Penile Cancer: Overview

What is penile cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.

Cancer that starts in cells in the penis is called penile cancer. It's rare. Most penile cancer is squamous cell carcinoma. This means the cancer starts in the flat skin cells (squamous cells) of the penis. Most penile cancers start on or under the foreskin or on the tip of the penis (glans). Penile cancer tends to grow slowly. It can often be cured if it's found early, when it's small and hasn't spread.

Who is at risk for penile cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors can't be controlled. But others may be things you can change. 

The risk factors for penile cancer include:

• Being in your 50s or older

• Not being circumcised

• Having a foreskin that's hard to retract (called phimosis)

• Poor hygiene that leads to a build-up of oil and dead skin cells under the foreskin (called smegma)

• HPV (human papillomavirus) infection

• Smoking and other tobacco use

• HIV/AIDS

• Having ultraviolet light treatment (PUVA) for psoriasis, a skin disease

Talk with your healthcare provider about your risk factors for penile cancer and what you can do about them.

Can penile cancer be prevented?

There's no sure way to prevent penile cancer. But you may be able to lower your risk for penile cancer by making some lifestyle changes. These include:

• Not smoking or using any other form of tobacco

• Having safe sex

• Having good personal hygiene habits, especially if you're not circumcised

What are the symptoms of penile cancer?

The symptoms of penile cancer can vary from person to person. The most common symptoms include:

• An ulcer, sore, lump, or growth on the penis, especially on the glans or foreskin

• Changes in skin color

• Skin thickening or tissue growth

• A red, velvet-like rash under the foreskin

• Bleeding from a growth or sore

• Small and crusty bumps

• Flat growths with a bluish-brown color

• Pain in the penis

• A discharge under the foreskin, with or without an odor

• Swelling at the tip of the penis, especially if the foreskin is tight

• Swelling in the groin area, which may be caused by enlarged lymph nodes

Many of these symptoms can be caused by other health problems. It's important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is penile cancer diagnosed?

If your healthcare provider thinks you may have penile cancer, you will need certain exams and tests to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. Penile cancer often starts on the surface of the penis. So, your healthcare provider will be able to see and feel it.

A biopsy is the only way to tell for sure if you have penile cancer. Medicine might be used to make the area numb. Then part or all of the changed area will be removed. This can be done with a needle or as a surgical procedure. The removed tissues (called biopsy samples) are sent to a lab and tested for cancer cells. The results will come back in about 1 week.

After a diagnosis of penile cancer, you'll need more tests. These help your healthcare providers learn more about your overall health and the cancer. They're used to find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what this means for your treatment. Ask your healthcare provider to explain the details of your cancer to you in a way you can understand.

How is penile cancer treated?

Your treatment choices depend on the size of the tumor, where it is on your penis, and the stage of the cancer. Other things to think about are if the cancer can be removed with surgery and your overall health. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer.

Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Be sure you understand exactly what to expect if surgery is an option. It might change your sex life and how your body looks and works. Sometimes part or even all of the penis is removed.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. Sometimes chemotherapy is put on the area as a cream. In this case, it's a topical treatment.

You may have just 1 treatment or a combination of treatments. Tests will be done during treatment to see how well it's working.

Penile cancer may be treated with:

• Surgery

• Radiation therapy

• Chemotherapy

• Topical immunotherapy

Talk with your healthcare provider about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your provider before making a decision.

What are treatment side effects?

Cancer treatments like chemotherapy and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting. Talk with your healthcare provider about the side effects linked with your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Coping with penile cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effects of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.