"It's something you never imagine will happen to you," says João, 63, who under went a partial amputation.

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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 two each day.

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.