Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosisPreventionCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Prevention
Coping
Penile cancer is a rarecancerthat develops in the skin or tissues of the penis. It is closely linked to thehuman papillomavirus (HPV)and can often start with a lesion on the foreskin, head, or shaft of the penis that turns wart-like and oozes blood or foul-smelling fluid. Surgery,radiation, andchemotherapyare commonly used to treat penile cancer.
When diagnosed and treated early, penile cancer has a five-year survival rate of over 80%.
Thomas Barwick / Getty Images
Types of Penile Cancer
About 95% of penile cancers aresquamous cell carcinomas. This is the type that forms on the surface of the skin and the lining of hollow organs from cells known askeratinocytes. These cells secrete keratin, a fibrous protein that makes up skin, hair, and nails.
Less common types of penile cancer arebasal cell carcinoma,melanoma,Merkel cell carcinoma, andsmall-cell carcinoma.
Penile Cancer Symptoms
As the predominant type of penile cancer, squamous cell carcinoma of the penis manifests in much the same way as it would on other areas of the skin.
Early Stages
In the early precancerous stage, referred to ascarcinoma in situ, penile cancer may present in one of three different ways:
Erytroplasia of Queyrat is the most common manifestation of penile carcinoma in situ.
Later Stages
Over time, the lesion can spread laterally across the skin, covering large parts of the glans, prepuce, or shaft. Bleeding and the seepage of foul-smelling fluid are common.
In addition to lesions, people with penile cancer will often experiencedysuria(pain or burning with urination) and swelling of theinguinal lymph nodesof the groin.
Signs and Symptoms of Cancer
There are a number of factors that can increase a person’s likelihood of developing penile cancer. Among them:
Penile cancer is considered rare in North America and Europe, accounting for less than 1% of all cancers in men. Around 2,000 cases are diagnosed in the United States each year, while around 450 people die annually as a result of the malignancy.
The diagnosis of penile cancer typically starts with a physical exam and a review of your medical history and risk factors for the disease. Because penile cancer typically manifests with visible lesions, the workup is more straightforward than with other types of cancer and generally starts with evaluating tissue samples.
Biopsy
The procedure, performed underlocal anesthesiaor with a numbing agent, only takes a few minutes and is typically done in a hospital or outpatient surgical center.
The samples are then sent to the lab for evaluation under the microscope, typically using immunostains to diagnose and classify HPV-associated penile cancer.
What to Know About Getting a Biopsy
Staging
If cancer is confirmed, other tests will be ordered that determine the extent and severity of the malignancy. This may include imaging tests likeultrasoundormagnetic resonance imaging (MRI)to see if and how deeply cancer has invaded tissues inside the penis and surrounding organs.
These tests aim to stage the disease.Stagingis a system used to establish how advanced the disease is, the determination of which helps direct the course of treatment and predict the likely outcome (prognosis).
As with many other forms of cancer, penile cancer is staged used the TNM classification system, which looks at three specific factors:
Based on these values (and other factors such as thegrade of the tumor), the lab can stage the disease on a scale of 0 to 4. There are also various substages that help healthcare providers choose the most appropriate treatment options.
Surgery
The aim of surgery is to ensure the removal of all affected tissues while avoiding the partial or complete amputation of the penis (penectomy), if possible.
Based on the extent of the tumor, this may involve:
The size and location of the tumor will determine the extent of the surgery. Most experts recommend the removal of 5 millimeters of surrounding healthy tissue (referred to as themargin) while allowing for the removal of as little as 2 millimeters in some cases.
Lymph Node Status and Cancer Treatment
Radiation and Chemotherapy
Radiation therapy may sometimes be used to treat stage 1 and 2 tumors, particularly in people who cannot withstand surgery. In other stages, radiation may be used before surgery to reduce the size of the tumor (neoadjuvant radiation) or afterward to clear any remaining cancer cells (adjuvant radiation).
Radiation is also used as a form ofpalliative carein people with stage 4 cancer to keep the cancer in check, reduce symptoms, and improve the quality of life.
Chemotherapy is most commonly used as a form of neoadjuvant therapy in people with stage 3 penile cancer, either on its own or in combination with radiation. It may also be used if the cancer recurs in the lymph nodes or a distant part of the body.
The Role of Palliative Radiation
By way of example, a five-year overall survival rate of 60% means that 60% of people with that disease have lived forat leastfive years. Some may live for far longer.
For penile cancer, the five-year overall survival rate is as follows:
It is important to note the survival rates are based on all people with the disease, irrespective of age, cancer type, or health status. As such, the survival rate may be far better for some people and less so for others.
How Performance Status Influences Cancer Survival
Coping with cancer of any sort can be difficult. With penile cancer, people often have the added fear of disfigurement and the loss of sex function—not to mention the possible loss of the penis itself.
If faced with a diagnosis of penile cancer, there are several things you can do to prepare yourself emotionally:
A Word From Verywell
Penile cancer can be frightening enough that some people will ignore the early signs and only seek treatment when the symptoms become more overt. Don’t.
If diagnosed and treated early, a person with penile cancer will stand a better chance of long-term remission—possibly never seeing cancer again—while limiting the amount of harm that extensive surgery can do.
If significant surgery is needed, don’t hesitate to seek asecond opinion, if only to put your mind at ease that it is the most appropriate course of action.
If you need a referral to anoncologistspecializing in cancers of the genitals, speak with your healthcare provider or aurologist, or call the American Cancer Society at 1-800-227-2345 to be connected to a local chapter near you.
10 Tips on How to Survive Cancer
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Survival rates for penile cancer.
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Chan SL, Watchorn RE, Panagou E, et al.Dermatoscopic findings of penile intraepithelial neoplasia: Bowenoid papulosis, Bowen disease and erythroplasia of Queyrat.Australas J Dermatol.2019 Aug;60(3):e201-7. doi:10.1111/ajd.12981
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American Cancer Society.Penile cancer stages.
Baumgarten AS, Fisher JS, Lawindy SM, Pavlinec JG, Carrion RE, Spiess PE.Penile sparing surgical approaches for primary penile tumors: Preserving function and appearance.Transl Androl Urol.2017 Oct;6(5):809-19. doi:10.21037/tau.2017.04.01
Qi F, Wei X, Zheng Y, Ren X, Li X, Zhao E.Incidence trends and survival outcomes of penile squamous cell carcinoma: evidence from the Surveillance, Epidemiology and End Results population-based data.Ann Transl Med. 2020 Nov;8(21):1428. doi:10.21037/atm-20-1802
Centers for Disease Control and Prevention.HPV vaccine recommendations.
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