Penile Cancer

Penile cancer occurs when cells in the penis begin to grow uncontrollably. It most commonly starts in the skin of the penis and may spread deeper if not detected early. Although penile cancer is rare, it is highly treatable, especially when diagnosed at an early stage.

Types of Penile Cancer

Several types of penile cancer can develop, including:

  1. Squamous Cell (Epidermoid) Carcinoma

The most common form—about 95% of all penile cancers. It usually starts on or under the foreskin, but can appear anywhere on the penis.

  1. Sarcoma

Arises from tissues such as muscles, blood vessels, or fat.

  1. Melanoma

Begins in pigment-producing skin cells (melanocytes).

  1. Basal Cell Carcinoma

A slow-growing cancer that starts in deeper layers of the skin and rarely spreads.

Causes and Risk Factors

The exact cause of penile cancer is not fully known, but it is more common in men who:

  • Have HPV (Human Papillomavirus) infection
  • Are over 60 years old
  • Smoke
  • Have a weakened immune system (HIV/AIDS)
  • Are not circumcised, leading to buildup of smegma under the foreskin
  • Have phimosis, a condition where the foreskin is tight and difficult to clean
  • Have had psoriasis treatments with psoralen and UV light (PUVA therapy)

Signs and Symptoms

Early signs usually involve changes to the skin of the penis. These may appear on the foreskin (in uncircumcised men), on the glans (penis head), or on the shaft.

Common symptoms include:

  • Changes in skin color or thickness
  • A rash or crusty bumps that resemble an unhealed sore
  • Bluish-brown growths
  • A lump on the penis
  • Foul-smelling discharge under the foreskin
  • A sore that may bleed
  • Swelling at the end of the penis
  • Lumps in the groin (enlarged lymph nodes)

These symptoms can also be caused by infections or skin conditions—but any unusual changes should be evaluated by a doctor promptly.

Diagnosis

Evaluation typically includes:

  • Physical Examination
    • Inspection of the penis and groin for visible or palpable abnormalities.
  • Biopsy
    • A small tissue sample is taken from the lesion and examined under a microscope to confirm the presence of cancer cells.
  • Imaging Tests
    • ray, CT scan, ultrasound, or MRI may be used to check for tumor spread.

Treatment Options

Treatment depends on the stage and extent of the cancer.

  • Early-Stage Treatments
    • Topical medications (cancer-killing creams)
    • Cryotherapy (freezing cancer cells)
    • Mohs surgery, where cancer is removed layer by layer
    • Laser therapy to destroy cancerous tissue
    • Circumcision, if cancer is limited to the foreskin
  • Advanced-Stage Treatments
    • Lymph node removal in the groin if cancer has spread
    • Radiation therapy and/or chemotherapy
    • Partial or total penectomy (removal of part or all of the penis) when necessary

Most early treatments preserve sexual function, though radiation and chemotherapy may cause side effects.