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Objective: To evaluate sexuality after successful treatment of penile cancer., Patients and Methods: Post-therapy sexuality was evaluated in 30 men (median age 57 years; range 28-75) treated for cancer of the penis 80 months previously (median; range: 11-225 months). Treatment regimes were: local excision/laser beam treatment, 5; definitive radio-therapy, 12; partial penectomy, 9; total penectomy, 4. Patients underwent a semi-structured interview and completed three self-administered questionnaires (psychosocial adjustment to severe illness [PAIS], mental symptoms [GHQ], quality of life [EORTC QLQ C-30]). A global score of overall sexual functioning was constructed consisting of sexual interest, sexual ability, sexual satisfaction, sexual identity, partner relationship and frequency of coitus., Results: In 10 of 12 patients treated by irradiation the sexual global score was not or only slightly reduced compared with two of nine patients after partial penectomy and one of five patients with local surgery/laser beam treatment. All four patients who had undergone total penectomy recorded a severely reduced sexual global score. Of the six single domains, sexual identity and partner relationship did not change with increasing age, whereas the other scores of sexual life deteriorated as the patient became older. In the patients treated by irradiation doctors evaluated the patients' post-treatment sexuality to be more impaired than that experienced by the patients., Conclusion: Within the limitations due to the small number of patients studied, radiotherapy seems to be the treatment of choice in limited cancer of the penis if preservation of sexuality is a major therapeutic aim. Physicians counselling patients with this rare malignancy need more information about treatment-related problems of sexuality after different therapeutic modalities.

A series of 49 previously untreated patients with category T3 or T4 bladder cancer underwent treatment with low dose methotrexate and cisplatin; 44 patients were eligible for assessment of response. Complete response (CR) was seen in 5 patients (11%) and partial response in 15 (34%) (overall response rate 45%). Treatment was reasonably well tolerated with no major morbidity and no treatment-related deaths. After a median follow-up of 3.5 years, the 1-year and 2-year survival rates were 70 and 30% respectively. Ten patients remain recurrence-free without having received "definitive local therapy" (cystectomy and/or radiotherapy) at follow-up extending from 20 to 50 months.

Twenty-five previously untreated patients with measurable locally advanced and/or metastatic transitional cell carcinoma of the urinary bladder were included in a phase II study with carboplatin. Bolus injections were administered in 2 courses every 4 weeks at an initial dose of 400 to 450 mg/m2 with the option of increasing the dose to 450 to 500 mg/m2 in individual patients during the second cycle, depending on haematological toxicity. Two patients had a complete response (CR), 13 showed no change (NC) and 9 had progression of disease (PD), including 4 early progressions. There was no delay in treatment because of myelosuppression. Thrombocytopenia led to a reduction in drug dosage. No reduction in renal function was observed. Increased dosage did not increase the response rate. This study indicated the low effectiveness of single agent carboplatin in transitional cell carcinoma of the urinary bladder.