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Penile Cancer

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What is Penile Cancer?

Penile cancer is a disease in which malignant cells are found on the skin and in the tissue of the penis. It is a rare cancer in the United States.

According to the American Cancer Society, penile cancer is rare. It accounts for fewer than 1% of cancers in men in the U.S. Every year, doctors diagnose about 2,200 new cases in the U.S., and about 440 men die from it.

Almost all penile cancers develop from skin cells called squamous cells. They can develop anywhere on the penis, but most commonly occur on the foreskin in uncircumcised men or on the glans (the tip of the penis).

Penile Cancer Causes

The exact cause of penile cancer is unknown. Although, there are factors that are believed to be involved in its cause.

Penile Cancer Risk Factors

Common risk factors of penile cancer include:

  • Human papillomavirus (HPV) infection. HPV is a group of related viruses. They pass from person to person through unprotected sex or other skin-to-skin contacts.
  • Tobacco use. Men who smoke have a higher rate of penile cancer than those who don't.
  • Age. About 80% of men who have penile cancer are over 55.
  • HIV. HIV infection has been shown to be associated with penile cancer.
  • Having an uncircumcised penis. Infant circumcision can lower the rate of penile cancer in adulthood.
  • Phimosis. Sometimes the foreskin becomes tight and difficult to retract, a condition known as phimosis. This can make examination of the penis and detection of penile cancer more difficult.
  • Poor hygiene. Poor hygiene can lead to chronic inflammation, which has been associated with penile cancer.

Symptoms of Penile Cancer

Some of these symptoms may not be visible unless the foreskin is pulled back. Most penile cancers do not cause pain, but some can cause ulcerations and bleeding.

The first sign of penile cancer is often a change in the skin of the penis. These changes may include:

  • Painless lumps
  • Redness or irritation
  • A sore that bleeds
  • A sore that doesn't heal
  • A red rash under the foreskin
  • Crusty bumps
  • Flat, dark-colored growths
  • A bad-smelling discharge from under the foreskin
  • Swelling at the end of the penis

If cancer has spread from the penis, you may also feel swelling of the lymph nodes in your groin.

Diagnosing Penile Cancer

A number of benign conditions, including genital warts and infections, may give similar symptoms to penile cancer. For this reason, it is very important to get a correct diagnosis as early as possible.

Diagnosing penile cancer includes:

  • Medical history: Your doctor will ask you questions regarding your symptoms and discuss your medical history.
  • Physical exam: Your doctor will look at your genital area for signs of penile cancer or other health concerns. Your doctor might also look at the lymph nodes in your groin to see if they are swollen.
  • Tests: Penile cancer is initially diagnosed with a biopsy. Other tests might be performed if needed.

Testing for penile cancer

If your medical history or physical exam suggests you might have penile cancer, your doctor will perform other tests.

Common tests include:

  • Biopsy: A small sample of tissue is removed from the penis and is looked at under a microscope.
  • Imaging tests: Photos of the inside of your body through x-ray, MRI, or sound waves. If your doctor suspects cancer has spread to another part of the body, these tests may be used.
  • Computed tomography (CT): This shows how big the tumor is and can determine if the cancer has spread elsewhere, such as the lymph nodes.
  • MRI: These scans use radio waves and magnets rather than x-rays to show detailed images of the inside of the body.
  • Ultrasound: This will show how deeply the cancer has spread into the penis, and find enlarged lymph nodes in the groin.

Penile Cancer Treatment

Squamous cell penile tumors tend to grow slowly and can usually be cured when they are detected early. Early detection leads to treatment that is simpler, more effective, and less likely to cause significant side effects or complications.

The three main methods for treating penile cancer are surgery, radiation therapy, and chemotherapy. Surgery is the most common treatment for all stages of penile cancer.

If doctors find penile cancer early, chances for a cure are better. Doctors can treat early-stage penile cancer with less invasive therapies. Doctors can treat advanced penile cancer, but this often requires much more invasive surgery.

Radiation is an alternative to surgery, especially if the tumor is small. Radiation uses high-energy rays to kill cancer cells. It is also used to keep cancer from returning. Chemotherapy is a treatment for more advanced penile cancer. If your cancer has spread beyond the penis, chemo drugs enter the body through a needle into a vein (IV).

Topical therapies are available for low-risk penile cancers which will then require close monitoring.

The Department of Urology provides expert diagnosis and treatment of penile cancer. Department surgeons perform a range of surgical options, including surgery to remove cancer that has spread to the lymph nodes.

For patient referral or consultations, contact the Department of Urology at 412-692-4100.