Penile cancer (cancer of the penis) is rare. Almost all cancers of the penis are squamous cell cancers. Squamous cells are found in the skin. They cover the surface of most parts of the body.
Rarely, other types of cancer can affect the penis. These include types of skin cancer such as basal cell carcinomas and malignant melanomas.
Most penile cancer is diagnosed over the age of 50. But it can also affect those who are younger.
The penis is the male sex organ. It is made of different types of tissue, such as skin, muscle and nerves. During sexual arousal, blood flow to the penis increases to make it hard and erect. The penis also contains a tube called the urethra. The urethra carries semen (sperm) from the testicles and pee (urine) from the bladder out of the body.
Signs and symptoms of penile cancer can include:
- a growth or sore (ulcer) on the head of the penis (the glans), the foreskin or the shaft
- thickening or raised areas
- changes in the colour of the skin, such as a redness, white patches or areas that look blueish, brown or black in colour
- discharge or bleeding
- pain, a lump or discharge underneath the foreskin, which is usually only seen if the foreskin is pulled back.
These symptoms can also happen with other conditions. But always see your GP straight away if you have any of these symptoms or any other changes. Penile cancer is easier to treat if it is diagnosed early.
The exact cause of penile cancer is not known. Having certain risk factors may increase the risk of developing it. But having one or more risk factors does not mean that you will develop penile cancer.
Penile cancer is not infectious and cannot be passed on to other people.
We have more information about the causes and risk factors of penile cancer.
If you have symptoms, you usually begin by seeing your GP. If your GP thinks that your symptoms could be caused by cancer they usually refer you to a doctor called a urologist. A urologist specialises in urinary or genital problems.
At the hospital, the urologist will ask you about your symptoms. They will examine the penis and check the area at the top of the legs (groin) for any swellings.
The main test to diagnose penile cancer is a biopsy. The doctor takes a sample of tissue (a biopsy) from any abnormal or sore-looking area on the penis.
Further tests for penile cancer
When you are diagnosed, you should be referred to a doctor at a hospital or centre that specialises in treating penile cancer. This is a rare cancer, so this may be some distance from your home and local hospital.
The specialist team will arrange further tests. These are to find out whether the cancer is only in the penis or if it has spread. The results help your specialist team plan your treatment.
These tests may include:
Tests to check the lymph nodes
One of the first places penile cancer can spread to is the lymph nodes in the groin. Lymph nodes are part of the lymphatic system. The lymphatic system helps protect us against infection and disease.
If the cancer has spread, the lymph nodes in the groin may be bigger than normal. But this can also happen because of infection. Your doctor may arrange for you to have tests on the lymph nodes.
An ultrasound scan uses soundwaves to build up a picture of the inside of the body. A gel is spread on to your groin and a small device that produces soundwaves is passed over the groin. This test is painless and only takes a few minutes.
Fine needle aspiration (FNA)
Removing a sample of lymph nodes
This operation is usually done under a general anaesthetic. The surgeon removes a sample of lymph nodes from one or both sides of the groin. They remove the nodes through a small cut in each side of the groin.
Sentinel lymph node biopsy (SLNB)
Waiting for test results can be a difficult time, we have more information that can help.
The stage of the cancer describes the size and position of the cancer and whether it has spread.
A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer may develop.
Knowing the stage and grade helps your doctors plan the best treatment for you.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.
The main treatments for penile cancer include:
You may also be offered treatment as part of a clinical trial.
We have more information about how different treatments are used to treat penile cancer.
After your treatment, you will have regular follow-up appointments with your surgeon or cancer specialist. They will examine you and you may have blood tests or scans.
These usually continue for several years. If you have any problems, or notice any new symptoms between appointments, let your doctor know as soon as possible.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
Relationships and sex
Your doctor or nurse will explain any possible effects your treatment may have on your sex life. If you have an early-stage cancer, treatment is unlikely to directly affect your sex life.
It is usually safe for you to have sex as soon as the treated area has completely healed and you feel ready. Your doctor or nurse will give you advice on this.
It can take time to recover from the side effects of radiotherapy before you feel ready to have sex. Radiotherapy may cause problems with getting and keeping an erection. This is called erectile dysfunction (ED). Your doctor or nurse will talk to you about the risk of this happening to you. There are different treatments to help with ED.
If you are having chemotherapy into a vein, it will not have a direct effect on your sex life. But side effects, such as tiredness, may mean you do not feel like having sex. You may find this slowly improves after treatment finishes.
Your doctor will advise you not to make someone pregnant while having chemotherapy. The drugs may harm the developing baby. It is important to use effective contraception during your treatment.
Some men may get side effects months or years after radiotherapy treatment. These are called late effects.
After radiotherapy, the healthy tissue in the penis may get thicker. This can cause narrowing of the tube that carries urine through the penis (the urethra). If this happens, you may find it difficult to pass urine. This can be treated with a simple operation to stretch the urethra. If you have difficulty passing urine, tell your doctor straight away.
We have more information about the late effects of pelvic radiotherapy for men.
Organisations such as Orchid offer more information and support for people with penile cancer.
Below is a sample of the sources used in our penile cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
EAU Guidelines: Penile Cancer (accessed 2018). Available from: uroweb.org/guideline/penile-cancer
Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up (accessed 2018). Available from: www.annalsofoncology.org/article/S0923-7534(19)31556-X/pdf
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.
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