Penis Cancer Causes, Signs, Symptoms & Treatment

Penis cancer facts*

*Penis cancer facts by John P. Cunha, DO, FACOEP

Penis cancer is a disease in which malignant (cancer) cells form in the tissues of the penis.
Penile cancer is usually found on the glans or foreskin of the penis but can also occur on the shaft of the penis. Almost all penile cancers begin in the skin of the penis.
Causes and risk factors for developing penis cancer include human papillomavirus (HPV) infection, not being circumcised, being age 60 or older, phimosis, poor hygiene, many sexual partners, AIDS, UV treatment for psoriasis, and tobacco use.
Signs and symptoms of penile cancer include sores, redness, irritation, discharge, bleeding, or a lump on the penis.
A biopsy may be taken to determine if you have penile cancer.
Treatments for penile cancer include surgery, radiation therapy, and chemotherapy.
Prognosis and treatment options depend on the stage of the cancer, the location and size of the tumor, and whether the cancer has just been diagnosed or has recurred.
For stage I and II penile cancer (cancer is limited only to the penis), the five-year survival rate is 85%. Once the cancer has spread to surrounding tissues or lymph nodes in stage II or IV, the five-year survival rate is about 59%.

Penile cancer is a disease in which malignant (cancer) cells form in the tissues of the penis.

The penis is a rod-shaped male reproductive organ that passes sperm and urine from the body. It contains two types of erectile tissue (spongy tissue with blood vessels that fill with blood to make an erection):

Corpora cavernosa: The two columns of erectile tissue that form most of the penis.
Corpus spongiosum: The single column of erectile tissue that forms a small portion of the penis. The corpus spongiosum surrounds the urethra (the tube through which urine and sperm pass from the body).

The erectile tissue is wrapped in connective tissue and covered with skin. The glans (head of the penis) is covered with loose skin called the foreskin.

Penile Cancer Symptoms & Signs

Cancer of the penis is the formation of a malignant tumor on or in the cells of the penis. The cancer mostly develops on the foreskin but can form in other areas.

Signs and symptoms of penile cancer include

a sore or irritation on the penis,
redness, and
a lump on the penis.

Read about other signs and symptoms of penile cancer »

Human papillomavirus infection may increase the risk of developing penile cancer.

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Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for penile cancer include the following:

Circumcision may help prevent infection with the human papillomavirus (HPV). A circumcision is an operation in which the doctor removes part or all of the foreskin from the penis. Many boys are circumcised shortly after birth. Men who were not circumcised at birth may have a higher risk of developing penile cancer.

Other risk factors for penile cancer include the following:

Being age 60 or older.
Having phimosis (a condition in which the foreskin of the penis cannot be pulled back over the glans).
Having poor personal hygiene.
Having many sexual partners.
Using tobacco products.

Signs of penile cancer include sores, discharge, and bleeding.

These and other signs may be caused by penile cancer or by other conditions. Check with your doctor if you have any of the following:

Redness, irritation, or a sore on the penis.
A lump on the penis.

Tests that examine the penis are used to detect (find) and diagnose penile cancer.

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The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking the penis for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue sample is removed during one of the following procedures:
- Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
- Incisional biopsy: The removal of part of a lump or a sample of tissue that doesn't look normal.
- Excisional biopsy: The removal of an entire lump or area of tissue that doesn't look normal.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

The stage of the cancer.
The location and size of the tumor.
Whether the cancer has just been diagnosed or has recurred (come back).

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New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied.

Radiosensitizers

Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers helps kill more tumor cells.

Sentinel lymph node biopsy followed by surgery

Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. After the sentinel lymph node biopsy, the surgeon removes the cancer.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

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Treatment options by stage

Stage 0 (Carcinoma in Situ)

Treatment of stage 0 may be one of the following:

Mohs microsurgery.
Topical chemotherapy.
Topical biologic therapy with imiquimod.
Laser surgery.
Cryosurgery.

Talk with your doctor about clinical trials that may be right for you.

Stage I Penile Cancer

If the cancer is only in the foreskin, wide local excision and circumcision may be the only treatment needed.

Treatment of stage I penile cancer may include the following:

Surgery (partial or total penectomy with or without removal of lymph nodes in the groin).
External or internal radiation therapy.
Mohs microsurgery.
A clinical trial of laser therapy.

Stage II Penile Cancer

Treatment of stage II penile cancer may include the following:

Surgery (partial or total penectomy, with or without removal of lymph nodes in the groin).
External or internal radiation therapy followed by surgery.
A clinical trial of sentinel lymph node biopsy followed by surgery.
A clinical trial of laser surgery.

Stage III Penile Cancer

Treatment of stage III penile cancer may include the following:

Surgery (penectomy and removal of lymph nodes in the groin) with or without radiation therapy.
Radiation therapy.
A clinical trial of sentinel lymph node biopsy followed by surgery.
A clinical trial of radiosensitizers.
A clinical trial of chemotherapy before or after surgery.
A clinical trial of new drugs, biologic therapy, or new kinds of surgery.

Stage IV Penile Cancer

Treatment of stage IV penile cancer is usually palliative (to relieve symptoms and improve the quality of life). Treatment may include the following:

Surgery (wide local excision and removal of lymph nodes in the groin).
Radiation therapy.
A clinical trial of chemotherapy before or after surgery.
A clinical trial of new drugs, biologic therapy, or new kinds of surgery.

Treatment options for recurrent penile cancer

Treatment of recurrent penile cancer may include the following:

Surgery (penectomy).
Radiation therapy.
A clinical trial of biologic therapy.
A clinical trial of chemotherapy.