Penile cancer, or cancer of the penis, is a relatively rare form of cancer that affects the skin and tissues of the penis. It occurs when normally healthy cells in the penis become cancerous and begin to grow out of control, forming a tumor.
The cancer may eventually spread to other areas of the body, including the glands, other organs, and lymph nodes. The American Cancer Society estimates approximately 2,300 cases of penile cancer are diagnosed in the United States every year.
What are the symptoms of penile cancer?
The first noticeable symptom of penile cancer is typically a lump, mass, or ulcer on the penis. It may look like a small, insignificant bump or a large, infected sore. In most cases, it’ll be located on the head or foreskin instead of on the shaft of the penis.
Other symptoms of penile cancer include:
• itching
• burning
• discharge
• changes in the color of the penis
• thickening of the penile skin
• bleeding
• redness
• irritation
• swollen lymph nodes in the groin
Call your doctor right away if you’re experiencing any of these symptoms. Getting an early diagnosis and treatment is critical for increasing the chances of a positive outcome.
What are the risk factors for penile cancer?
Men who are uncircumcised are more likely to develop penile cancer. This may be because uncircumcised men are at risk for other conditions that affect the penis, such as phimosis and smegma.
Phimosis is a condition in which the foreskin becomes tight and difficult to retract. Men with phimosis have a high risk of developing smegma. Smegma is a substance that forms when dead skin cells, moisture, and oil collect underneath the foreskin. It may also develop when uncircumcised men fail to clean the area under the foreskin properly.
Men are also at an increased risk for penile cancer if they:
• are over age 60
• smoke cigarettes
• practice poor personal hygiene
• live in a region with poor sanitation and hygiene practices
• have a sexually transmitted infection, such as the human papillomavirus (HPV)
How is penile cancer diagnosed?
Your doctor can make a penile cancer diagnosis by performing a physical examination and using certain diagnostic tests.
During the physical exam, your doctor will look at your penis and inspect any lumps, masses, or sores that are present. If cancer is suspected, your doctor will likely perform a biopsy. A biopsy involves the removal of a small sample of skin or tissue from the penis. The sample is then analyzed to determine whether cancer cells are present.
If the biopsy results show signs of cancer, your doctor may want to perform a cystoscopy to see if the cancer has spread. A cystoscopy is a procedure that involves the use of an instrument called a cystoscope. A cystoscope is a thin tube with a small camera and light at the end.
During a cystoscopy, your doctor will gently insert the cystoscope into the penis opening and through the bladder. This allows your doctor to view the different areas of the penis and the surrounding structures, making it possible to determine whether the cancer has spread.
In some cases, an MRI of the penis is sometimes conducted to make sure that cancer hasn’t invaded the deeper tissues of the penis.
Stages of penile cancer
The stage of the cancer describes how far the cancer has spread. Based on the results of the diagnostic tests, your doctor will determine which stage the cancer is currently in. This will help them determine the best treatment plan for you and allow them to estimate your outlook.
The staging criteriaTrusted Source for penile cancer are outlined as follows:
Stage 0
• Cancer is only on the top layer of the skin.
• Cancer hasn’t to spread any glands, lymph nodes, or other parts of the body.
Stage 1
• Cancer has spread into the connective tissue just below the skin.
• Cancer hasn’t spread to any glands, lymph nodes, or other parts of the body.
Stage 2
• Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels or cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
• Cancer hasn’t spread to any other parts of the body.
Stage 3A
• Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels or cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
• Cancer has spread to one or two lymph nodes in the groin.
• Cancer hasn’t spread to any other parts of the body.
Stage 3B
• Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels or cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
• Cancer has spread to multiple lymph nodes in the groin.
• Cancer hasn’t spread to any other parts of the body.
Stage 4
• Cancer has spread to nearby areas, such as the pubic bone, prostrate, or scrotum, or cancer has spread to other areas and organs of the body.
How is penile cancer treated?
The two main types of penile cancer are invasive and noninvasive. Noninvasive penile cancer is a condition in which the cancer hasn’t spread to deeper tissues, lymph nodes, and glands.
Invasive penile cancer is a condition in which the cancer has moved deep into the penis tissue and surrounding lymph nodes and glands.
Some of the main treatments for noninvasive penile cancer include:
• Circumcision. The foreskin of the penis is removed.
• Laser therapy. High-intensity light is focused to destroy tumors and cancer cells.
• Chemotherapy. An aggressive form of chemical drug therapy helps eliminate cancer cells in the body.
• Radiation therapy. High-energy radiation shrinks tumors and kills cancer cells.
• Cryosurgery. Liquid nitrogen freezes tumors and removes them.
Treatment for invasive penile cancer requires major surgery. Surgery may involve the removal of the tumor, entire penis, or lymph nodes in the groin and pelvis. Surgery options include the following:
Excisional surgery
Excisional surgery may be performed to remove the tumor from the penis. You’ll be given a local anesthetic to numb the area so you don’t feel any pain. Your surgeon will then remove the tumor and affected area, leaving a border of healthy tissue and skin. The incision will be closed with stitches.
Moh’s surgery
The goal of Moh’s surgery is to remove the least amount of tissue possible while still getting rid of all the cancer cells. During this procedure, your surgeon will remove a thin layer of the affected area. They’ll then examine it under a microscope to determine whether it contains cancer cells. This process is repeated until there are no cancer cells present in the tissue samples.
Partial penectomy
A partial penectomy removes part of the penis. This operation works best if the tumor is small. For larger tumors, the entire penis will be removed. Full removal of the penis is called a total penectomy.
Regardless of the type of surgery performed, you’ll need to follow up with your doctor every two to four months during the first year after your surgery. If your entire penis is removed, you can talk to your doctor about whether penis reconstructive surgery may be an option.
What’s the long-term outlook for people with penile cancer?
Many people who receive diagnoses of early stage penile cancer often make a full recovery.
According to the American Cancer Society, the five-year survival rate for people with tumors that never spread to the glands or lymph nodes is approximately 85 percent. Once the cancer reaches the lymph nodes in the groin or nearby tissues, the five-year survival rate is approximately 59 percent.
It’s important to note that these are general statistics. Your outlook may differ depending on your age and overall health. The most important thing you can do to increase your chances of recovery is to stick with the treatment plan suggested by your doctor.