What is penile cancer?

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 men diagnosed with penile cancer are over the age of 50. But it can also affect younger men.

The penis

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.

The male reproductive system

Symptoms of penile cancer

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.

Causes of penile cancer

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.

Diagnosis 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.

Biopsy

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:

  • CT scan

    CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of your body.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

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.

  • Ultrasound scan

    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)

    If a lymph node is bigger than normal, the doctor may use a needle to take some fluid from it into a syringe. This is called a fine needle aspiration. Your doctor may recommend removing one or more lymph nodes. This may be done at the same time as surgery to remove the cancer.

  • 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)

    sentinel lymph node biopsy (SNLB) is a way of checking the smallest possible number of lymph nodes in the groin to see if they contain cancer cells.

Waiting for test results can be a difficult time, we have more information that can help.

Staging and grading of penile cancer

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.

Treatment for penile cancer

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:

  • Surgery

    Surgery is the main treatment for cancers of the penis that are larger. Depending on their position, small early cancers can be treated with minor surgery.

  • Radiotherapy

    Radiotherapy is sometimes used instead of chemotherapy. It may sometimes be used instead of surgery. Radiotherapy may be given to lymph nodes in the groin after surgery.

  • Chemotherapy

    Chemotherapy is sometimes given before or after surgery. Or it can be used if the cancer has spread to other parts of the body.

  • Chemoradiation

    You may have chemotherapy at the same time as radiotherapy to make it work better. This is called chemoradiation.

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 penile cancer treatment

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.

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.

After radiotherapy

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.

After chemotherapy

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.

Late effects

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.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

How we can help

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