Penile cancer is a rare cancer that typically begins at the tip of the penis and extends upwards.

The tumors can begin in the foreskin or the head of the penis and eventually involve the urethra or erectile bodies of the penis. If penile cancer is found early, the prognosis is usually good, but a delay in diagnosis or treatment can worsen outcomes.

Symptoms

  • Redness or rash that appears on the penis
  • Lump or growth on the penis
  • An ulcer or sore that is non-healing
  • New drainage or discharge from the penis
  • Persistent swelling of the penis or foreskin

Risk Factors

  • Sexually Transmitted Infections – Human papillomavirus 16 and 18 are commonly linked to penile cancer. HIV can also be linked to higher risk.
  • Smoking
  • Hygiene – men who are circumcised and men with good hygiene are less likely to get penile cancer.
  • Age – Typically occurs after age 50

Diagnosis

Self-exam is critical to the diagnosis of penile cancer. Men should immediatley see a urologist if they notice any new growth on the penis or change in the appearance of the skin on the penis. These new findings may be embarrassing for some men but timely evaluation can prevent further progression of the tumor and allow for easier treatment. Diagnosis involves a biopsy of the affected area to view cells under a microscope in order to determine whether cancer is present. Imaging is typically obtained with a CT scan or MRI to ensure the cancer is limited to the penis. If lymph nodes in the groin are enlarged, a fine needle aspiration may be performed. This involves inserting a small needle into one of the lymph nodes in the groin to check for cancer cells.

Treatment

Options for treatment depend on the aggressiveness and stage of the penile cancer. Treatment will range from topical treatments to local surgery and/or more systemic options.

Surgical Treatments

  • Laser surgery – used to treat early non-invasive tumors
  • Mohs surgery – the tumor is shaved away in microscopic layers until no further cancer is seen under the microscope in order to limit the amount of tissue that has to be removed. After tumor removal, reconstruction then takes place to close the wound.
  • Circumcision – excision of the foreskin if tumor is limited to this location
  • Partial penectomy – removal of the part of the penis that the cancer has invaded
  • Total penectomy – removal of the entire penis if there is extensive invasion

Non-surgical Treatments

  • Topical creams – utilized in very early tumors that are only on the superficial surface of the penis
  • Radiation Therapy – can typically be used to treat affected lymph nodes
  • Chemotherapy – used in higher stage disease when cancer cells have escaped outside of the penis

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