Wednesday, February 4, 2015

Penile Cancer: Carcinoma in situ


Carcinoma in situ (CIS) of the penis refers to a squamous cell cancer limited to the most superficial layers of the penile skin. This cancer is also known as Erythroplasia of Queyrat if on the glans (head) of the penis or Bowen Disease if on the shaft of the penis and was covered in a previous blog. While CIS is technically a non-invasive cancer and believed to have low metastatic potential, it has features of high-grade (potentially aggressive) cancer that warrants careful management.

History

CIS was inititally described by Queyrat in 1911 as a red, velvety, well-marginated lesion of the glans penis or prepuce (of uncircumcised men). Bowen described a similar lesion of the penile skin in 1912. The original description of Bowen disease related to subsequent internal malignancy, however subsequent studies have demonstrated that this relationship was nothing more than coincidence.[1]

 

Presentation and Prognosis

CIS has a similar clinical presentation whether on the glans penis or shaft. As described above, CIS can appear as a red, velvety, well-marginated lesion on the penis. Alternatively the lesion can be scaly, crusted or ulcerated – similar in appearance to eczema or psoriasis. Development of metastasis for CIS is incredibly rare – however 10-33% of CIS on the glans and 5% of CIS on the shaft can progress to more invasive, dangerous disease.[2,3]

 

Management

As CIS rarely metastasizes, treatment is focused on (1) confirmation of a non-invasive lesion, (2) resection of lesions with an adequate microscopic margin and (3) penis-sparing techniques if the lesion is on the glans. Confirmation of non-invasive malignancy may require multiple biopsies or complete excision of the area of concern. A 5mm margin if often adequate for lesions on the shaft, while circumcision will cure most cases of CIS on the prepuce. Lymph node dissection is only performed in cases suspicious for invasion or enlarged lymph nodes.

Penis-sparing treatments

Lesions of the glans penis can be difficult to treat surgically without distorting normal penile anatomy or sensation. A number of topical treatments including 5-fluorouracil, 5% imiquimod, laser ablation (YAG or KTP lasers) and radiation therapy have all been used with success.[4-10] For patients with large tumors or lesions refractory to topical treatment, local skin excision can be performed with skin grafting as needed.

Penile lesion (CIS) completely excised (left) and with a skin graft using non-hair bearing skin of the groin (right).


For patients with CIS involving the glans, partial or complete excision with partial or complete resurfacing can be performed.[11,12]



A. CIS on the glans penis, B. Glanular skin removed, C. Skin graft placed on the glans, D. Final, cosmetically pleasant result.  From Palminteri etal. [12]

These penile surgeries often involve a multidisciplinary approach including a urologic oncologist, plastic (reconstructive) surgeon and excellent pathologists to ensure eradication of the disease.  Penile cancer is a rare disease and balancing the risks of cancer with penile reconstruction and function is best done at a center with experience treating this disease.


  1. Anderson SL, Nielson A, and Reymann F: Relationship between Bowen disease and internal malignant tumors. Arch Dermatol 1973; 108: pp. 367.
  2. Buechner SA: Common skin disorders of the penis. BJU Int 2002; 90: pp. 498-506.
  3. Bleeker MCG, Heideman DAM, Snijders PJF, et al: Penile cancer: epidemiology, pathogenesis, and prevention. World J Urol 2009; 27: pp. 141-150.
  4. Harrington KJ, Price PM, Fry L, Witherow RO. Erythroplasia of Queyrat treated with isotretinoin. Lancet. Oct 16 1993;342(8877):994-5. 
  5. Micali G, Nasca MR, De Pasquale R. Erythroplasia of Queyrat treated with imiquimod 5% cream. J Am Acad Dermatol. Nov 2006;55(5):901-3. 
  6. Conejo-Mir JS, Munoz MA, Linares M, Rodriguez L, Serrano A. Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol. Sep 2005;19(5):643-4. 
  7. Arlette JP. Treatment of Bowen's disease and erythroplasia of Queyrat. Br J Dermatol. Nov 2003;149 Suppl 66:43-9. 
  8. Orengo I, Rosen T, Guill CK. Treatment of squamous cell carcinoma in situ of the penis with 5% imiquimod cream: a case report. J Am Acad Dermatol. Oct 2002;47(4 Suppl):S225-8. 
  9. Micali G, Lacarrubba F, Dinotta F, Massimino D, Nasca MR. Treating skin cancer with topical cream. Expert Opin Pharmacother. Jun 2010;11(9):1515-27. 
  10. Grabstald H, and Kelley CD: Radiation therapy of penile cancer. Urology 1980; 15: pp. 575-576.
  11. Pompeo AC, Zequi Sde C, Pompeo AS. Penile cancer: organ-sparing surgery. Curr Opin Urol. 2015 Mar;25(2):121-8. doi: 10.1097/MOU.0000000000000149.
  12. Palminteri E, Berdondini E, Lazzeri M, Mirri F, Barbagli G. Resurfacing and reconstruction of the glans penis. Eur Urol. 2007 Sep;52(3):893-8. Epub 2007 Jan 22.

32 comments:

  1. You need to recollect when utilizing home medications you that you need to give it an opportunity to check whether it really works or not. pearly penile papules removal cream

    ReplyDelete
    Replies
    1. hello everyone i am Anthony walters from USA i never thought i will be happy in my life again because of my small penis situation,i have struggling with this issue my life time and i could not find a professional result i wanted ,i ave went to hospitals,used vaccines,tried several herbs online ,penis pumps and all but none rendered me the solution i wanted ,i felt like killing myself when my fiance JENNIFER the woman i wanted to get married to in 1month time left me after undressing myself in front of her,my size was too embarrassing and shameful imagine a 37years old man like having 3.0inches penis size..the world seem to an end to me when we she left so one faithful day as i was watching a video on youtube i saw the comments of one MR MARIO MAMARU ABIYE testifying of this great herbal healer DR HARRY helped him enlarge his penis .i was shocked and happy so i quickly visited his website https://drharrysolution7.wixsite.com/solutiontemple and emailed him within 30mins he got back to me and told me all i need to buy and i did so after 4 days i received his herbal medicine ,he gave me instructions on how to use it ,as i am speaking to you people now after using the cream for just two weeks my penis size is 10 inches long and 8.0 girth ,,am so happy and grateful for his work in my life thank you so much dr harry ,,i later got married last week and i am a happy man now i also learnt he has cure for LOW SPERM COUNT,PREMATURE EJACULATION,ERECTILE DYSFUNCTION,HIV/AIDS VIRUS,DIABETES 1/2,HERPES DISEASE,PROSTRATE CANCER,ALS,HPV,LOVE SPELL and lots more you can email him on drharrysolution@gmail.com or call/whatsapp him directly on +2348143240563 you can text or call me on my number +14086506534 thanks

      Delete
    2. MY STORY OF HOW DR HARRY HERBAL MIXTURE ENLARGE MY PENIS SIZE FROM 3.5 INCHES TO 10.5 INCHES
      hello i am Paul Hussein from Pakistan but residing in the united state of america …i have been having sexual battles with my wife in my marriage because of my small penis and it was really so embarrassing imagine a grown up man of 39 years old having a small dick…i could not satisfy her and she threatened to cheat on me if i do not find a way..i searched for cure and results but none of them avail..i even used online pills,vaccines,drugs,herbal herbs but still no result so i was about going penis Sugery when i read about this great herbalist called Hr harry ..i quickly message him and he got back to me within 30 mins and told me all i need to do ,,i followed all his instructions and he sent down his herbal cream through UPS SERVICE to me and gave me instruction on how to apply it and within two weeks i was Beginning to feel myself …i now measure 10.5 inches long in erection and 8.0 girth fat …my wife is so proud and happy with me now..All thanks to DR HARRY for saving my marriage ..i am 100% grateful to you sir .NOTE
      he also have herbal remedies to problems like
      1.LOW SPERM COUNT
      2.PREMATURE EJACULATION
      3.ERECTILE DYSFUNCTION
      4.DIABETES CURE
      5.HIV/AIDS CURE
      6.CANCER CURE
      7.GENITAL HERPES CURE
      8.STROKE
      9.HEART FAILURE
      so if you are out there and need such help please contact him on drharrysolution@gmail.com or visit his website http://drharryherbaltempl.wixsite.com/solutiontemple you can Whatsapp him on +2349036417079 …

      Delete
    3. Hello everyone my name is john Scott,i was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr Austin and decided to email him on DRaustinenlargementhome@gmail.com
      so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis Enlargement, Within 1 week of it, i began to feel the enlargement of my penis, " and now it just 2 weeks of using his products my penis is about 9 inches longer and am so happy..feel free to contact DRaustinenlargementhome@gmail.com call him or what-apps him through +2349054007337..

      Delete
  2. Hey guys i just had an important question regarding the first photo .for that graft that was done does the skin that was added eventually change colour to suit everything around it or it stays white (please reply to me id really appreciate it and reply just really quick to alimakki99@hotmail.com

    ReplyDelete
  3. The big penis is always like by the every women, and every women want to sex with the person who has the big size of penis which gives women more pleasure and orgasm during sex. But what about for those who have the small size of penis what they do for giving the sexual satisfaction to their women, penis advantage review is here to help you to increase the size of your penis for giving satisfaction to every women.

    ReplyDelete
  4. My husband left me and our 6 month old daughter at the end of last month. I was and still am devesated. He said he fell out of love with me and that we were no good for each other since all we did was argue and fight. He then changed his story before he left saying he would come back for us after 2 weeks of working and saving up and move us all down to flordia to live so we could raise our daughter without my family’s meddling in our business. Well once he was down there I found this wasn’t true. He told me it was over and that he wanted to sign his rights away to our daughter and he wants to divorce. He claims he is very happy down there and I am happy for him. Turns out I found from one of his friends that he had no intention of coming back and he said that stuff so I wouldn’t over react and cause a scene. I miss him so terribly much..we’ve only been married since Septmeber 2014 and he’s about to turn 21 next month and I am 22. My family says it’s his age that caused this and that he’s scared. I’ve prayed to god every single night to be there for him and to help him grow up and understand what it is he’s doing. Meanwhile my heart..it’s not feeling broken like it first was..yes I’m sad and miss my husband terribly but it’s like my heart is full of hope..even after us bickering on the phone 2 days ago I still feel hope that things will get better and we can save our marriage and Dr.OOMIRIMIRI spell brought smile back in our marriage contact him today on his email: OOMIRIMIRI@GMAIL.COM OR CALL +2349073244122

    ReplyDelete
  5. PENIS ENLARGEMENT CREAM $ LOST LOVER SPECIALIST bring back your lost lover/friend within two days, Penis Enlargement Cream for making Penis big and strong, it also Stops early Ejaculations, Do you what medicine to attract customers for your business, Court cases even if one is convicted (If there 'is chance of appealing), Do you want children of your choice, Do you want promotion at work? he also remove bad spells from house or business; Win any kind of court case guaranteed, Do you want to recover your stolen property? Do you want to stop drinking and smoking or drugs? Ensure success in your business with the help of my business spells, Ensure success in your business with the help of my business spells, he remove black spots in your hands that keep taking your money away,he also have cure to all cancer , Find out why you are not progressing in life and get solution to it. Call or whatsapp :+2348139452225 or contact dr.noble via website http://noblespellhome1.wixsite.com/drnoble Email:(noblespellhome@gmail.com)

    ReplyDelete
  6. hello everyone in this forum i am little bit ashamed to share this marvelous story about a great spell caster who helped me enlarge my small penis size through his herbal mixture cream,i was heartbroken before because i have a very small penis about 3 inches which was so annoying and shameful i could not satisfy my wife in bed ,,my marriage was really breaking and i needed help urgently,i have used pills,vaccines,drugs,surgery but none worked...so one faithful day as i was browsing through the internet i saw few comments on a forum about how Mr MARK HENRY from UK testified of how he helped him enlarge his penis and also cured his MOM diabetes type 2 disease,,i contacted him through his email enlargementherbs@yahoo.com he replied and gave me steps to follow and i did just as he said ,and he sent me the herbal cream to me through UPS and i received it within 4 days and used the herbal cream for just 14 days to my greatest surprise my penis that was 3 inches before enlarge to 10.5 inches long when fully erected ,for just two weeks of using his herbal mixture cream ,,wow my wife loved me more and was so happy that i can satisfy her very well now in bed ,,i even last longer than before thank you so much DR James for making life a better one to live in ..so if you are out there having similar problems please contact him now on his email enlargementherbs@yahoo.com or whatsapp and call him on +2349055637784 thanks

    ReplyDelete
  7. hello everyone i am Anthony walters from USA i never thought i will be happy in my life again because of my small penis situation,i have struggling with this issue my life time and i could not find a professional result i wanted ,i ave went to hospitals,used vaccines,tried several herbs online ,penis pumps and all but none rendered me the solution i wanted ,i felt like killing myself when my fiance JENNIFER the woman i wanted to get married to in 1month time left me after undressing myself in front of her,my size was too embarrassing and shameful imagine a 37years old man like having 3.0inches penis size..the world seem to an end to me when we she left so one faithful day as i was watching a video on youtube i saw the comments of one MR MARIO MAMARU ABIYE testifying of this great herbal healer DR HARRY helped him enlarge his penis .i was shocked and happy so i quickly visited his website https://drharrysolution7.wixsite.com/solutiontemple and emailed him within 30mins he got back to me and told me all i need to buy and i did so after 4 days i received his herbal medicine ,he gave me instructions on how to use it ,as i am speaking to you people now after using the cream for just two weeks my penis size is 10 inches long and 8.0 girth ,,am so happy and grateful for his work in my life thank you so much dr harry ,,i later got married last week and i am a happy man now i also learnt he has cure for LOW SPERM COUNT,PREMATURE EJACULATION,ERECTILE DYSFUNCTION,HIV/AIDS VIRUS,DIABETES 1/2,HERPES DISEASE,PROSTRATE CANCER,ALS,HPV,LOVE SPELL and lots more you can email him on drharrysolution@gmail.com or call/whatsapp him directly on +2348143240563 you can text or call me on my number +14086506534 thanks

    ReplyDelete
  8. HOW DR.JOHN HELP ME TO MAKE MY PENIS INCREASE IN 10 INCHES LONG CONTACT ME MAIL<JOHNAUSTIN1100@GMAIL.COM NEW
    by: John Austin

    I'm Here to tell people over the world how Dr.john is real herbalist that we help you in any situation problem...my testimony is about a herbalist Doctor called Dr.john I was heartbroken because i had a very SMALL PENIS, not big enough to satisfy a Woman, i have been in so many relationship,but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the internet about this specialist called Dr.john and decided to email him on his email i saw on the internet, (drjohneenlargementhome@gmail.com) so I decided to give his herbal medicine a try. i emailed him and he got back to me, he gave me some comforting words with his herbal medicine for Penis Enlargement,Within 2 week of it, i began to feel the Enlargement of my penis, "and now it just 3 weeks of using his herbal medicine my Penis is about 10 inches longer, and i had to settle out with my Ex (Girlfriend) i was surprised when she said that she is satisfied with my sex and i have got a large penis,Am so happy..email him to help you too.his WhatsApp number:+2348060259313
    he also specialize on the following things

    Permanent penis enlargement
    Thick penis
    Bigger penis head
    Improved force and intensity
    Boosted semen quantity
    Effective erections
    Cures and prevents impotence
    Have multiple orgasms
    Ends Early ejaculation
    Increased stamina
    Hight blood pressure
    Best regard
    JOHN AUSTIN

    ReplyDelete
  9. Order quality Actavis, Ritalin, Xanax, Ativan, Oxycotin,Valium, Oxycodone Etc Text..(253) 948-4796
    ?Order quality Oxycodone, Percocert, Dilaudid, Codeine, Klonopin, Fentanyl, Nembutal, Ritalin, Valium, Roxicodone and many more..TEXT#(253) 948-4796 / EMAIL: globalresearchpharmacy@yahoo.com
    Stop buying fake or low quality stuffs. Order high quality stuffs from us with or without prescription. Are you a patient interested to order prescription drugs or are you interested to Get high? don't hensitate to contact us and refill your cup with or without prescription or insurrance. We are interested to be your long term supplier and you our reliable and value customers. We are proud of our quality and prices are discounted to all customers.

    we do offer secure and fast shipping via UPS, EMS, FedEx. packaging is dicrete and sealed proffessionally with aluminium foil.

    Text: (253) 948-4796

    email: globalresearchpharmacy@yahoo.com

    place your order

    Roxicodone
    Cialis

    Viagra

    Klonopin

    Percocert

    Fentalyn patches

    Mandrax

    Nipam

    Lexotan

    Subutex

    Nembutal ; powder,liquid and pills forms .

    Xanax

    Onax

    Rivotril

    Ativan

    Phentermine

    Ambien

    Ritalin

    Opana

    Hydrocodone

    Acetaminophen

    Alprazolam

    Bramodol

    Ibuprofen

    Arimidex

    Adderall

    Codeine

    Demerol

    Oxycodone

    Oxycontin

    SOMA

    Actavis Promethazine with Codeine purple cough syrup

    etc........

    my services...

    -No prescription required

    -Express prior overnight or next day delivery

    -Packing is highly discreet sealed, wrapped with an aluminum foil, safe and secure

    -No signature required upon arrival of parcel

    -Money back guarantee

    -I offer door to door delivery services

    -Excellent and unbeatable prices.

    -Good quality Meds.

    -Buy Direct and Save Time and Money!

    -100% Customer Satisfaction Guaranteed !

    Place your order and i will supply

    text: (253) 948-4796

    email: globalresearchpharmacy@yahoo.com

    ***PLEASE READ***

    This is a safe and secure environment, please conduct yourself in a professional manner.SERIOUS INQUIRIES ONLY. by contacting, you are agreeing that you are not law enforcement or affiliated, postal inspector, etc. please no thugs, jackboys, homies, kids, rippers, etc.

    ReplyDelete
  10. I have been living with my wife with a small penis in my marriage and this has resulted to an everyday problem with me and my wife because we had no child and we have been maried for 4 years, i was really confused and i was so shy to say it out to anybody until my wife treathen to go for a diveorce and that will be a shame to my path, so i read about a Shared Testiminy of Dr JIM FACEBOOK on how he has helped to many people to solve there problems with his herbal cream so i applied and he sent it to me and insttucted me on how to use it, what surprised me was that it took just 1 month and my penis was 12.9cm(5.1inches) when erect, and now my wife is 4 months pregnant, Do not be shy to loss what you cherish so much take a bold step today and contact him on his below contacts via Email drjimsolutioncenter@gmail.com or WhatsApp :+2348100368288 click Dr FB Page https://web.facebook.com/Dr-JIM-Solution-Center-368240946983102/posts/ so you can benefit from his herbal medicine

    ReplyDelete

  11. We have medications for the treatment of chronic back pains, cough, anxiety,panic disorder, depression, erectile dysfunction, dysfunction,adhd,narcolepsy, obesity,depression, fatigue,Weight Loss supplement and more online (no prescription required).We sell quality medications online at affordable and discount prices. Fast and secure overnight delivery. We are ready to sell minimum quantities and large supplies of our product worldwide (SHIPPING IS WORLDWIDE).

    Below is a list of some of our product :

    Klonopin 1mg,2mg
    Ativan
    Opama 10mg,20mg,30mg,40mg
    Ambien
    Soma 350mg
    Oxycotin
    Hydrocodone
    Roxicodone
    Percocert
    Lorazepam 2.5 mg (Ativan)
    Clonazepam 2 mg (Rivotril)
    Valium 2mg,5mg and 10mg
    Fentalyn patches
    Tramadol (Ultram) 50mg etc........

    We offer:
    - Good quality Medications
    - Good and affordable prices.
    - Fast and Reliable delivery -Tracking Available!
    -Tracking numbers available with references.
    - Various shipping option (Overnight and Airmail).
    -Shipping secure and discreet ,Delivery time OVERNIGHT & 1-5 days depending on location.
    - Buy with and without Prescription Required!
    -Additional Discounts on Bulk Orders
    - Buy Direct and Save Time and Money!
    - 100% Customer Satisfaction Guaranteed !

    Contact via details below:
    EMAIL.....jamesbernal2001@gmail.com
    CONTACT NUMBER...9046868791

    ReplyDelete
  12. Viagra Online Generic is the best and effective treatment for male impotence.

    ReplyDelete
  13. Online shop where you get 100% authentic products from pharmacies. We have the following products in stock: pain medications, anxiety medications and injections, ED pills and Cough Syrups and many other Pharmaceutical products at attractive prices. email at:(bodybuildingpharma59@gmail.com)

    Oxycodone, Roxicodone, Xanax 1 mg ksalols blues, Anesket Ketamina 1000 mg/10 mL, Flunitrazepam (rophynol) Methadone, Xanax 2 mg Bars, Oxycontin, percocet, MDMA, Meth, Cocaine, Adderall, Medical Marijuana Strains, Nembutal, Diluadid, Actavis etc

    TEXT OR CALL US (325) 261-0302
    ALSO VISIT OUR SITE http://allmedspharmacy.site123.me

    ReplyDelete
  14. Top grade marijuana,Edibles,Wax oils and Pain relief pills

    Top legit and genuine suppliers of Best medical marijuana like,Cannabis,
    sour diesel etc at affordable prices available. Very good for patients of
    cancer of all kinds.We await good customers.

    *Grand Daddy Purple Grade: A
    *Sensi Star x ak47 Grade: AAA
    *Northern Lights #5 :Grade: A+
    *Lemon KUSH:Grade: A+
    *Purple Kush:Grade:A+ Top Shelf
    *OG Kush :Grade:A++ Top
    *purple-urkle:Grade:A+
    *White Widow:A+
    *Blue Dream:A++
    *kurupts moonrock: A+
    *Kratom:A
    *Edibles
    *Wax oils

    And more....

    we are also suppliers of pain anxiety pain relief meds. Discount are also
    applicable for bulk buyers.The shipping is meticulously planned; packaging
    is done. Such as ,Adderall,Ativan,Oxycontin,Xanax,percocets,Morphin and
    more...
    E-mail Address; (bodybuildingpharma59@gmail.com)
    Text or Call; (325) 261-0302

    ReplyDelete
  15. Everything that is said about penis pills can be said about penis patches. Basically, the ingredient stacks are quite similar between the two. The major difference is a patch employs a transdermal method of allowing the ingredients to enter into the system.

    Pills can take much longer to digest and filter through the metabolism. Patches allow the ingredients to absorb through the skin slowly throughout the day. For many, this is a much more preferable method. full prosolution review here

    ReplyDelete
    Replies
    1. Hello viewers around the Globe, I was despondent because i had a very small penis, about 2.5 inches soft and 4 inches hard not nice enough to satisfy a woman, i have been in so many relationship, but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the INTERNET about this specialist called Dr,MOSES BUBA and decided to contact him on his email: buba.herbalmiraclemedicine@gmail.com) so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis Enlargement, Within 3 week of it, i began to feel the enlargement of my penis, " and now it just 4 weeks of using his products my penis is about 9 inches longer, and i had to settle out with my Ex girlfriend JOY, i was surprised when she said that she is satisfied with my sex and i have got a large penis. Am so happy, thanks to Dr MOSES BUBA I also learn that Dr MOSES BUBA also help with Breast Enlargement Hips and Bums Enlargement etc.. If you are in any situation with a little Penis, weak ejaculation, small breast_hips_bums do get to Dr MOSES BUBA now for help on his email ( buba.herbalmiraclemedicine@gmail.com ).

      Delete
  16. Dr. Sam has really made me so much believe in him by getting me cured with his herbal treatment. i really appreciate you Dr.Sam for bringing back happiness to my life again. thanks you so much,friends join me to thank him for what he has actually done for me i pray to you all for a good life and good health, and most especially to you Dr. Sam THANKS.

    I have been suffering from (HERPES SIMPLEX VIRUS) disease for the past four years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few months ago i came on search on the internet if i could get any information concerning the cure of this disease, on my search i saw a testimony of someone who has been healed from (HERPES SIMPLEX VIRUS) by this Man Dr Sam and she drop the email address of this man and advise we should contact him for any sickness that he would be of help, so i wrote to Dr. Sam telling him about my (HERPES Virus) well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me. I am now here to testify that i am not longer a herpes patient, I have experience a total transformation in my life,for all herpes patients get your herbal medicine to cure your sickness. And there has being rapid improvement in my health, I no longer feel pains and I wake up each morning feeling revived. So friends my advise is if you have such sickness or any other at all,you can contact him. (Supremecurehome@gmail.com) Wbesite: http://www.supremecurehome.blogspot.com
    CANCER
    EPILEPSY.
    GENPILENCIN.
    HIV AIDS.
    DIABETICS
    STROKE.
    EXPANDS OF PENIS BREAST
    H.P.V TYPE 1 TYPE 2 TYPE 3 AND TYPE 4. TYPE 5.
    HUMAN PAPAILOMA VIRUS.
    HERPES.
    SYPHILIS.
    HEPATITIS A B and C.

    Email: Supremecurehome@gmail.com WhatsApp number +2347087462033

    ReplyDelete
  17. Nembutal,Klonopin Ativan Dilaudid AMBIEN Oxycontin Percocet Roxicodone ETC

    contact us with your order

    Call/text/Whatsapp us : +1-(727) 201-1822
    Send Email:------------------ tropicpharma3 @gmail.com---------
    WEBSITE....................http://tropicpharmaceuticals.webs.com/




    I will supply you the best quality of the following medication and more:

    Medical Marijuana (Sinaloa Kush, Strawberry Kush, OG Kush, Arizonan western light purp, Afghani #1, Northern Lights etc)
    Ketamine vials (FOR DEPRESSION)
    Xanx: Pfizer Long Bars
    Fentalyn patches
    Nembutal (Pills, Liquid & Powder)
    Klonopin
    Ativan
    Dilaudid
    AMBIEN
    Oxycontin
    Percocert
    Roxicodone
    Quaaludes - Methaquallone pills

    KETAMINE CRYSTALS,
    KETAMINE VIALS,
    ACTAVIS POMETHAZINE COUGH SYRUP WITH CODIENE,,

    OXYCOTIN,
    ADDERALL,
    ACTAVIS,
    OPANA,
    XANAX,NORCO,
    DILUADID,
    MATHADONE,
    PERCOCET,
    RITALIN ,
    HYDROCODONE,
    SUBOXONE,
    SUBUTEX,
    IBRPOHEN ,
    ADVIL PM,
    VIAGRA GOLD ,
    LO LOESTRIN FE,
    EPHEDRINE,


    FENTANYL ( brand name: duragesic 5-12 12.5 mcg/hr patches box),
    DEMEROL ( Meperidine HCL) caps 8,
    AMBIEN 10MG,
    MORPHINE 30MG,
    VICODIN 5MG,
    VICODIN ES 7.5MG,
    EPHEDRINE 30MG,
    CELEBREX 100mg,
    CODEINE 15mg, and
    many more not mentioned

    My services are available for both clients with prescription and those without prescription

    ReplyDelete
  18. Hello everyone get the cure to low sperm count, penis enlargement, weak erection and premature ejaculation problem from DR OLIHA , my wife left me because i was not able to perform on bed,and because of that we were childless,he sent his product (herbal medicine) to me which i used and it is a permanent cure to weak erection and premature ejaculation my new wife is two month pregnant now, so i give all thanks to DR OLIHA for making me a man again,i was cured with his herbal product. contact DR OLIHA Email { oliha.miraclemedicine@gmail.com} or +2349038382931

    ReplyDelete

  19. I wake up every day and singing praises to this wonderful man called DR,KOBEKO i used to have a small penis 9 cm but only 1 and half months to have it reaches 18cm! My sex life is amazing and my girlfriend is mad and pleased by the enormous size of my penis. And all thanks be to DR.KOBEKO for his powerful herbal cream and oil i used for a little time in case you also need help email drkobekoenlragementhome@gmail.com u can also call him on his telephone number or whatsapp +2349064844957

    ReplyDelete
  20. We are urgently in need of KlDNEY donors for the sum of $500,000.00 USD, WhatsApp or Email for more details:
    hospitalcarecenter@gmail.com
    WhatsApp +91 779-583-3215

    ReplyDelete
  21. Good day readers, My name is
    Perry Terry, I want to share this article to notify the general globe how DR MADOu helped me to enlarge my penis. My penis size was 2.5 inches when soft and 5 inches when erected and due
    to this I was unable to satisfy my partner. I have being in great mess and have many of my partners had broke up
    with me because of this. I tried several pills prescribed to me by medical doctors but none was able to help me, so
    one day a came across a Great herbal doctor called MADOU a powerful herbal Dr and I contacted him, I explained
    to him about my condition and he told me that he is going to help me. DR MADOU sent me an enlargement product
    and when I received it, he told me how I to use it, after using it for just couple of days, I decided to see some
    changes, my penis was gradually increasing in size and now am happy to say that I am having 10.5 inches when
    erected and 8 inches when relaxed. I can now satisfy my partner the way I ever wanted and am very excited and
    happy. Anybody in same line of condition with small penis or weak erection and ejaculation can also contact DR MADOU via the below bestherbalhome@gmail.com
    All Thanks to DR MADOU for is help.

    ReplyDelete
  22. I would like to let all know that the size of your Penis really matters in your relationship or marriage. I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 4.5 inch long on erection and i am 39 years old. My wife said it was forbidden by the women of this world. My wife started sleeping with other men outside. Sometimes i will return from work without finding my wife at home and whenever i call or ask her where she was, she will always snub at me and sometimes just tell me to go get a larger dick. All this continued for a long time and it hurt me so much that i was at the edge of breaking up on the marriage till when i read about a doctor called DR.OMOHAN. online. I never thought i could smile and be in a happy marriage again if not for the help of DR.OMOHAN. I got the doctors Emails:(dromohanherbalmedicine@gmail.com ) on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs cream which i use for just 8 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 10 days and to my surprise my wife keeps screaming that she love my big dick now. Now my wife no longer cheat on me, and my penis is now about 10.5 inches long on erection and off course very large round. And now my wife uses breasts, hips and bums enlargement. I and my wife are very happy for the help rendered to me by DR.OMOHAN , and i want to say a big thanks to Doctor for the help. You can contact the Doctor now on his Email:( dromohanherbalmedicine@gmail.com ) Am thankful to the doctor for helping me.
    his whataspp number +2348164816038

    DOCTOR OMOHAN CAN AS WELL HELP THE FOLLOWING PROBLEMS
    1. HIV/AIDS SPELL
    2. HERPES SPELL
    3. CANCER SPELL
    4 IF YOU WANT YOUR EX LOVER BACK SPELL
    5 IF YOU NEED A BABY SPELLhim to solve
    6 LOW SPERM COUNT SPELL
    get all your problem solve. No problem is too big for him to solve.

    ReplyDelete


  23. Our meds are all of good quality from original manufacturers.
    We ensure safe and prompt delivery of parcel to your respective destination.
    We have available in stock Variety Medications And Medical marijuana for sale at discount prices.


    Contact us via details below:
    Contact email:- drugshome61@gmail.com
    SMS/CALL:- +1(424) 262-4463

    We do sell meds such as:

    - Oxycontin
    - Roxicodone
    - Rohypnol
    - Opana
    - Ativan
    - MSContin
    - Klonopin
    - Phentermine
    - MDMA (Pills and Powder form)
    - Percocet
    - Lortab
    - Norco
    - Nembutal Pentobarbital Sodium (Powder, Pills and Liquid form)
    - Seconal
    - Codeine Pills
    - Suboxone
    - Methadone
    - Valium
    - Hydrocodone
    - Desoxyn
    - Xanax
    - Dilaudid
    - Actavis Promethazine Codeine Purple Cough Syrup (16oz and 320z)
    - Ambien
    - Adderall
    - Ritalin
    - Vicodin
    - Ketamine
    - Soma
    - Viagra
    - Dexedrine
    - Mandrax (Quaalude)
    - Fentanyl

    We do sell HGH and steriods such as:

    - Anadrol
    - Testosterone
    - Deca Durabolin
    - Sustanon
    - Dianabol
    - Winstrol
    - Riptropin
    - Jintropin
    - Igtropin
    - Hypertropin
    - Hygetropin
    - Ansomon
    - Kigtropin and variety Steriods available.

    Marijuana strains:
    - AK-47
    - Og Kush
    - Sour diesel
    - White Widow
    - Hindu Kush
    - Blueberry/Blackberry Kush, etc


    We do have other meds available in stock though not mention above feel free to place your order for any meds.

    Contact via details below:

    GLOBAL MEDS ONLINE
    Contact email:- drugshome61@gmail.com
    SMS/CALL:- +1(424) 262-4463

    ReplyDelete
  24. Hello viewers around the Globe, I was despondent because i had a very small penis, about 2.5 inches soft and 4 inches hard not nice enough to satisfy a woman, i have been in so many relationship, but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the internet about this specialist called Dr, OLHIA and i decided to contact him on his website i saw on the internethttp://olihawonderfulherbs.webs.com/ so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis Enlargement, Within 3 week of it, i began to feel the enlargement of my penis, " and now it just 4 weeks of using his products my penis is about 9 inches longer, and i had to settle out with my Ex girlfriend Ella, i was surprised when she said that she is satisfied with my sex and i have got a large penis. Am so happy, thanks to Dr OLIHA I also learn that Dr OLIHA also help with Breast Enlargement Hips and Bums Enlargement etc.. If you are in any situation with a little Penis, weak ejaculation, small breast_hips_bums do get to Dr OLIHA now for help on his email {oliha.miraclemedicine@gmail.com} or whats app him number: +2349038382931

    ReplyDelete
  25. I would like to let all know that the size of your Penis really matters in your relationship or marriage. I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 4.5 inch long on erection and i am 39 years old. My wife said it was forbidden by the women of this world. My wife started sleeping with other men outside. Sometimes i will return from work without finding my wife at home and whenever i call or ask her where she was, she will always snub at me and sometimes just tell me to go get a larger dick. All this continued for a long time and it hurt me so much that i was at the edge of breaking up on the marriage till when i read about a doctor called DR.OMOHAN. online. I never thought i could smile and be in a happy marriage again if not for the help of DR.OMOHAN. I got the doctors Emails:(dromohanherbalmedicine@gmail.com ) on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs cream which i use for just 8 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 10 days and to my surprise my wife keeps screaming that she love my big dick now. Now my wife no longer cheat on me, and my penis is now about 10.5 inches long on erection and off course very large round. And now my wife uses breasts, hips and bums enlargement. I and my wife are very happy for the help rendered to me by DR.OMOHAN , and i want to say a big thanks to Doctor for the help. You can contact the Doctor now on his Email:( dromohanherbalmedicine@gmail.com ) Am thankful to the doctor for helping me.
    his whataspp number +2348164816038

    DOCTOR OMOHAN CAN AS WELL HELP THE FOLLOWING PROBLEMS
    1. HIV/AIDS SPELL
    2. HERPES SPELL
    3. CANCER SPELL
    4 IF YOU WANT YOUR EX LOVER BACK SPELL
    5 IF YOU NEED A BABY SPELLhim to solve
    6 LOW SPERM COUNT SPELL
    get all your problem solve. No problem is too big for him to solve.

    ReplyDelete
  26. I would like to let all know that the size of your Penis really matters in your relationship or marriage. I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 4.5 inch long on erection and i am 39 years old. My wife said it was forbidden by the women of this world. My wife started sleeping with other men outside. Sometimes i will return from work without finding my wife at home and whenever i call or ask her where she was, she will always snub at me and sometimes just tell me to go get a larger dick. All this continued for a long time and it hurt me so much that i was at the edge of breaking up on the marriage till when i read about a doctor called DR.OMOHAN. online. I never thought i could smile and be in a happy marriage again if not for the help of DR.OMOHAN. I got the doctors Emails:(dromohanherbalmedicine@gmail.com ) on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs cream which i use for just 8 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 10 days and to my surprise my wife keeps screaming that she love my big dick now. Now my wife no longer cheat on me, and my penis is now about 10.5 inches long on erection and off course very large round. And now my wife uses breasts, hips and bums enlargement. I and my wife are very happy for the help rendered to me by DR.OMOHAN , and i want to say a big thanks to Doctor for the help. You can contact the Doctor now on his Email:( dromohanherbalmedicine@gmail.com ) Am thankful to the doctor for helping me.
    his whataspp number +2348164816038

    DOCTOR OMOHAN CAN AS WELL HELP THE FOLLOWING PROBLEMS
    1. HIV/AIDS SPELL
    2. HERPES SPELL
    3. CANCER SPELL
    4 IF YOU WANT YOUR EX LOVER BACK SPELL
    5 IF YOU NEED A BABY SPELLhim to solve
    6 LOW SPERM COUNT SPELL
    get all your problem solve. No problem is too big for him to solve.

    ReplyDelete
  27. hello everyone this is real and i want to tell the whole world about
    how DR OSCAR HERBAL CREAM and LIQUID helped me enlarge my penis size,
    i have been trying since 23 years of age to enlarge my penis but none rendered
    me the help i want i have used vaccine ,penis pump,surgery,online creams
    from USA SAMOA,CANADA CAMBODIA and more but none of them enlarge my penis
    i was really frustrated and tired of living because my penis was too small
    ,imagine a cute and handsome man of 38 years old like me having 3.5 inches
    and to make it worse i was having erectile dysfunction which was so annoying
    to me,my girlfriends have left me because of my small penis ....to GOD be the
    glory as i was searching through the online for help on a facebook page i saw
    one Mr john from USA testifying of how DR OSCAR HERBAL CREAM and LIQUID enlarge
    his penis from 3 inches to 10 inches within two weeks of using his herbal cream..
    so i quickly contacted him through his email droscarenlargementhome@yahoo.com and
    message him and he replied me and gave me comforting words and He told me all i
    need to do and i was surprise after one week of using his cream my penis enlarge to
    7 inches and is now 10 inches long and very thicker i am so happy to feel like a real
    man in the bedroom at last so if you need penis enlargement,breast enlargement,weak
    erection,erectile dysfunction cure and many sexual relation cure do not hesitate to
    email him now on droscarenlargementhome@yahoo.com

    ReplyDelete
  28. Women Lie : Size DOES Matter

    And if you've ever taken a girl home, gotten hot and heavy and then felt embarrassment and PANIC when you take off your pants and see the look of DISAPPOINTMENT on her face, you need to go check this out right now . . .

    ===> Don't Disapoint Her With Your Little Guy <=====

    I'll tell you right now (and I've got proof), that anyone who tells you "size doesn't matter to women" is flat out lying to your face and trying to make you feel better . . .

    Heck, just recently I asked a focus group of women via an anonymous online survey if size matters, and again and again they said "Oh my god, I HATE IT when it's SMALL."

    For a long time I didn't know what to tell the guys who'd write in to me and ask how to get "bigger."

    I'd say something lame like "Women actually like guys who are smaller . . . you just have to get good with your hands."

    Then I found "THE BIBLE of Penis Enlargement" by this guy named John Collins . . .

    ===> They HATE It When It's Small <=====

    What's crazy about this is that John has ACTUAL VIDEO PROOF that his stuff works . . .

    He's got a literal mountain of testimonials from customers not just SAYING that they added 3 or even FOUR inches . . .

    But actual VIDEOS that can't be faked.

    I was 100% skeptical until I saw these vids, so even if you think it's "impossible" to get bigger (and there's no pills or suction devices or any of that crap) go check out the overwhelming proof on John's site.

    ===> Women Lie : Size DOES Matter <=====

    Best,

    [Ana]

    P.S. There's absolutely nothing in the world that will make you smile as wide as pulling down your pants and seeing a look of AWE and ANTICIPATION on a woman's face. The first time you hear her say "It might be too big" in a soft, excited voice, you're going to feel a thrill through your spine like you just snorted 3 lines of cocaine.

    If you aren't at least 7 inches you owe it to yourself (and to the women in your life) to check this out.

    ===> Proof Of REAL Growth <=====


    ReplyDelete