Brazilian pensioner João sought medical attention in 2018 after discovering a wart on his organ.

"I started visiting medical clinics to understand what it was, but all the doctors told me it was due to excess skin and gave me medication," the 63-year-old recalls.

Despite the treatment, the wart continued to grow. This began to affect his marriage and João and his wife's sex life suffered. He was determined to find out what was going on.

For five years, João visited specialists who prescribed more drugs and ordered new biopsies. "Nothing solved it," says João. Then in 2023 he was diagnosed - João has cancer of his male organ.

"It was a very unpleasant surprise for my family, especially since they had to amputate part of my organ. I felt like my head had been cut off," João told the BBC.

Cancer of the male organ is rare, but the incidence and mortality rates are increasing worldwide. According to recent studies, Brazil has one of the highest rates of 2.1 per 100.000 men.

Between 2012-2022, there were 21.000 cases according to Brazil's Ministry of Health. This has resulted in over 4.000 deaths and over the past decade there have been over 6.500 amputations - an average of one every two days.

Maranhão, the poorest state in Brazil, was found to have the highest global incidence rate of 6.1 per 100.000 men.

Symptoms often begin with a sore that won't heal and a foul-smelling discharge. Some people also experience bleeding and spotting in the organ.

If detected early, there is a high probability of cure through treatments such as surgical removal of the lesion, radiotherapy and chemotherapy. But if left untreated, partial or total amputation may become necessary, and possibly even the testicles.

João underwent a partial amputation in January and says it was a difficult time.

"I was terrified of the operation, but there was no alternative. The feeling in the first weeks after the operation was a feeling of sadness, I can't deny it. It's terrible to lose a part."

Thiago Camelo Mourão from the Urology Department of the Camargo Cancer Center in Sao Paulo says that in the case of a partial amputation, urine continues to flow through the organ.

"However, in a complete amputation, the opening of the urethra may be displaced to the perineum, between the scrotum and the anus, requiring the patient to urinate sitting on the toilet."

Mauricio Dener Cordeiro of the Brazilian Association of Urology says that long-term infection with the human papillomavirus (HPV) is one of the main risk factors.

"Mass vaccination against HPV is essential because of its high effectiveness in preventing associated lesions," says Cordeiro, adding that vaccination rates in Brazil are below the level needed to be truly effective.

"The HPV vaccination rate in Brazil remains low for girls - reaching only 57% - and for boys it does not exceed 40%. The ideal coverage to prevent disease is 90%,” explains Cordeiro.

In 2022, the journal JMIR Public Health and Surveillance published the results of an analysis of 43 countries, according to which the highest incidence of cancer of the male organ between 2008-2012 was in Uganda (2.2 per 100.000), Brazil (2.1 per 100.000) , Thailand (1.4 per 100.000), while the lowest in Kuwait (0.1 per 100.000).