
International
Penis cancer on the rise, resulting in 6,500 amputations in Brazil
“I started visiting medical clinics to find out what it was, but all the doctors told me it was due to excess skin and prescribed medication,” the 63-year-old recalls.
Despite the medication, the wart continued to grow. It started to take a toll on his marriage and João and his wife’s sex life declined. “We were like siblings,” he admits. He was determined to find out what was going on.
For five years João, not his real name, went back and forth to specialists who prescribed more medication and ordered new biopsies. “Nothing solved it,” he says.
Then, in 2023, he was given a diagnosis – João had penile cancer.
“For my family, it was a very unpleasant surprise, even more so because I had to have part of the penis amputated. I feel like I was decapitated,” he says.

“It’s a type of cancer that you can’t talk about with people because it could turn into a joke.”
Penile cancer is rare, but incidences and mortality rates are on the rise around the world.
According to the latest studies, Brazil, where João is from, has one of the highest incidence rates of 2.1 per 100,000 men.
‘Terrified of surgery’
Between 2012 and 2022, there were 21,000 reported cases, according to Brazil’s Ministry of Health. This resulted in more than 4,000 deaths and, over the past decade, there have been more than 6,500 amputations – averaging one every two days.
Maranhão, the poorest state in Brazil, was found to have the highest incidence rate globally at 6.1 per 100,000 men.
Symptoms of penile cancer often start with a sore on the penis that does not heal and a strong-smelling discharge. Some people get bleeding and colour changes of the penis, too.
When detected early, there is a high chance of recovery through treatments such as the surgical removal of the lesion, radiotherapy and chemotherapy.
But if left untreated, partial or total amputation of the penis, and possibly other nearby genital organs such as the testicles, may become necessary.
João underwent a partial amputation in January and says it was a difficult time.
“It’s something you never imagine will happen to you, and when it does, you can’t just go around telling people,” he says.
“I was terrified of surgery, but there was no other alternative. The feeling in the first weeks after the surgery was one of sadness, I can’t deny it. Not having part of your penis is horrible.”
Some patients undergo a total amputation which is life-changing.
Thiago Camelo Mourão from the Department of Urology at AC Camargo Cancer Center in São Paulo says: “In the case of partial amputation, urine continues to exit through the penis.
“However, in total amputation, the urethral orifice can be relocated to the perineum, between the scrotum and the anus, requiring the patient to urinate while sitting on the toilet.”
Mauricio Dener Cordeiro of the Brazilian Society of Urology says the persistent infection of human papillomavirus (HPV), a name given to a common group of viruses, is “one of the main risk factors”. HPV can be transmitted during sex and in some cases, it can lead to cancers including in the mouth and penis.
He says: “Mass vaccination against HPV is essential due to its high effectiveness in preventing related lesions,” but he adds that vaccination rates in Brazil are below the level needed to be truly effective.
“In Brazil, despite the availability of the vaccine, the HPV vaccination rate remains low for girls – reaching only 57% – and for boys, it doesn’t exceed 40%,” he says. “The ideal coverage to prevent the disease is 90%.”
He believes misinformation about the vaccine, unfounded doubts about its effectiveness and a lack of vaccination campaigns have contributed to the low take-up.
According to the UK’s National Health Service (NHS) website, smoking can increase the risk of getting penile cancer, too. It also says you might be more likely to get penile cancer if you “have problems pulling back your foreskin (the skin covering your penis) to keep your penis clean (a condition called phimosis)”.
“When a man does not expose the glans and fails to clean the foreskin properly, it produces a secretion that accumulates,” Dr Cordeiro says. “This creates a highly favourable environment for bacterial infections.
“If this occurs repeatedly, it becomes a risk factor for the appearance of the tumour.”
But Brazil is not the only place where penile cancer is on the rise. According to the latest research, the number of cases is increasing around the world.
In 2022, the journal JMIR Public Health and Surveillance published the results of a large-scale analysis involving the latest data from 43 countries.
It found the highest incidence of penile cancer between 2008 and 2012 was in Uganda (2.2 per 100,000), followed by Brazil (2.1 per 100,000) and Thailand (1.4 per 100,000). The lowest was in Kuwait (0.1 per 100,000).
“Although developing countries still bear the higher incidence and mortality of penile cancer, the incidence is on the rise in most European countries,” the team of researchers led by Leiwen Fu and Tian Tian from Sun Yat-Sen University in China found.
They reported that England had seen an increase in penile cancer, rising from 1.1 to 1.3 per 100,000 between 1979 and 2009 and in Germany cases increased by 50% from 1.2 to 1.8 per 100,000 between 1961 and 2012.
These figures are only set to get higher, according to the Global Cancer Registries prediction tool. It estimates that by 2050, the global incidence of penile cancer will rise by more than 77%.
This change can largely be attributed to the ageing population, according to the experts, who say the highest incidence occurred in men in their 60s.
Dr Cordeiro says: “Penile cancer is a rare disease but also highly preventable”.
He advised that using condoms during sex and undergoing surgery to remove the foreskin in cases of phimosis could help reduce the risk of penile cancer.
Neil Barber, Clinical Lead for Urology at Frimley Health NHS Foundation Trust, adds: “Penile cancer is almost unheard of in the circumcised population. Poor hygiene and infections beneath the foreskin, as well as conditions like phimosis that make it difficult to retract the foreskin and maintain good hygiene, are risk factors. This is linked to higher overall infection risks”.
“Established risk factors also include unprotected sex, specifically not using condoms, with poor hygiene further increasing risks through this route.”
João is currently waiting for his latest test results, which he will receive later this year. “I’m confident that these exams will show that I’ll be cured,” he says.
“Now, following the amputation, the pain has gone away, and I’ve been feeling much better. But I’ll have to live with a partially amputated penis for the rest of my days.”
According to Cancer Research UK, more than 90% of men diagnosed with penile cancer which has not spread to nearby lymph nodes survive for five years or more. (BBC)
International
Spain Train Crash Kills at Least 64, Leaves 80 Injured
At least 64 people have been killed and about 80 others injured after two high-speed trains collided in central Spain, according to regional authorities.
The accident occurred early Wednesday near Urda in Toledo province, south of Madrid, along the high-speed railway line connecting the Spanish capital with Seville.
The head of the Castilla-La Mancha regional government, Emiliano García-Page, said about 50 of the injured were in serious condition, while 15 others were critically injured. He warned that some of the most seriously injured victims might not survive.
Spain’s Health Minister, Mónica García, said the injured were being transported to several hospitals across the region for treatment.
The collision involved a Renfe-operated AVE high-speed train travelling from Madrid to Seville and another train operated by private railway company Iryo.

Esther Padilla, a spokeswoman for the Castilla-La Mancha regional government, told Spanish public broadcaster TVE that both trains were travelling in the same direction when one struck the rear of the other, which had stopped.
The impact caused carriages to derail, with two carriages of the Iryo train reportedly plunging down an embankment.
Authorities said 397 passengers were aboard the Renfe train, while 147 were travelling on the Iryo train, bringing the total number of passengers involved to 544.
Signalling System Failure Under Investigation
Spain’s Transport Minister, Óscar Puente, said a failure of the railway’s signalling and control system preceded the accident.
Puente explained at a press conference that the LZB train control system went down at about 8:30 a.m. along a 63-kilometre stretch of railway, affecting six trains, although he said the exact number remained uncertain.
Following the failure, control was transferred to the Atocha control post, where a decision was made to allow the Renfe train to resume its journey.
“The decision to resume traffic without the system having been restored corresponds to the control centre,” Puente said, describing the circumstances as “inexplicable”.
Emergency workers were concentrating on rescuing survivors and recovering bodies from the most severely damaged carriages.
More than 200 members of Spain’s Military Emergencies Unit were deployed to the crash site, while local authorities mobilised food and other essential supplies for those affected.
Footage circulating on social media showed wreckage scattered along a slope, with rescue workers and members of the public gathered around the damaged train.
High-Speed Rail Services Suspended
Spain’s railway infrastructure operator, ADIF, suspended high-speed rail services between Madrid and the southern region of Andalusia following the collision.
The disruption resulted in delays and cancellations, with passengers waiting at railway stations, including Sevilla Santa Justa station.
The Civil Guard also deployed a disaster investigation team to the scene to assist with the investigation into the circumstances surrounding the crash.
Madrid Mayor José Luis Martínez-Almeida said the capital was sending emergency medical teams and firefighters to support rescue operations.
Government, European Leaders React
Spanish Prime Minister Pedro Sánchez said he was shocked by the tragedy and was in contact with Transport Minister Puente and Castilla-La Mancha regional leader García-Page as emergency crews continued their work.
“Shocked by the serious train accident in Toledo. My affection, solidarity, and support to all the victims and their families,” Sánchez said in a post on X.
European Commission President Ursula von der Leyen also expressed her condolences to the victims and their families.
“Today, Europe mourns with you,” she said.
French President Emmanuel Macron expressed solidarity with Spain, saying his thoughts were with the victims, their families, the injured and the emergency workers responding to the disaster.
The crash comes nine months after another accident involving high-speed trains operated by the same companies on the same railway line reportedly killed 46 people.
Journalist Graham Keeley, speaking to Al Jazeera from Spain, said the latest tragedy had come at a difficult time for the Spanish government, with an election expected in just over a month.
He noted that following the January accident, the government had promised to conduct safety checks across the country’s railway network.
The investigation is expected to examine the signalling failure, the decision to resume train movements and the sequence of events that led to the collision.
International
France braces for another weekend of protests as authorities launch massive security operation
France is bracing for yet another wave of protests this weekend with authorities racing to prevent a repeat of the kind of violence and riots that hit the nation last week.
French authorities will be launching a massive security operation with some 70,000 police officers deployed across the country over the weekend, according to the interior ministry.
Specialist SWAT units, helicopters, armored vehicles, police dogs and water cannons will all be part of the operation. On top of that, the number of French army soldiers that normally patrol Paris as part of the country’s counter-terrorism measures will be increased to free the police from stationary guard duties.
Interior Minister Laurent Nuñez issued a stark warning on Friday to anyone looking for trouble, saying the government would be “uncompromising with those who engage in destruction.”
Last week’s violence followed weeks of protests over education, dismal job prospects and the cost of living. Initially peaceful and attended mostly by students, the demonstrations quickly turned into the worst wave of deadly, nationwide violence in years.

This week, curfews were imposed in some cities to help maintain calm.
Bracing for Saturday
A large demonstration has been called for Saturday afternoon in Paris and French media are expecting hundreds of thousands of people to attend.
The protest is organized by France’s main student union, UNEF, with one of the country’s biggest trade unions, CGT, announcing it would join. Other groups are expected to attend, including farmers, climate activists and the Yellow Vests, the movement that first emerged in 2018 during the protests over fuel costs.
While the protest in Paris has been authorized by the authorities, French President Emmanuel Macron on Thursday banned all non-trade union protests on Saturday as he seeks to control the civil unrest.
But the preparations go well beyond bans and police warnings, especially since last week’s riots sparked criticism of the authorities for not taking the threat seriously enough.
A police officer ties in place a perimeter tape near Chatelet – Les Halles to enforce a curfew, in central Paris on October 20.

A police officer ties in place a perimeter tape near Chatelet – Les Halles to enforce a curfew, in central Paris on October 20.
Simon Wohlfahrt/AFP/Getty Images
The City of Paris announced earlier this week it was clearing public spaces of equipment and materials that could be used to cause damage, including barriers, bins, construction material and other items.
Many of the main tourist sites in the French capital, including world-famous museums like the Louvre, the Musée d’Orsay and the Musée de l’Orangerie will be closed on Saturday.
Art Basel finished the Paris version of its fair on Friday, two days earlier than scheduled. The Paris National Opera cancelled its performances on Saturday, citing the protests as the reason, and at least two dozen metro stations will also be closed for much of the day, according to Paris municipal authorities.
An NFL game between Pittsburgh Steelers and New Orleans Saints is set to take place at the Stade de France just outside of the capital on Sunday. While the match is scheduled to go ahead, a Steelers fan event in Paris was cancelled by the NFL.
During last weekend’s riots, at least two people died and multiple others suffered serious injuries, including two people who lost their hands. French Justice Minister Gérald Darmanin said some 2,700 people were held for questioning and 232 have been incarcerated in connection to the riots. (CNN)
International
Six people missing as plane vanishes from Bermuda to Boston
There are grave fears for the passengers of a private plane that suddenly vanished mid-flight, sparking a major search off the coast of the US.
US authorities say the Gulfstream G100 lost contact with air traffic control about 2am local time on Saturday (4pm Saturday AET) while flying from L.F. Wade International Airport in Bermuda to Boston Logan International Airport.
The US Coast Guard said the Federal Aviation Administration alerted it after contact was lost with the aircraft – which plummeted from 23,500 feet to 11,000 feet in just three minutes, according to FlightAware data.
“We are praying for a safe outcome,” a spokesperson for Latitude Air Ambulance, which operates the missing plane, told City News.
A search is now under way off Nantucket in the air and on water as crews work to locate the missing jet, the Coast Guard said. Data from FlightRadar24 showed a number of aircraft searching south of the island.

Six people are missing after a private jet vanished, sparking a major search off the coast of Nantucket in the US.
The plane was en route from Bermuda to Boston when it vanished.
“Air & surface crews have launched in search of the aircraft. Updates will be provided here as info becomes available,” the Coast Guard Northeast District said on X.
The plane was carrying out a medical evacuation in Bermuda – a British overseas territory in the north Atlantic Ocean, according to Clarence Togeretz, Director of Flight Operations at Latitude Air Ambulance.
“We always get rather concerned when our crew doesn’t report to us in a timely manner,” he told NBC News.
“But I will say that again, optimistically and positively, that doesn’t mean that the worst has happened.”
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