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Is this Cancer?

For several months now I have been concerned that I have cancer in the uro-genital area. It started with pinched-nerve type pains at the base of my penis that became more noticeable and then slowly disappeared. Now however my erections on the left side of my penis are definately stronger than those on the right side as if a cancerous growth were somehow blocking blood and sensation in the right side of my penis. Because the left side is firmer and fuller my erection has a slight tilt to the left (I am very familiar with the signs and symptoms of peyronies and I and my doctor can detect no prescence of it. Besides, the tilt is slight, starts at the base, and the side the tilt is to is stronger, all of the these are inconsistent with benign peyronies). My doctor gave me urine tests which came back fine, but I was unwilling to discuss the full extent of my problems. My erections initially feel very strange and the veins on the RIGHT side are much thicker and more colorful than they ever were before. Nocturnal/waking erections are very weak.I did engage in rough sex/masturbation prior to this but my urologist said that this is not likely the cause of any tissue damage. My grandfather was diagnosed with penis cancer so it is naturally a concern of mine although I am circumcised. I am 24, don't smoke non-diabetic and in excellent shape so normal ED would not seem to be a factor. I am very scared of what this could be and I still have light pain at the right base of my penis from time to time. I went around my penis with a pin and the whole thing was very sensitive but I have little sensation inside the base of my penis (Where I think the cancer is) unless I use extensive manual stimulation to acheive a nearly complete erection, but even then the base on the right side is unsturdy and deflates promptly. What can I do to rule out cancer and get to the bottom
of my problem. Can this kind of cancer/problem be treated successfully?
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Dear Mitch,
Erectile dysfunction may be caused by psychological problems, neurogenic dysfunction, hormonal alterations, or compromised blood flow, or venous leak.  In your case, the later 2 problems, compromised blood flow and venous leak, may be present.  I still would not rule out peyronies disease as a cause for your unilateral erectile dysfunctionm but I am unable to evaluate you personally, so I must leave it as a possibility (common things are common).  You may have a proximal plaque at the base of the penis which cannot be fully evaluated.   The most common cause in a 24 year old, would be some sort of trauma.   However, what we do know about penile the anatomy, would indicate that the connection or communication between the pair of corpora cavernosa in your situation must be altered.  An open communication would allow for equal pressures to accumulate in the paired erectile bodies and would not allow one side to become erect without the other.  Either a history of penile trauma, sludging of red blood cells with scarring from diseases such as sickle cell, or leukemia, may be responsible for the physiology you explain.  Another thought would a vascular (venous) leak at the base of the penis.  Again this could result from trauma or a fracture of the corpora cavernosa with aberrant healing.
The best thing for you to do is see a urologist.  He or she can get a full history and examine your condition.  They are knowledgeable in the area of erections and can suggest diagnostic tests that may identify a problem.  In terms of this being primary cancer of the penis, I would have to say this is very unlikely.  The insensitive areas could also be explained by scarring after penile trauma or peyronies disease.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).


Sincerely,
HFHS M.D.-AK
*keyword:Erectile dysfunction
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