Cancer patient, 81, is left with a three-month ‘erection’
Cancer patient, 81, is left with a three-month ‘erection’ after the disease spread to his penis and made it solid
- The unnamed man came into hospital when he was unable to urinate for 15 hours
- Examination revealed his penis, scrotum and stomach were hardened
- A tumour was found in his bladder confirming an aggressive form of cancer
- It had spread to surrounding tissue which caused his penis to stay rigid
An 81-year-old man had an ‘erection’ which lasted for three months and was caused by undiagnosed bladder cancer, doctors say.
The unnamed Australian patient didn’t seek medical help for his painful erection until it left him struggling to urinate.
He was diagnosed with an aggressive form of bladder cancer after scans revealed a tumour in the wall of his organ.
Doctors said the cancer was so severe it had spread to the surrounding tissue in his abdomen and genitals.
Cancer may cause priapism – a persistent, painful erection – if cancer cells grow in a way which traps blood in parts of the penis which make it erect.
One expert added that the man probably didn’t have a normal erection, which is when the penis fills with blood, but that tumours were what made his member solid.
An 81-year-old man had an erection that lasted for three months that was caused by undiagnosed bladder cancer, according to doctors in Queensland, Australia
In this case the erection can only subside when the underlying cancer is treated, removing all cancer cells. But it was too late for the elderly man and he died.
An erection that lasts longer than four hours is considered to be priapism and is a medical emergency.
It may be caused by medications such as antidepressants, recreational drugs including cannabis and cocaine, or a blood disorder.
Malignant priapism, which is secondary to cancer, has poor outcomes. Fewer than 500 cases have been reported in literature, but the exact number is unclear.
Dr Ryan Pereira at Princess Alexandra Hospital, Woolloongabba, Queensland, said the elderly man came to hospital when he hadn’t urinated for 15 hours.
The man also said he had been suffering with worsening pelvic pain and an erection for three months.
WHAT IS BLADDER CANCER?
Bladder cancer is caused by a tumour developing in the lining of the bladder or the organ’s muscle.
Around 10,300 new cases are diagnosed in the UK each year and 81,200 people in the US, according to figures.
It is the 10th most common cancer in the UK – but a little more prevalent in the US – and accounts for about three per cent of all cases.
The cancer is more common in men and has a 10-year survival rate of about 50 per cent. Around half of cases are considered preventable.
Symptoms of the disease include blood in the urine, needing to urinate more often or more urgently than normal and pelvic pain.
However, unexpected weight loss and swelling of the legs can also be signs of the killer disease.
Smoking and exposure to chemicals in plastics and paints at work can increase the risk of getting bladder cancer.
Treatment varies depending on how advanced the cancer is, and may include surgery, radiotherapy or chemotherapy.
Source: NHS Choices
He claimed to have also seen blood in his urine – the most common sign of bladder cancer.
On examination, doctors could clearly see he had malignant priapism which was causing him pain.
The patient was found to have a very tense head of the penis and shaft, and he couldn’t retract his foreskin because it was so tight. The skin on his stomach and scrotum were also firm.
He was sent for scans which found a lump measuring around 3cm in the bladder wall lining.
The results from biopsies taken from the stomach confirmed a diagnosis of a rare form of bladder cancer called plasmacytoid urothelial carcinoma (PUC).
Tobacco smoke is common cause of bladder cancer, accounting for more than a third of cases, according to the NHS.
The man was a former heavy smoker, having started at the age of four and smoked more than 100 packs a year, according to the doctors.
By the time he was diagnosed, the cancer had spread to the lymph nodes in his groin, causing a number of them swell.
The team of medics pondered over how to treat the man, who was not likely to survive for very long.
They managed to relieve the urine in his bladder by inserting a catheter into the wall of his abdomen.
But the severity of the man’s condition meant treating the bladder cancer with surgery was not feasible.
He was in discussions with doctors about receiving palliative care to ease his symptoms but his health quickly got worse and he died.
Dr Richard Viney, an urologist at the Bladder Clinic, Birmingham, commented on the patient’s story which was published in BMJ Case Reports.
He told MailOnline: ‘It’s not really an erection but a tumour filling the penis. It’s solid with tumour rather than solid with blood.
‘It would have been a combination of cancer in the penis, fluid not being able to exit the area because lymph nodes were filled with cancer, and possibly lack of blood flow.
‘There is no real treatment for it and the man probably died a slow death.’
Dr Viney said he had never treated priapism caused by bladder cancer, but had seen cases caused by prostate cancer.
Bladder cancer usually takes a long time to develop, so it is most commonly diagnosed in older people.
In 2015, around 10,200 people were diagnosed with bladder cancer in the UK, making it the 10th most common cancer in the UK, and the 8th most common cancer in men, according to Cancer Research UK.
WHAT IS PRIAPISM?
Priapism is a long-lasting painful erection which can cause permanent damage to your penis if not treated quickly, including scarring and permanent erectile dysfunction.
Priapism can occur in all age groups, including newborns. However, it usually affects men in two different age groups: between the ages of 5 and 10, and 20 and 50.
The condition develops when blood in the penis becomes trapped and is unable to drain.
There are two types of priapism: low-flow and high-flow.
Low-flow priapism: This is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell disease, leukemia (cancer of the blood), or malaria.
High-flow priapism: This is more rare and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally.
Priapism most commonly affects people with sickle cell disease.
Less common causes include blood-thinning medicines, like warfarin, some antidepressants, recreational drugs – like cannabis and cocaine – some medicines for high blood pressure, other blood disorders, like thalassaemia and leukaemia and some treatments for erection problems.
Malignant priapism, which is secondary to cancer, is rarely reported and has poor outcomes.
It occurs when the cancer causes the penis to become rigid and can only be relieved when the cancer is treated.
An erection that lasts longer than four hours is known as priapism and is a medical emergency.
- try to urinate
- have a warm bath or shower
- drink lots of water
- go for a gentle walk
- try exercises such as squats or running on the spot
- take painkillers like paracetemol if you need to
- do not apply ice packs or cold water to your penis – this can make things worse
- do not have sex or masturbate – it won’t make your erection go away
- do not drink alcohol
- do not smoke
The goal of all treatment is to make the erection go away and preserve the ability to have erections in the future, and may include surgical ligation, intravenous injection and surgical shunt.
Source: NHS and Cleveland Clinic
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