‘Cancer Avoidable With Soap and Water’: Myths and Truths About Penis Hygiene

Physician Luiz Otávio Torres, director of the Brazilian Society of Urology, is very straightforward in explaining the main form of cancer prevention that affects the male sexual organ: “The only tumor you can avoid with soap and water is the one that affects the penis “.

Although it seems simple, doing the hygiene of this part of the body is still an important barrier for a significant part of men. Proof of this is the number of deaths from this disease in Brazil: according to the National Cancer Institute (Inca) the penis tumor causes 458 deaths each year here.

Another fact that draws attention in this matter comes from the Brazilian Society of Urology: every year, more than a thousand individuals have their penises amputated in a total or partial way in the country because of tumors that were not diagnosed and treated early.

“We know that men’s health is surrounded by taboos. And this starts in childhood, when we dress boys as superheroes and we reinforce the message that they are self-sufficient and do not need to be afraid”, says surgeon Gustavo Guimarães, director of the Institute of Urology, Oncology and Robotic Surgery, in São Paulo.

“From a very early age, we men learn that we must be infallible and indestructible. Or at least we think this is the truth”, completes the doctor, who is also general coordinator of the Oncology Surgical Departments at BP —A Beneficência Portuguesa de São Paulo .

Another example of how this subject is sensitive, surrounded by myths and still causes strangeness was the episode that took place in São Paulo on November 19: the São Paulo government withdrew a campaign from subway stations that warned of the importance of penile hygiene, after a motion of repudiation by a state deputy (better understand the discussion below).

What is penile cancer?

According to Guimarães, penile cancer represents about 2% of all tumors that affect men.

“In the general scenario, this rate is considered low. But it is up to three times more common here compared to developed countries in Europe and North America, where the incidence does not reach 0.6%”, he says.

The doctor explains that this type of cancer is directly related to poverty and the absence of good socioeconomic conditions.

According to a study carried out by four universities and research centers in the country, Maranhão, the poorest state in Brazil, is the place that concentrates the largest proportion of penile tumors in the world: there are 6.1 cases for every 100 thousand inhabitants.

To make matters worse, most diagnoses of the disease occur at an advanced stage and more than 90% need to go for amputation.

Experts interviewed by BBC News Brasil reinforce that lack of hygiene is the main element behind most cases.

“When the organ is not washed, there is an accumulation of secretions and moisture, which cause infections and wounds. Over time, they can develop into a tumor”, explains Torres.

Another cause of cancer in this region is the human papillomavirus, known by the acronym HPV.

In Brazil, a third risk factor for the disease cannot be ignored: zoophilia. A survey carried out in 2011 by the AC Camargo Cancer Center, in São Paulo, found that sex with animals increases by twice the risk of developing penile cancer.

Despite the practice being classified as a crime, the survey showed that about a third of respondents who live in rural areas had already practiced the act with different species.

“Zoophilia is often treated in a jocular manner, but it is a practice that mistreats animals and increases the likelihood of tumors in the penis”, says Guimarães.

The forms of prevention

As mentioned at the beginning of the report, most cases of penile cancer can be avoided with simple hygiene habits.

“And you don’t even need to wash the organ ten times a day or buy a special soap. At bath time, just pull the foreskin, that skin that covers the head of the penis, and wash it well with the same soap you use on the rest of your body “, explains Torres.

If, when pulling the foreskin, you find it difficult to expose the glans (or get a crushing sensation in the head of the penis), it is important to see a health care professional.

“Another thing that many men don’t do is properly dry the penis with the towel. Moisture can lead to infections”, adds the doctor.

These precautions are also valid when peeing: the ideal is to pull the foreskin before the urine comes out — and shake the penis when you finish so that no droplets remain there (or wet your underwear).

“It is also worth washing the organ after ejaculation, whether after sexual intercourse with a partner or during masturbation”, says Torres.

According to the urologist, the accumulation of semen or other secretions in the glans (the head of the penis) or in the genital region causes irritations that can progress to more serious conditions.

Still in the field of prevention, it is worth paying attention to the appearance of any different manifestation in the organ, such as reddish spots, white balls or sores.

“It’s always good to make an assessment with the urologist, as the early diagnosis of any disease, from herpes infection to cancer, facilitates treatment”, points out Torres.

Guimarães emphasizes that the delay in seeking a health professional can make a previously small inconvenience evolve.

“Half of men with penile cancer take more than a year to seek medical attention. Then the lesion grows, forms an ulcer and even creates a large wound that can spread to other areas of the body”, he says.

“When the lesion is small, we can make a conversational and simpler treatment. Now, when it is larger and already affects other tissues in the genital region, we often need to proceed with the partial or total amputation of the penis”, he adds. This is exactly what happens every year with around a thousand Brazilians.

The surgeon points out another indispensable attitude to avoid future cases of this and other types of tumor: the vaccine against HPV.

“The doses are available in the public network and are recommended for all boys from 11 to 14 years old”, he recalls.

“Vaccination reduces the risk of having penile tumors and also reduces the transmission of this virus to girls. HPV is related to cervical cancer in them”, he concludes.

The controversy of the time

Despite the consensus between experts in Brazil and the world, the main method of preventing penile cancer has caused an intense debate in recent days: a campaign entitled “Wash the Dito Cujo” was withdrawn from the São Paulo Metro after a formal complaint made by state deputy Lieutenant Nascimento (PSL).

The images, spread across the stations of the public transport service in São Paulo, called attention to the hygiene of the penis. They are part of an action of Novembro Azul, month of awareness about prostate cancer and men’s health in general, carried out by Instituto Lado a Lado, a non-profit organization that works in the health area.

The illustrations, which can be seen below, were made by several artists and portray the penis and the campaign motto (“Wash the Dito Cujo”) in different ways.

The institute reports that 15 informational totems were installed on Thursday (18) and removed the following day.

The main reason for the removal would have been a motion of repudiation made by Nascimento at Alesp (Legislative Assembly of São Paulo).

In the text, the deputy states that “this exhibition in a public place with wide circulation, with unrestricted access, such as a subway station, is inadmissible from a cultural, educational, social and religious perspective, as it is an affront to the customs and tradition of Brazilian family”.

In another excerpt, the parliamentarian asks for “the immediate removal of the poster entitled ‘Wash the Dito Cujo’, which contains about 40 drawings exposing the male genitalia, embarrassing men, women and children who pass through the place daily”.

BBC News Brasil sought out the deputy’s office, who sent us a note for clarification. The deputy argues that “November Azul has the sole objective of alerting to the importance of early diagnosis of prostate cancer, the most frequent among Brazilian men”.

“The advertising piece used at the subway station, ‘Lave o Dito Cujo’, should be better clarified as to the correct form for the early diagnosis of the disease, which would be the digital rectal exam and blood test (PSA). advertising, by mentioning only the cleaning of the male organ, does not reach the objective of the November Blue campaign as a form of prevention, and brings the false feeling that only the cleaning of the male organ is enough to protect against prostate cancer”, continues the text.

Finally, Nascimento says he is “totally favorable to prevention campaigns”, but emphasizes that “the figures used to propagate the importance of cleaning the male organ, due to the way in which they were used, take the serenity of the subject away, leading to a misunderstanding of this important campaign that is the Blue November”.

The Metropolitan Transport Secretariat of the São Paulo State Government, responsible for the subway, also sent a clarification note and followed the same line of reasoning as Nascimento when saying that the campaign “was withdrawn from the stations for not meeting medical guidelines for prevention of prostate cancer, which is the goal of the Blue November”.

“Washing the penis, despite being an important measure to prevent a series of diseases, is not one of the ways to prevent this type of cancer, but the prostate touch test and the PSA blood test. in relation to November Azul, it can give a false sense of protection to the population, with these exams being the only means of early detection of the disease”, write those responsible for the secretariat.

Finally, Instituto Lado a Lado clarified that the November Blue campaign even has a great emphasis on prostate cancer, but “since its first edition [em 2011], also includes relevant information about penile cancer in Brazil.” And washing the sex organ is the main method of preventing this second type of tumor.

“The institute regrets that public policy makers understand that talking about a neglected disease, which leads to death and mutilates thousands of men in the country is an ‘affront to the customs of the Brazilian family'”, concludes the note sent by the organization for the report.