Penile cancer

Introduction

Penile cancer is a rare type of cancer that occurs on the skin of the penis or within the penis. It most commonly affects men over 50 years of age.

There are several types of penile cancer, depending on the type of cell the cancer developed from. The most common types include:

  • Squamous cell penile cancer  this accounts for more than 90% of cases and starts in the cells that cover the surface of the penis.
  • Carcinoma in situ (CIS)  a particular type of squamous cell cancer where only the cells in the skin of the penis are affected and it hasn't spread any deeper.
  • Adenocarcinoma  cancer that starts in the glandular cells of the penis that produce sweat.
  • Melanoma of the penis  this is where the cancer develops in the skin cells that give the skin its colour.

Symptoms of penile cancer

You should be aware of any abnormalities or signs of penile cancer, including:

  • a growth or sore on the penis that doesn't heal within four weeks 
  • bleeding from the penis or from under the foreskin
  • a foul-smelling discharge
  • thickening of the skin of the penis or foreskin that makes it difficult to draw back the foreskin (phimosis)
  • a change in the colour of the skin of the penis or foreskin
  • a rash on the penis

If you experience these symptoms, it's important to see your GP as soon as possible. It's unlikely they'll be caused by penile cancer, but they need to be investigated.

Any delay in diagnosing penile cancer could reduce the chances of successful treatment.

Causes of penile cancer

The cause of penile cancer isn't known, but certain risk factors can increase your chances of getting it, including:

  • Carrying the human papilloma virus (HPV) – there are more than 100 types of HPV. Some types cause genital warts
  • Age – the condition rarely affects men under 40 years of age. It's most common in men aged over 50.
  • Smoking – chemicals found in cigarettes can damage cells in the penis, which increases your risk of getting penile cancer.
  • Having phimosis – when the foreskin is difficult to retract, the chances of developing infections such as balanitis increase. Repeated infections are linked to a higher risk of developing some types of penile cancer because they can weaken your immune system.

The Cancer Research UK website has more information about the risks and causes of penile cancer.

Diagnosing penile cancer

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 to 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 2017 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 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.

Treating penile cancer 

Treatment for penile cancer depends 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 usually involves either using a chemotherapy cream or having laser surgery to remove the affected area of skin. You'll usually have a skin graft after surgery.

The main treatments for later-stage penile cancer are:

Surgery involves 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. In some cases, the lymph glands may need to be surgically removed.

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.

Want to know more?

The Cancer Research UK website has more information about: 

You can also read about penile cancer on the male cancer website Orchid or call the helpline on 0203 465 5766 (Monday to Friday, 9am-5.30pm).

Preventing penile cancer

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:

  • using condoms to reduce the risk of catching HPV
  • regularly washing your penis with warm water, including under the foreskin

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.