Cancer of the penis is rare in the United States, and if it's caught early, there's a good chance of successful treatment and even a cure. Treatment for more advanced cancer may be less successful and more disfiguring.
Men who are uncircumcised are at greater risk for penile cancer, but all men should be aware of changes in the way their penis looks and feels. Most changes are a sign of a bacterial or fungal infection or an allergic reaction. However, these changes, especially if they return or don't go away, could be an indication of cancer. Men should notify their provider if they notice any of the following on the foreskin, shaft, or head of their penis:
- An area of skin becoming thicker or changing color
- A lump on the penis
- An ulcer, or sore, that might bleed
- A reddish, velvety rash
- Small, crusty bumps
- Flat, bluish-brown growths
- Smelly discharge or fluid under the foreskin
Penile tumors may be the result of chronic inflammation of the penile skin, which can sometimes occur when uncircumcised men develop phimosis, or narrowing of their foreskin. Phimosis can make proper hygiene of the penis difficult, leading to chronic or recurrent infections. Another possible cause of penile cancer is a sexually transmitted infection, or STI, caused by human papillomavirus, or HPV. Smokers and older men are more likely to get penile cancer than other populations.
Diagnosis and staging of penile cancer are done with a biopsy, in which a small sample of tissue is removed from the penis and examined under a microscope. If it's suspected that the cancer has spread to nearby lymph nodes, a lymph node biopsy may be done. If cancer is thought to have spread to other parts of the body, imaging tests may be done.
Treatment for penile cancer that is found early is often successful and low risk. Tumors on top of the skin may be treated with a skin cream that has few side effects. External radiation therapy is another treatment option for small lesions on the skin of the penis.
For slightly larger lesions, a small local excision, called Moh's surgery, may be done. In this procedure, layers of abnormal tissue are shaved off until normal tissue is reached. In most cases, Moh's surgery does not cause significant change to the appearance or function of the penis.
Large lesions require more tissue to be removed, and it's more likely that cancer has spread to nearby lymph nodes. A mix of surgery, radiation therapy, and chemotherapy may be considered in these situations. In addition, it may be necessary to remove or drain lymph nodes in the groin.
When cancer is more advanced, the whole penis may need to be removed.