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Penile Cancer

By

Thenappan Chandrasekar

, MD, Thomas Jefferson University

Last full review/revision Feb 2022
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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 (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted infections may be caused... read more Overview of Sexually Transmitted Infections (STIs) (particularly with human papillomavirus Human Papillomavirus (HPV) Infection Human papillomavirus (HPV) causes warts. Some types of HPV cause skin warts, and other types cause genital warts (growths in or around the vagina, penis, or rectum). Infection with some HPV... read more Human Papillomavirus (HPV) Infection 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 can cause acquired immunodeficiency syndrome (AIDS). HIV is transmitted... read more Human Immunodeficiency Virus (HIV) Infection ), 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 is inflammation of the glans penis. Posthitis is inflammation of the foreskin. Balanoposthitis... 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 Squamous Cell Carcinoma 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. (See also Overview of Skin Cancer... read more Bowen Disease , 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. (See also Overview of Skin Cancer.) The term Paget disease... read more Paget Disease of the Nipple , 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

  • Biopsy

  • Sometimes computed tomography (CT) or magnetic resonance imaging (MRI)

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) causes warts. Some types of HPV cause skin warts, and other types cause genital warts (growths in or around the vagina, penis, or rectum). Infection with some HPV... read more Human Papillomavirus (HPV) Infection in adolescents.

Treatment of Penile Cancer

  • Sometimes topical fluorouracil or imiquimod cream

  • Surgery

  • Radiation

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.

Drugs Mentioned In This Article

Generic Name Select Brand Names
CARAC
ALDARA
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