Cancers of the penis are usually types of skin cancers. Skin cancer can occur anywhere on the penis, but it most commonly occurs at the glans penis (the cone-shaped end of the penis), especially its base. Cancers affecting the skin of the penis, uncommon in the United States, are even rarer in men who have been circumcised.
Causes of Penile Cancer
The cause of cancer of the penis may be long-standing irritation, usually under the foreskin. Other risk factors include having a sexually transmitted infection Overview of Sexually Transmitted Infections (STIs) Sexually transmitted infection (STI) refers to an infection that is passed through blood, semen, vaginal fluids, or other body fluids during oral, anal, or genital sex with an infected partner... read more (particularly with human papillomavirus Human Papillomavirus (HPV) Infection Human papillomavirus (HPV) can be sexually transmitted and causes changes in cells, which can lead to genital warts or to precancer or cancer of the cervix, vagina, vulva, anus, or throat. Different... read more and HIV/AIDS Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause... read more ), balanitis Inflammation of the Penis The foreskin of the penis and the glans penis (the cone-shaped end of the penis) can be inflamed. Balanitis, which is inflammation of the glans penis, most commonly occurs when hygiene is poor... read more , being uncircumcised, having poor hygiene, and using tobacco. Squamous cell carcinoma Squamous Cell Carcinoma Squamous cell carcinoma is cancer that begins in the squamous cells of the skin. Thick, scaly growths appear on the skin and do not heal. To diagnose the cancer, doctors do a biopsy. Treatment... read more occurs most commonly. Early forms of cancer that are less common include Bowen disease Bowen Disease Bowen disease is an early form of squamous cell carcinoma that is confined to the outer layer of the skin (epidermis) and has not yet invaded the deeper layers. Bowen disease most commonly occurs... read more , extramammary Paget disease Paget Disease of the Nipple Paget disease of the nipple is a type of breast cancer that originates in milk ducts under the nipple but first appears on the skin. The term Paget disease also refers to an unrelated... read more , and erythroplasia of Queyrat.
Symptoms of Penile Cancer
Cancer usually first appears as a painless, reddened area, often with sores, but it can also be a hardened area or look like a wart. Cancers, unlike many other growths, do not heal for weeks. Erythroplasia of Queyrat causes a discrete, reddish, velvety or crusted area on the penis, usually on the glans penis or the inner foreskin. Bowen disease appears the same but affects the shaft. Bowenoid papulosis appears as bumps that are usually smaller, on the shaft of the penis. Lymph nodes in the groin may become enlarged because the cancer has spread to them or because they are infected and inflamed.
Diagnosis of Penile Cancer
Sometimes computed tomography (CT) or magnetic resonance imaging (MRI)
To diagnose cancer of the penis, doctors remove a tissue sample for examination under a microscope (biopsy). Sometimes computed tomography Computed tomography There are a variety of tests that can be used in the evaluation of a suspected kidney or urinary tract disorder. (See also Overview of the Urinary Tract.) X-rays are usually not helpful in evaluating... read more or magnetic resonance imaging Magnetic resonance imaging There are a variety of tests that can be used in the evaluation of a suspected kidney or urinary tract disorder. (See also Overview of the Urinary Tract.) X-rays are usually not helpful in evaluating... read more is done to determine whether the cancer has spread into nearby structures or other tissues outside the penis. Enlarged and inflamed lymph nodes may be biopsied.
Prevention of Penile Cancer
Strategies to prevent penile cancer include circumcision in early life, improved long-term hygiene in uncircumcised men, and vaccination against the most common cancer-causing strains of human papillomavirus Human Papillomavirus (HPV) Infection Human papillomavirus (HPV) can be sexually transmitted and causes changes in cells, which can lead to genital warts or to precancer or cancer of the cervix, vagina, vulva, anus, or throat. Different... read more in adolescents.
Treatment of Penile Cancer
Sometimes topical fluorouracil or imiquimod cream
To treat early or small cancers, doctors prescribe a cream containing fluorouracil or imiquimod or remove the cancer and some normal surrounding tissue with a laser during surgery. For some cancer, radiation therapy can be considered, either as seeds that are inserted or external radiation. For other cancers, doctors surgically remove the cancer, sparing as much of the penis as possible. Usually, men who undergo this type of surgery are able to use the remaining penile tissue for urination and sexual function. If cancer involves larger areas, the penis needs more extensive surgery.
Sometimes penile cancer spreads to the lymph nodes in the groin, and these nodes may need to be removed. Doctors treat men with multiple, bilateral or bulky inguinal lymph nodes that are concerning for cancer with neoadjuvant chemotherapy (given to shrink the tumor prior to surgical removal). If the tumor cannot be completely resected (surgically removed), then radiation may also be a consideration.
In most men, cancers are small and have not spread. These men survive for many years after treatment. Most men with cancer that has spread beyond the groin lymph nodes die within 5 years.