then it’s
very important in this specific because
of course you related with the most
intimate part of the patient what about
the incidence they’re gonna be 26 26
thousand cases globally and United
States DC is gonna be more than two
thousand cases for penile cancer even
that in United State is one for 100,000
patients in Brazil for example in some
areas of Brazil the penile cancer is
more common that prostate cancer to give
you an idea we always see prostate
cancer in some area of Brazil penile
cancer is gonna be more common that
prostate cancer it means that really
this is an important issue in some areas
in the United States
what touch me more is that 72% of the
affected are Hispanics and that’s why I
feel that as a Latino as a Venezuelan
human I found that it’s very very
important that we teach and we we
educate the people how to prevent this
problem not only that is more frequent
in Hispanic is that Hispanic develop
penile cancer a younger age it means not
that we detected younger it means that
they develop the cancer earlier very
important even with all the science and
all the advanced that we have had in
medicine we have decreased and we have
improved the survival for many cancers
including prostate and breast but if you
see here it’s very important that even
during 2012 and 2013 you see the reports
the survival for penile cancer instead
of getting better is getting worse
around 40 50 percent of the patient are
gonna be died at five years and that’s
very important that we need to do
something we need to invest resources in
technology in in science to not only
make educate the patient we need to also
see how we can improve the survival of
these patients why this patient are
coming late to treatment in some
countries maybe they don’t have access
to the health system but in the United
States
they’re not coming not because they
don’t have access to the health system
they’re not coming
first because their shame what they have
second because they have fear and third
because they don’t know how risky could
be what they have and they could they
never imagine that could be cancer and
they could never imagine they can die
because that and that’s why they come
late with that lesions
what are these symptoms basically any
kind of alteration tumor any grow
anything that you found in your penis
that it doesn’t resolve after few weeks
of treatment you have to go back and
tell them this is not normal and you may
require a biopsy to rule out that
there’s nothing else that anything that
no it’s a fungal infection be careful
you need to check that’s really not a
cancer behind that what are the risk
factors basically these are the most
important factors HPV human
papillomavirus pure I hear a gene and
low socioeconomic status lack of
circumcision and smoking I want to be
very clear about HPV human
papillomavirus because I don’t want to
get people are afraid that if they have
HPV or they have words they’re gonna
have penile cancer this is another acute
process this is something that is a
chronic inflammation and if you have one
of the risk factor it can be HPV smoking
we’re gonna see uncircumcised as magma
all these risk factors along a very long
period of inflammation will end or could
end in a penile cancer it doesn’t mean
that if you have HPV you can have cancer
it means you have one risk factor and
you have to pay attention because if you
have HPV
there’s impatient with HPV is six times
more common that they can have cancer
and also when we dissect the tumor the
penile cancer we found that in the
tissue of the penile cancer there’s up
to 85% they found the virus that’s
obvious at relation between the virus
and the cancer but again again it
doesn’t mean that if you have h VD you
can have cancer the same thing for
cervical cancer if you have HPV doesn’t
mean you’re going to have cancer
have a risk factor and you have to take
care of that risk factor – don’t add
more factors that you’re going to end in
having a chronic inflammation process
that can end Longley in a cancer the
second risk of course when we talk about
HPV devack the vaccine is not only for
cervical cancer it can be also helpful
for penile cancer sexual behavior is
very important because the people feel
that the condom it’s important of course
but it’s not enough the condom will not
protect all the genital area and most
important you know you may know your
partner for a gene very important you
see this slide well all this is magma
some of this page you’ll have all the
foreskin that does not retract and if
that doesn’t retract they can have a
tumor behind that skin and they never
see it then it’s very important that
they have this a gene they need to
retract the foreskin they need to learn
how to have all the at how to clean it
and to prevent that very important when
we talk about hygiene
everybody knows that patient that was
sick on size when it was newborn they
have less chance of having penile cancer
that’s right but there’s a very
interesting story for example this
Danish Danish serious they found that
the rate of circumcision is only one
point six and they decrease the cancer
incidence between 115 to 0.8 only doing
an improving the hygiene not doing
circumcision the conclusion is what we
need is very location for hygiene have
it natural transition the circumcision
is only recommended and you’re gonna see
that I shave it I did a second session
very important that the circumcision is
only recommended in regions where
minimum conditional hygiene cannot be
guarantee for men’s there’s the only
indication for seek incision the real
indication is we need to do education
and we need to improve the hygiene
habits smoking three four three three to
five times more common penile cancer in
patient that smoke and very important I
wanna I want to say very clear that we
have improving the treatment we have
improved how to make how to preserve the
penis okay but sometime of course we
need to do partial or complete remove
and of course sometimes we also need to
remove the lymph nodes around the area
we have improve also that we have
decreasing morbidity of the treatment
but that’s not enough we should really
go one step before we need to really
decrease the incidence of penile cancer
this one again there’s have been only
three penal transplant in the world and
we have to be clear that this is another
option because this is not a partial
fillet to me that you need this is a
patient that are in moon suppress you
cannot do a transplant and then we have
not been clear that this is not the way
to go we need to prevent the penile
cancer and then if no we need to see how
we can improve the treatment to the
trees the morbidity of the surgery this
is an example of a page on that you can
see that the tumor already destroyed the
complete penis an additional to destroy
the penis we have all these leaf nodes
they did a complete fail egg to me and
the scrotum they remove it and even that
this patient was 21 years old seven
months later this patient died and then
we really need to do something to stop
this because their men start dying
because penile cancer and this is
definitely something to do it to treat
some men as a physician and as a father
were responsible for educate and we are
responsible speaking were kids about
hygiene habits about STDs the STDs are
increasing and we’re responsible to talk
to them about making and selling
and their partners and know their
partners because this is the only way
we’re going to really decrease the
incidence we need to stop men’s dying
because penile cancer we need to stop
men’s walking without penis and this is
something we can do together thank you
for the invitation [Applause]
they she they also they were always
encouraging me to get in plastic surgery
because of course they was looking for
themselves when they got elder it but I
decide I decided to become a urologist
and when I say you’re always some people
misunderstood I am a neurologist and I
say no I’m your life and when we say
urology’s it’s we’re not only taking
care of this area we also take care of
kidneys bladder stones infection which
we see a lot of things but basically we
see and many people see us because we
see prostate
it’s very important but because when we
are urologist and when we go up party
it’s typically there’s gonna be two
questions the first one is going to be I
have a friend of a friend that have some
kind of erection or some kind of problem
and they will never will recognize out
themselves until the end of the party
and this second is gonna come with all
the jokes about you early that’s when
all the jokes begin and I always
remember when I when I always the
patient have a different funny joke and
the most one that I always remember is
for example I had one that he told me
after I did a rectal exam he told me
who’s gonna call me next are you gonna
call me tomorrow are you gonna send me
flowers tomorrow and I say wow there’s
you can imagine how many jokes you can
get about rectal exam and of course
because they see us as a prostate and of
course prostate has on ribbon and
there’s celebrities that take care and
make their warrants for prostate cancer
same thing happen for testicular cancer
there’s Atlantic’s there’s also a ribbon
and many people are aware about
testicular cancer but I bet you that you
don’t know that also you can get cancer
in the penis
and I always ask did you know the penis
also can get cancer and many people of
course get surprised because they don’t
even know that the penis can also get
cancer and it’s very important because
the good news different that prostate
and testicular cancer is that this type
of cancer we can prevent it and that’s
good news and we’re going to talk today
is that we’re going to give exactly how
we can do on how we can prevent the
penile cancer the penis is a very very
complex organ it’s very difficult to
think that you can transplant a penis
and we’re going to talk that at the end
it’s very important because it’s not
only for urination it has to be with
reproduction because this this sperms
this Simmons goes out through the
urethra it has to be with intercourse
relations and it has to be with identity
and that’s why it’s so difficult that if
we section some of the penis what we’re
going to do to preserve the function and
and when we see the s I was trying to
illustrate that the treatment can be
dramatically sometimes if we don’t make
the diagnosed on time that we can give
some local treatment that we can freeze
we can burn this small tumor if it’s too
deep of to extensive sometime we need to
make sections and sometimes we need to
do a complete excision of the penis and
the scrotum it calls complete valet to
me open ectomy and then I always ask
this question how many men could live a
full life without penis and that’s why
it’s very important then when we see a
patient that has penile cancer we have
to really create a very good relation
with the patient because when we give
that bad news
the first thing they wanna go is run
away and when they come back and they
found that you was right it’s gonna be
too late and then you have to spend your
time to sprain him exactly what you have
to do and you need to convince him that
you need to do some specific treatment
sometimes you need to resect some of the
penis but if you don’t play them on time
they will get upset they will deny what
they have and they run away and when
they come back they will have metastases
and they will they will die then it’s
very important in this specific because
of course you related with the most
intimate part of the patient what about
the incidence they’re gonna be 26 26
thousand cases globally and United
States DC is gonna be more than two
thousand cases for penile cancer even
that in United State is one for 100,000
patients in Brazil for example in some
areas of Brazil the penile cancer is
more common that prostate cancer to give
you an idea we always see prostate
cancer in some area of Brazil penile
cancer is gonna be more common that
prostate cancer it means that really
this is an important issue in some areas
in the United States
what touch me more is that 72% of the
affected are Hispanics and that’s why I
feel that as a Latino as a Venezuelan
human I found that it’s very very
important that we teach and we we
educate the people how to prevent this
problem not only that is more frequent
in Hispanic is that Hispanic develop
penile cancer a younger age it means not
that we detected younger it means that
they develop the cancer earlier very
important even with all the science and
all the advanced that we have had in
medicine we have decreased and we have
improved the survival for many cancers
including prostate and breast but if you
see here it’s very important that even
during 2012 and 2013 you see the reports
the survival for penile cancer instead
of getting better is getting worse
around 40 50 percent of the patient are
gonna be died at five years and that’s
very important that we need to do
something we need to invest resources in
technology in in science to not only
make educate the patient we need to also
see how we can improve the survival of
these patients why this patient are
coming late to treatment in some
countries maybe they don’t have access
to the health system but in the United
States
they’re not coming not because they
don’t have access to the health system
they’re not coming
first because their shame what they have
second because they have fear and third
because they don’t know how risky could
be what they have and they could they
never imagine that could be cancer and
they could never imagine they can die
because that and that’s why they come
late with that lesions
what are these symptoms basically any
kind of alteration tumor any grow
anything that you found in your penis
that it doesn’t resolve after few weeks
of treatment you have to go back and
tell them this is not normal and you may
require a biopsy to rule out that
there’s nothing else that anything that
no it’s a fungal infection be careful
you need to check that’s really not a
cancer behind that what are the risk
factors basically these are the most
important factors HPV human
papillomavirus pure I hear a gene and
low socioeconomic status lack of
circumcision and smoking I want to be
very clear about HPV human
papillomavirus because I don’t want to
get people are afraid that if they have
HPV or they have words they’re gonna
have penile cancer this is another acute
process this is something that is a
chronic inflammation and if you have one
of the risk factor it can be HPV smoking
we’re gonna see uncircumcised as magma
all these risk factors along a very long
period of inflammation will end or could
end in a penile cancer it doesn’t mean
that if you have HPV you can have cancer
it means you have one risk factor and
you have to pay attention because if you
have HPV
there’s impatient with HPV is six times
more common that they can have cancer
and also when we dissect the tumor the
penile cancer we found that in the
tissue of the penile cancer there’s up
to 85% they found the virus that’s
obvious at relation between the virus
and the cancer but again again it
doesn’t mean that if you have h VD you
can have cancer the same thing for
cervical cancer if you have HPV doesn’t
mean you’re going to have cancer
have a risk factor and you have to take
care of that risk factor – don’t add
more factors that you’re going to end in
having a chronic inflammation process
that can end Longley in a cancer the
second risk of course when we talk about
HPV devack the vaccine is not only for
cervical cancer it can be also helpful
for penile cancer sexual behavior is
very important because the people feel
that the condom it’s important of course
but it’s not enough the condom will not
protect all the genital area and most
important you know you may know your
partner for a gene very important you
see this slide well all this is magma
some of this page you’ll have all the
foreskin that does not retract and if
that doesn’t retract they can have a
tumor behind that skin and they never
see it then it’s very important that
they have this a gene they need to
retract the foreskin they need to learn
how to have all the at how to clean it
and to prevent that very important when
we talk about hygiene
everybody knows that patient that was
sick on size when it was newborn they
have less chance of having penile cancer
that’s right but there’s a very
interesting story for example this
Danish Danish serious they found that
the rate of circumcision is only one
point six and they decrease the cancer
incidence between 115 to 0.8 only doing
an improving the hygiene not doing
circumcision the conclusion is what we
need is very location for hygiene have
it natural transition the circumcision
is only recommended and you’re gonna see
that I shave it I did a second session
very important that the circumcision is
only recommended in regions where
minimum conditional hygiene cannot be
guarantee for men’s there’s the only
indication for seek incision the real
indication is we need to do education
and we need to improve the hygiene
habits smoking three four three three to
five times more common penile cancer in
patient that smoke and very important I
wanna I want to say very clear that we
have improving the treatment we have
improved how to make how to preserve the
penis okay but sometime of course we
need to do partial or complete remove
and of course sometimes we also need to
remove the lymph nodes around the area
we have improve also that we have
decreasing morbidity of the treatment
but that’s not enough we should really
go one step before we need to really
decrease the incidence of penile cancer
this one again there’s have been only
three penal transplant in the world and
we have to be clear that this is another
option because this is not a partial
fillet to me that you need this is a
patient that are in moon suppress you
cannot do a transplant and then we have
not been clear that this is not the way
to go we need to prevent the penile
cancer and then if no we need to see how
we can improve the treatment to the
trees the morbidity of the surgery this
is an example of a page on that you can
see that the tumor already destroyed the
complete penis an additional to destroy
the penis we have all these leaf nodes
they did a complete fail egg to me and
the scrotum they remove it and even that
this patient was 21 years old seven
months later this patient died and then
we really need to do something to stop
this because their men start dying
because penile cancer and this is
definitely something to do it to treat
some men as a physician and as a father
were responsible for educate and we are
responsible speaking were kids about
hygiene habits about STDs the STDs are
increasing and we’re responsible to talk
to them about making and selling
and their partners and know their
partners because this is the only way
we’re going to really decrease the
incidence we need to stop men’s dying
because penile cancer we need to stop
men’s walking without penis and this is
something we can do together thank you
for the invitation [Applause]
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