Penile cancer is a rare type of cancer that occurs on the skin of the penis or within the penis.
In the UK, around 550 men are diagnosed with cancer of the penis each year. It most commonly affects men over 60 years of age.
Over the last 30 years, the number of penile cancer cases has increased by more than 20%, possibly due to changes in sexual practices.
However, improvements in diagnosis, staging and treatment have led to a similar reduction in the number of deaths resulting from the condition.
You should be aware of any abnormalities or signs of penile cancer, including:
If you experience these symptoms, it's important that they're checked by your GP as soon as possible. It's unlikely they'll be caused by cancer of the penis, but they need to be investigated.
Any delay in diagnosing penile cancer could reduce the chances of successful treatment.
The penis is made up of many different types of tissue. The type of penile cancer you have will depend on the type of cell the cancer developed from.
The most common types of penile cancer include:
The cause of penile cancer isn't known, but certain risk factors can increase your chances of getting it.
Studies have found that almost 5 out of 10 men (47%) with penile cancer also have an HPV infection.
Age is also a risk factor for cancer of the penis. The condition rarely affects men under 40 years of age, and most commonly occurs in men aged over 60.
Smoking is the most significant lifestyle factor associated with penile cancer. Chemicals found in cigarettes can damage cells in the penis, which increases your risk of getting the condition.
Repeated infections are linked to a higher risk of developing some types of penile cancer, because they can weaken your immune system.
Your GP will ask you about any symptoms you have and when they occur. They'll also examine your penis for signs of penile cancer.
In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of penile cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected penile cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral.
If your GP suspects penile cancer, they may refer you to a specialist – usually a urologist (a doctor who specialises in conditions that affect the urinary system and genitals).
The specialist will ask about your symptoms and check your medical history. They may also check for any physical signs of penile cancer.
A blood test may be carried out to check your general health and the number of blood cells.
To confirm a diagnosis of penile cancer, you may need to have a biopsy. A small tissue sample will be removed so it can be examined under a microscope for cancerous cells.
Treatment for penile cancer will depend on the size of the affected area and the rate at which the cancer has spread.
For example, in most cases of carcinoma in situ (CIS), where only the skin cells of the penis are affected, treatment will usually involve either using a chemotherapy cream or having laser surgery to remove the affected area of skin. You will usually have a skin graft after surgery.
The main treatments for penile cancer that isn't at a very early stage are:
Surgery will involve removing the cancerous cells and possibly some of the surrounding tissue.
In most cases, any physical changes to your penis after an operation can be corrected with reconstructive surgery. Skin and muscle can be taken from elsewhere in the body to recreate a functioning penis.
However, with early diagnosis and modern surgical techniques, your surgeon will usually be able to preserve as much penile tissue as possible.
As part of most treatments for penile cancer, the lymph glands (small organs that are part of the immune system) in the groin will be assessed to determine if the cancer has spread.
As with most types of cancer, the outlook for individual cases depends largely on how far the cancer has advanced at the time of diagnosis.
It isn't always possible to prevent penile cancer, but you can reduce your chances of getting it.
One of the main ways you can reduce your chances of developing penile cancer is to give up smoking (if you smoke).
It's also important to maintain good penis hygiene to prevent the bacterial and viral infections that can increase the risk of penile cancer.
This is easier if you were circumcised as a child, but there are steps you can take if you haven't been circumcised. Simple penis hygiene can include:
There's little evidence to suggest that being circumcised as an adult will reduce your chances of developing penile cancer. However, if you have sores that don't heal, or if it's becoming increasingly difficult to clean under your foreskin, seek advice from your GP about the possibility of circumcision.
Read more about penis health.