×
A. Cancer is abnormal cell growth in the skin or organ tissue. When this cell growth starts in the penis, it is called penis cancer or penile cancer.
It is more common in men older than age 40, but younger men can get it. Most penis cancer patients are 60–70 years old.
A. Penis cancer usually appears on the penis skin. It can look like a rash or a sore that doesn’t heal. You might notice bleeding or a bad smell. If you have a foreskin, it might change in appearance or may have become too tight to pull back. If you notice these symptoms, ask your doctor if you have penis cancer or another medical problem. Problems with your penis might make you feel embarrassed or worried. Your doctor will be used to talking about these kinds of problems. Don’t wait to see your doctor.
Signs of advanced penis cancer:
A. The exact cause of penis cancer is not known. Men with certain conditions have a higher risk of getting penis cancer:
Men who have had the foreskin removed surgically (circumcision) have the lowest risk of getting penis cancer. Circumcision prevents phimosis and lichen sclerosis and makes men less likely to get HPV.
Other risk factors for penis cancer include:
Female sexual partners of men with penis cancer do not have a higher risk of cervical cancer from HPV.
A. The type of penis cancer depends on the type of cell that started growing. More than 90% of penis cancer starts in skin cells called squamous cells. Penis cancer develops mostly on the skin at the glans (head) or in the inner layer of the foreskin.
Carcinoma in situ (CIS) is a type of squamous cell cancer that affects only the cells in the skin of the penis and has not grown any deeper.
Penis cancer can arise from different cell types. The prognosis is usually dependent on the stage of the disease. But some specific cell types are more aggressive, and others are never life-threatening.
A. Your doctor will talk with you about your symptoms and medical history. The doctor will do a physical exam of your penis and check the lymph nodes in your groin for swelling. Tests might be arranged if your doctor thinks you could have penis cancer:
A. Penis cancer is classified by stage based on the aggressiveness of the cancer cells. Staging is a standard way to describe whether the cancer has spread. The kind of treatment you receive will depend on the stage. For staging, the Tumour Node Metastasis (TNM) classification is used. This classification system describes the penile tumour (T), spread to lymph nodes (N) and spread to other tissues or organs in the body (M).
Pattern of spread: A growth of abnormal cells forms a tumour. The first tumour on the penis, called primary tumour, can spread (metastasize) to other sites and form new tumours there (metastases). Penis cancer spreads gradually. In most cases, the tumour spreads first to the lymph nodes in the groin (inguinal) and then to the pelvic lymph nodes in the abdomen, both called regional spread. After that, new tumours can form in the lungs, bones, skin, or other organs. This is the usual pattern of spread, but exceptions may occur.
A. Penis cancer treatment involves removing the primary tumour and managing the lymph nodes and other tumours. The type of treatment depends on how deep the tumour has grown into the penis tissue. This is based on cancer stage, as discussed under Classification.
Treatment of Carcinoma in situ: Various options exist to treat penis CIS. The goal is to keep the penis looking healthy and working normally:
Treatment of Penis tumour: Treatment of the penis tumour depends on the size of the tumour and the tissues the tumour has grown into. Penis tumours are mostly treated with surgery.
If the whole penis is removed, a new opening must be created surgically to carry urine out of the body. This opening is usually placed on the perineum-the space between your scrotum and anus-between your legs.
Treatment of the lymph nodes:
Treatment of distant metastases:
When the cancer has spread to other tissues than lymph nodes in your body, you are very unlikely to be cured by therapy. The goal of treatment is to control or stop the cancer and relieve symptoms via:
A. If a tumour has grown into surrounding tissue, removing it surgically is the best chance of cure. If the tumour is in your penis tissue, some or all of your penis might need to be removed to get rid of the cancer.
A. After penis cancer treatment, your doctor will schedule you for regular visits to check your progress. Visits will be more frequent in the first year or two after surgery and then less
often over time.
A physical exam will look at your penis and check for new signs of cancer (recurrence).
You should examine your penis and lymph nodes regularly (self-examination). Get to know what is normal for you. Contact your doctor if you notice changes.
A. A satisfying sex life is part of your quality of life after penis surgery. Your doctor will consider this in recommending treatment. And surgery will preserve as much of your penis as possible. The type of treatment you have will affect your sex life after penis cancer.
Men treated for CIS and stage 1 penis cancer can usually continue their sex lives as before.
Partial penectomy for stage 2 or 3 penis cancer will preserve as much of the penis as possible. Many men are still able to have an erection and perform penetrative sex after surgery.
The whole penis may be removed to treat stage 3 or 4 penis cancer. You can have a fulfilling sex life after total penectomy, but it will likely be different. Your scrotum, testicles, and perineum will still be sensitive, and orgasm may be possible.
Explore new ways to be sexual with your partner. An erection might be possible after penis reconstruction surgery. It will depend on whether your nerves and blood supply can be reconnected. Ask your surgeon about what results are possible.
A. Sometimes penis cancer comes back after treatment is complete. This is called recurrence. Your doctor will check for recurrence during your follow-up visits. Regular self-examination will also help catch recurrence early.
Treatment is based on your previous type of treatment and the location of the new cancer: