A Guide to Penile Cancer

Medically Reviewed By Julie Scott, DNP, ANP-BC, AOCNP
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Penile cancer is cancer that begins in the penis when cells grow out of control. Penile cancer is rare in the United States. Penile cancer is a form of cancer that rarely occurs in North America and Europe. Less than 1 in every 100,000 people assigned male at birth receive a penile cancer diagnosis each year. Penile cancer accounts for only 1% of cancer cases in the U.S.

This article will discuss the symptoms of penile cancer and what causes it. It will also discuss the risk factors for penile cancer and its types. Finally, it will go over the stages of penile cancer, treatments, and how to prevent it.

What are the symptoms of penile cancer?

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Keep in mind that experiencing any of these symptoms does not automatically mean you have developed cancer. It is more likely that the symptoms occur due to other conditions. However, contact your doctor if you experience any of these symptoms.

The first signs of penile cancer are typically changes to the skin, including:

  • thickening of the skin
  • discoloration of the skin
  • a lump
  • an ulcer that may bleed
  • small, crusty bumps
  • flat, bluish-brown growths
  • smelly discharge or bleeding under the foreskin

Tell your doctor about any changes, lumps, or sores on your penis. This is especially important for any changes that worsen or do not resolve after 4 weeks.

What causes penile cancer?

Penile tumors may occur due to bodily fluids in the foreskin. These fluids can have cancer-causing effects if you do not wash them away frequently.

Around one-half of all penile cancer cases result from the human papillomavirus (HPV). HPV is a sexually transmitted infection (STI) that often spreads through:

  • any skin-to-skin contact with the genital area
  • vaginal, oral, or anal sex
  • sharing sex toys

However, most people who develop HPV will not also develop penile cancer. Conditions that weaken your immune system, such as HIV or AIDS, can also lead to penile cancer.

What are the risk factors for penile cancer?

Having any risk factors for penile cancer does not mean you will develop it. However, certain factors may put you at a higher risk.

The risk factors for penile cancer include:

  • being uncircumcised
  • being over the age of 60
  • having difficulty pulling back your foreskin to clean it
  • having improper hygiene
  • having multiple sexual partners
  • using tobacco products
  • having a history of HPV
  • having a weakened immune system due to conditions such as HIV or AIDS

What are the types of penile cancer?

The various types of tissue in the penis contain different cell types. The different types of penile cancer begin within these cells. Nearly all penile cancer cases begin in the penis, rather than spreading from elsewhere.

Squamous cell carcinoma

Most penile cancers begin in the squamous cells, which are flat skin cells. This cancer can occur anywhere on the penis. However, it most commonly occurs on the glans (tip of the penis) or under the foreskin in people who are uncircumcised.

Squamous cell carcinoma typically grows slowly. Treatment is generally successful if it begins early enough.

Verrucous carcinoma

Verrucous carcinoma, or a Buschke-Lowenstein tumor, is a subtype of squamous cell carcinoma. It typically looks like a large genital wart. It can grow deep into the tissue of the penis but rarely spreads to other areas of the body. It is generally a slow-growing tumor.

Other types of penile cancer

Other types of penile cancer include:

  • Melanoma: This is a type of skin cancer. Melanomas typically grow and spread quickly. Most often, they occur in areas with frequent sun exposure. It is rare to find melanomas on the penis.
  • Basal cell carcinoma: This is a slow-growing type of cancer that makes up only a small portion of penile cancers. It rarely spreads to other areas of the body.
  • Adenocarcinoma (Paget’s disease of the penis): This type of penile cancer develops within the sweat glands in your skin. It is very rare, and people often mistake it for carcinoma in situ (CIS).
  • Sarcomas: Sarcomas account for only a small number of penile cancers. This type of cancer develops in the blood vessels, smooth muscles, and other connective tissue cells.

Learn more about melanoma.

What are the stages of penile cancer?

Penile cancer progresses in the following stages:

Stage 0

Stage 0 has two parts:

  • Stage 0is: In this stage, abnormal cells exist on the surface skin of your penis. Doctors may also refer to this as CIS.
  • Stage 0a: In this stage, squamous cells that do not spread exist either on the skin’s surface or under the foreskin. Doctors may refer to this stage as noninvasive localized squamous cell cancer.

Stage 1

In this stage, cancer has formed on the skin’s surface and spread to the deeper tissues of the penis. However, it has not spread to any other areas of the body, such as:

  • lymph nodes
  • blood vessels
  • nerves

Typically, the cells still appear closer to normal under a microscope.

Stage 2

Stage 2 has two parts:

  • Stage 2A: In this stage, cancer has spread to the tissue just under the skin. It may also have spread to the lymph nodes, blood vessels, and nerves. Additionally, it may have spread to erectile tissue that fills with blood to form an erection. The cells in this stage generally appear highly irregular under a microscope.
  • Stage 2B: In this stage, cancer has spread through the connective tissue and into the corpus cavernosum. This is the spongey tissue that runs along the shaft of the penis.

Stage 3

Stage 3 has two parts:

  • Stage 3A: In this stage, cancer has spread to one or two of the lymph nodes on one side of your groin.
  • Stage 3B: In this stage, cancer has spread to three or more lymph nodes on one or both sides of your groin.

Stage 4

Stage 4 is the most advanced stage. In this stage, penile cancer has typically spread to tissue in nearby areas, such as the:

  • scrotum
  • prostate
  • pubic bone

It may also have spread to lymph nodes near the surrounding tissue. In some cases, the cancer may have reached the lymph nodes in distant areas of the body, such as the:

  • lungs
  • liver
  • bones

What are the treatments for penile cancer?

Surgery is the most common treatment for penile cancer at any stage. Your doctor may only need to remove the affected tissues. However, in advanced stages, they may need to remove more tissue and possibly your lymph nodes.

Other possible treatments include:

Speak with your doctor about treatment options and the most effective treatment for your circumstances.

Can you prevent penile cancer?

It is not always possible to prevent penile cancer. However, you can take steps to possibly prevent or reduce your risk of developing it.

Ways to prevent penile cancer include:

  • being circumcised
  • practicing proper genital hygiene
  • using condoms during sexual activity to prevent STIs, such as HPV
  • avoiding using tobacco products
  • incorporating cancer-fighting foods into your diet

Read about cancer-fighting foods.

Summary

Penile cancer rarely occurs in the U.S. Early signs include changes to your skin, such as discoloration, lumps, or lesions.

Penile cancer typically resolves with early diagnosis and treatment. The most common treatment for this type of cancer is surgery.

If you notice any changes to your penis, contact your doctor.

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Medical Reviewer: Julie Scott, DNP, ANP-BC, AOCNP
Last Review Date: 2022 Oct 3
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