Read on to learn more about the causes, symptoms, and treatment of penile cancer.
What is penile cancer?
For men, penile cancer accounts for less than 1 percent of all cancer cases.
Penile cancer is a rare disease in the United States. According to the American Cancer Society (ACS), penile cancer affects about 1 in every 100,000 males. This type of cancer accounts for less than 1 percent of all cancer cases in men.
In 2018, the ACS estimate that doctors will diagnose approximately 2,320 new cases and that penile cancer will cause about 380 deaths.
Penile cancer develops on or in the penis, which consists of many different types of cell. The type of cell that cancer affects will help determine the best course of treatment for a person.
Regardless of the type of penile cancer, it will usually present on the skin of the penis initially.
The most common type of penile cancer appears in the squamous cells, which are flat skin cells. This type of cancer typically starts in the glands at the tip of the penis or on the foreskin of uncircumcised men.
Squamous cell carcinoma tends to spread slowly, and it is usually easy to treat when doctors catch it in the early stages.
Less common types of penile cancer include:
- Verrucous carcinoma: A growth that resembles a large genital wart.
- Carcinoma in situ (CIS): The earliest stage of squamous cell cancer that has not yet penetrated deeper into the penis.
- Melanoma: A type of skin cancer that can form on the penis.
- Basal cell carcinoma: Another type of skin cancer that can develop on the penis.
- Adenocarcinoma: A rare type of cancer that forms in the sweat glands of the penis.
- Sarcoma: A very rare form of penile cancer that affects the connective tissue, muscles, and blood vessels in the penis.
What does penile cancer look like?
Image credit: DermNet New Zealand
HPV increases the risk of developing penile cancer.
Image credit: Rrreeewww, 2016
Causes and risk factors
Doctors do not understand the exact causes of penile cancer, but they have identified some possible contributing factors. These include:
Some men are more at risk of developing penile cancer than others. Common risk factors include:
- being over 65 years old
- smoking cigarettes
- being uncircumcised
Many of the early signs and symptoms of penile cancer may indicate other issues that are much more common than cancer. Still, it is best for people with any concerns about their symptoms to speak to a doctor, as early detection improves the likelihood of successful treatment.
The signs and symptoms of penile cancer include:
- a lump on the skin
- changes in skin color near the tip or on the shaft
- formation of an ulcer, which may bleed
- thickening skin
- formation of crusty bumps
- foul-smelling discharge
- bleeding beneath the foreskin
- red rash under the foreskin
- bluish-brown growths
As the cancer develops, there may be swelling near the tip of the penis. This sign is especially noticeable in uncircumcised men, as it will become harder to draw the foreskin back.
Cancer often spreads to lymph nodes in the area first, which can cause them to swell.
A doctor will begin the diagnosis with a physical examination of the penis, and they will often ask the person about their medical history. A doctor will examine the skin of the penis carefully and may also feel the lymph nodes to check for swelling.
As several of the symptoms of penile cancer could be a result of more common conditions, a doctor is likely to order several tests to rule those causes out.
Some of the tests that a doctor may conduct include:
- an incisional biopsy, which is the removal of a small tissue sample
- an excisional biopsy, requiring the removal of the entire lesion on the penis
- lymph node biopsy, which involves taking a sample of tissue from the lymph nodes
- CT scan
- chest X-rays, if the cancer may have spread to the lungs
The type of treatment will depend on the stage of cancer. When a doctor diagnoses penile cancer in the early stages, treatment may involve one or more of the following:
- laser therapy to cut away the affected area
- medicated creams
- cryotherapy to freeze off affected areas
- circumcision, in cases where the cancer is in the foreskin
- Mohs' surgery, or the removal of the affected layers of skin
If the cancer has reached a more advanced stage, a doctor is likely to choose a different treatment method, such as:
- removal of part or all of the lymph nodes
- penectomy, which is surgery to remove part or all of the penis
A 5-year survival rate refers to the percentage of people who are still alive 5 years after their diagnosis. Relative survival rates compare the survival of people with a specific disease to that of people in the general population without the disease.
According to the ACS, the 5-year relative survival rates for penile cancer are:
- 85 percent for stages 1 and 2, where cancer remains confined to the penis.
- 59 percent for stage 3 and some stage 4, if the cancer has spread to nearby tissues, such as lymph nodes.
- 11 percent for stage 4, where the cancer has spread to distant organs.
However, there is a lack of research on the survival rates for penile cancer because the disease is relatively rare. A doctor can help determine an individual's likelihood of successful treatment and survival.
Early detection leads to the best outcome. The treatment options at the early stages are less invasive and allow for a faster recovery.
Anyone who experiences any signs of penile cancer should speak to a doctor as soon as possible.