Modern diagnostic and treatment regimens are needed to achieve the best cancer and quality of life control

Penile cancer is a very rare disease, with incidence and mortality of 0.3% and 0.2% in Poland, respectively [1]. In 2010, 232 new cases were diagnosed (standardized rate 0.8/105) and 89 patients died from the disease (standardized rate 0.2/105). Most new cases and deaths were observed in men aged over 50, with a slight improvement in one– and five–year survival rates in the last 10 years [1]. The clinical symptoms of penile cancer are highly diverse (from erythematous plaques and indurations to more verrucous and exophytic lesions that may co-alesce into an irregularly shaped mass). The initial abnormal changes may be difficult to recognize, both for the patient and the physician, particularly if the lesion is accompanied by phimosis. The risk factors of penile cancer include phimosis, lack of circum-cision, chronic inflammatory conditions (poor hygiene), multiple sexual partners, history of smoking, HPV and HIV infections [2]. Psychological problems are still the most important reasons for the delay in reporting to the doctor. Shame, embarrassment, reluctance to undress in front of the doctor, and the threat of losing the attribute of masculinity associated with a potential surgical treatment are significant barriers to an early contact with the doctor. Despite a large effort made to build a health–con-scious society and raising awareness of the relationship between risk factors and diseases, e.g. bladder cancer and smoking, there seems to be a great need for discussion in the community about cancer of the penis, as well as testicular cancer. Most likely, a leading role in the education and diagnosis should be played by urologists, who are perfectly familiar with the natural course of these rare cancers. Another important aspect to consider is the quality of life (QoL) of patients during the treatment process. Health related quality of life is defined as a subjective assessment of one's position in life made during the illness and treatment, which is not the same as health [3]. QoL is a functional effect of the disease and its treatment, as experienced by the patient. Psychooncology considers QoL, in addition to the survival rate, to be a main factor defining the quality of cancer diagnostic and care. The authors of the study " Metastatic penile car-cinoma – an update on the current diagnosis and treatment options " published in this issue of CEJU, accurately show what modern effective diagnostics should look like [4]. Careful medical history taking and physical examination, …