Penile Cancer: What It Is and How It Is Treated

Written by Medicover Team and Medically Reviewed by Dr Avinash Gottumukkala , Urologists

Penile cancer, though relatively rare, is a serious condition that develops in the tissues of the penis and requires early detection and prompt treatment. Understanding its types, risk factors, symptoms, diagnosis, and treatment options can help support timely medical care and better outcomes.

What are the Types of Penile Cancer?

Penile cancer can develop from different types of cells in the penis, with squamous cell carcinoma being the most common. The type and extent of cancer help determine the most appropriate treatment approach.

The main types of penile cancer include:

Squamous Cell Carcinoma

The most common type, squamous cell carcinoma, accounts for around 95% of penile cancer cases. It typically begins in the flat skin cells lining the penis and can spread to deeper tissues and other parts of the body if not treated early.

Basal Cell Carcinoma

Basal cell carcinoma is rare in penile cancer but occurs in the basal cells of the epidermis. It tends to grow slowly and is less likely to spread compared to squamous cell carcinoma.

Melanoma

Melanoma of the penis is extremely rare but can be aggressive. It originates in the melanocytes, the pigment-producing cells of the skin.

Adenocarcinoma

Adenocarcinoma is another rare form that starts in glandular cells. It can be challenging to diagnose and may require specialized evaluation.

What are the Early Symptoms of Penile Cancer?

Early penile cancer may cause subtle changes that can be mistaken for infections or other skin conditions. Persistent or unusual changes should be evaluated by a healthcare professional rather than ignored.

Common early symptoms may include:

Penile Lump or Growth

One of the common early signs is a lump, growth, or thickened area on the penis, which may be painless or painful. Any new growth that does not heal should be evaluated promptly.

Changes in Skin Color or Texture

Penile cancer can cause changes in the color or texture of the penile skin, including thickening, changes in pigmentation, or the development of sores.

Persistent Redness or Rash

Persistent redness, rash, or inflammation that does not improve with usual treatment may be an early sign of penile cancer and should be assessed by a doctor.

Unusual Discharge or Bleeding

Unexplained penis discharge or bleeding, particularly when associated with a persistent lesion or foul odor, requires medical evaluation.

What Causes Penile Cancer?

Penile cancer does not have a single known cause. It develops when cells in the penis undergo abnormal changes that cause them to grow and divide uncontrollably. In some cases, these cellular changes are associated with infections such as certain types of human papillomavirus (HPV), although the exact cause may not always be identified.

Human Papillomavirus (HPV) Infection

Infection with certain high-risk strains of HPV can cause changes in penile cells that may contribute to cancer development.

Abnormal Cell Changes

Penile cancer begins when genetic changes cause cells in the penile tissues to grow abnormally and avoid normal cell death. Over time, these abnormal cells can form a tumor.

When to See a Doctor?

Consult a urologist or healthcare provider if you notice any persistent or unusual changes in the penis that could indicate Penile Cancer. Early evaluation can help identify cancer at a more treatable stage.

Get medical help immediately if:

Early diagnosis and prompt treatment are crucial for managing Penile Cancer and improving treatment outcomes.

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How Is Penile Cancer Diagnosed?

Diagnosing penile cancer involves examining the lesion and confirming whether cancer cells are present. Early and accurate diagnosis also helps determine whether the disease has spread.

The diagnostic process may involve the following:

Physical Examination

A healthcare provider examines the penis and nearby areas for lumps, sores, changes in skin appearance, or other abnormalities. The groin may also be examined for enlarged lymph nodes.

Biopsy

If a suspicious lesion is identified, a biopsy is performed by removing a small tissue sample for microscopic examination. A biopsy is essential for confirming penile cancer and identifying its type.

Imaging Tests

Imaging tests such as ultrasound, MRI, or CT scans may be recommended to assess the depth of the tumor and determine whether cancer has spread to nearby tissues or lymph nodes.

Lymph Node Examination

Because penile cancer can spread to nearby lymph nodes, doctors may assess the groin lymph nodes using imaging, fine-needle aspiration, sentinel lymph node procedures, or other appropriate tests.

What are the Treatment Options for Penile Cancer?

Penile cancer treatment depends on the cancer type, tumor size and location, stage, lymph node involvement, and overall health. The main goal is to remove or control the cancer while preserving as much normal penile tissue and function as possible.

Treatment options may include:

Surgery

Surgery is the primary treatment for many localized penile cancers. Depending on the tumor, procedures may range from local excision and tissue-sparing surgery to partial or total penectomy.

Mohs Surgery

Mohs micrographic surgery may be considered for selected small, localized tumors. It removes cancerous tissue layer by layer while helping preserve as much healthy tissue as possible.

Radiation Therapy

Radiation therapy uses high-energy radiation to destroy cancer cells. It may be used for selected early-stage cancers or in combination with other treatments depending on the location and stage of the disease.

Chemotherapy

Chemotherapy uses medicines to destroy or control cancer cells. It may be used for advanced penile cancer, particularly when the disease has spread or when other treatments are not sufficient.

Targeted Therapy

Targeted therapies act on specific molecular changes or targets involved in cancer growth. Their use in penile cancer depends on the tumor's characteristics and the availability of suitable treatment options.

Immunotherapy

Immunotherapy helps the immune system recognize and attack cancer cells. It may be considered in selected advanced cases, particularly when the cancer has progressed despite other treatments.

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What are the Risk Factors for Penile Cancer?

Several factors can increase the likelihood of developing penile cancer. Having one or more risk factors does not mean that a person will develop cancer, but understanding them can help with prevention and early detection.

HPV Infection

Certain high-risk types of HPV are associated with an increased risk of penile cancer. HPV is commonly transmitted through sexual contact.

Smoking and Tobacco Use

Smoking and other forms of tobacco use can damage cells and increase the risk of penile cancer.

Phimosis

Phimosis, a condition in which the foreskin cannot be fully retracted over the glans, can make genital hygiene difficult and is associated with an increased risk of penile cancer.

Poor Genital Hygiene

Poor genital hygiene may contribute to chronic irritation, infections, and inflammation, which can increase the risk of penile cancer.

Chronic Inflammation

Long-term inflammation of the penis, including conditions such as balanitis, may increase the risk of abnormal cellular changes.

Older Age

The risk of penile cancer increases with age, and it is more commonly diagnosed in older men, particularly those over 60.

How Can Penile Cancer Be Prevented and Detected Early?

Although not all cases of penile cancer can be prevented, reducing known risk factors and recognizing abnormal changes early may lower the risk and support earlier diagnosis.

Regular medical evaluation is especially important when persistent penile changes are present.

HPV Vaccination

HPV vaccination can reduce the risk of infection with HPV types associated with several cancers, including penile cancer. Vaccination is most effective when given before exposure to HPV, although eligibility may extend to older individuals depending on age and individual circumstances.

Smoking Cessation

Quitting smoking can reduce the risk of penile cancer and many other cancers. People who smoke can seek professional support and evidence-based cessation programs to improve their chances of quitting successfully.

Regular Check-ups and Self-Examinations

Regular medical check-ups and awareness of normal penile appearance can help identify unusual changes early. Any persistent lump, sore, discoloration, bleeding, or discharge should be reported to a healthcare professional.

Good Genital Hygiene

Maintaining good genital hygiene, including regular washing and drying of the genital area, can help reduce infections and chronic inflammation. Men with phimosis or difficulty retracting the foreskin should discuss appropriate care with a healthcare provider.