STD Concern

[STDworries7]

Dear Doctor,

In December 2006 I had intercourse with a 40 year old Chinese worker. She provided a condom which I assume was latex. I've gotten tested for every STD and everything has come in negative. However, I freaked out after the exposure (because I've never done anything like that before) and I begged to be put on PEP. I did that for a month and finished up in January 07. Fastforward to December 2007 (one year later).

I have been having pain throughout the shaft of my penis. The skin on my penis has been changing dramatically. My penis head is completely cut up and there are visible dark spots. And I have been having diarrhea since January 2006. It seems to me that the skin changes I drink a lot of alcohol (but not sure). Next, my groin (exactly where the lymph nodes are located) has been in terrible on and off pain. This pain goes to my kidneys (I think). I had an MRI that showed nothing wrong.

My question is, does this sound like any STD. The only conclusion I came to was penile cancer. I read at a reputable cancer website that shaft pain is a symptom as well as abnormal skin change. I know I should see a dermatologist but what do you think? My penis and groin is in terrible pain. I am circumsized and I know that everyone says that penile cancer is extremely rare but statistics that I've read said that more than one thousand men will be diagnosed yearly (that doesn't sound too rare to me).

Please help!

[Edward W Hook, MD]

Penile cancer is rare and is more common in uncircumcised men than those who have been circumcised.  

I disagree.  Little, if anything points to penile cancer and, if you have been worrying about this for months, why have you not gone to see a dermatologist or urologist to deal with it instead of wandering around the e-mail looking for things to fuel your fears.  I will not comment further--YOU NEED TO SEE A DERMATOLOGIST.  EWH

[STDworries7]

As a followup Q,

Can you answer me a few questions about Penile Cancer and HPV?

My understanding is that penile cancer is very rare. And even more rare for circumsized males. I am cricumsized. However, the Doc on the Urologic Cancers board implies (from how I interpreted it) that circumsized males are just as susceptible to HPV caused penile cancer as uncircusized. Is this true?

Everything points to Penile Cancer and I cannot get it out of my mind. Also, it did not take a full year for these symptoms to start. They actually started 6 months after and have been getting progressivley worse. Recently I've been seeing dark spots on the penis glans. I'm very worried about penile caner (I'm 24 years old and worried about the chances of HPV caused penile cancer).

What are the chances that I got HPV (While wearing a condom)? To my understading that its only transfered to exposed skin. Can thighs have HPV?

[Edward W Hook, MD]

You need to see a physician.  The chance that you got an STD nearly a year ago that is only now becoming apparent is virtually non existent.  Penile cancer typically starts as a small painless bump which GRADUALLY gets larger and can become an open sore.  The symptoms you describe do not suggest penile cancer either.

Reading between the lines of your post, it also appears that you are interacting with other health care providers.  This is what you should be doing.  See a dermatologist for the rash.  Stop worrying about last year's exposure.  This old news and not relevant to this problem.  If you cannot resolve your anxiety with this reassurance and all that you already know, it is time to work through this with professional help.

Hope thi shelps.  EWH