Penile cancer is the growth of harmful cells in the skin and tissues of the penis. Treatment options and outlook for a person with penile cancer depend on the stage of cancer at the time of diagnosis.
Penile cancer is rare. According to the American Cancer Society, penile cancer accounts for less than
A doctor can determine the stage of penile cancer to help inform which treatment is the most appropriate.
Read on to learn more about the stages of penile cancer.
The process of staging is when a doctor determines the extent of cancer growth.
According to the
- Extent of the tumor (T): This describes how far the cancer has spread into the penis.
- Spread to nearby lymph nodes (N): This examines whether cancer has affected nearby lymph nodes, such as in the groin.
- Metastasis (M) to distant sites: This describes whether the cancer has spread to distant parts of the body.
Doctors may use cell grading systems to analyze and determine penile cancer stages. These vary between grades 1–3, assessing how the cancerous cells compare visually to healthy cells.
Rarer forms of penile cancer may require different methods of staging.
Stage 0 is when the cancerous tumor is only present in the top layer of skin on the penis. There is no evidence of cancer in deeper tissues.
No spread of cancer to nearby lymph nodes is present or to any other parts of the body.
Using the TNM staging system, doctors classify this stage of penile cancer as:
- Tis or Ta: the tumor affects the top layer of the skin
- N0: cancer has not spread to the nearby lymph nodes
- M0: cancer has not spread to the distant parts of the body
This stage of penile cancer is when a tumor spreads to the layer of soft tissue just below the top layer of skin. However, it does not affect nearby blood vessels or nerves.
As with stage 0, there is no spread to distant tissues or nearby lymph nodes.
The TNM system describes stage 1 penile cancer as the following:
- T1a, meaning it is not high grade penile cancer
Stage 2a is when cancer spreads to the layer of soft tissue just below the top layer of skin. It also affects the nearby blood and lymph vessels or nerves.
Stage 2a can also mean that the cancer grows into a section of the penis called the corpus spongiosum. It located along the bottom and into the top of the penis.
In both forms of stage 2a, the cancer has not spread to nearby or distant lymph nodes.
The TNM staging system describes stage 2a penile cancer as the following:
- T1b or T2
Stage 2b means that cancer has spread to the corpus cavernosum. This is the name of the two internal chambers that run along the top of the penis. The cancer has not spread to nearby or distant lymph nodes.
The TNM staging system describes stage 2b penile cancer as the following:
Stage 3 penile cancer is the first time the cancer cells spread beyond the penis to the nearby lymph nodes.
Stage 3a is when cancer is present in the top layer of the skin, corpus spongiosum, or corpus cavernosum. It may be present in one or two nearby lymph nodes but not in distant parts of the body.
The TNM staging system describes stage 3a penile cancer as:
Stage 3b is the same as stage 3a, but the cancer has spread to three or more nearby lymph nodes.
The TNM staging system describes stage 3b as:
- T4, any N, M0: This means the cancer has spread to the nearby structures, such as the scrotum or prostate. It may have spread to nearby lymph nodes.
- Any T, N3, M0: Regardless of the growth of the tumor, the cancer has spread to the pelvic or inguinal lymph nodes.
- Any T, any N, M1: Regardless of how deep the tumor has spread or the lymph node involvement, there is evidence of cancer as distant sites.
How quickly penile cancer spreads depends on the type of cancer present. For example, squamous cell carcinoma causes
This type of skin cancer tends to grow slowly. If a person receives a diagnosis early, it can be curable.
Other types of penile cancer may spread more quickly.
- Stage 0: For a person with cancer on the foreskin only, circumcision is sufficient. If cancer is elsewhere, treatment may include local therapies, such as cryotherapy, wide local excision, or Mohs surgery.
- Stage 1: Treatment is the same as stage 0, with the addition of radiation therapy or laser ablation for tumors below the skin.
- Stage 2: Treatment includes a partial or total penectomy. This surgery removes a part of, or all of, the penis. Surgeons may also perform surgery to remove lymph nodes if cancer is present. Radiation therapy may also be suitable for people who cannot undergo surgery.
- Stage 3: Treatment may involve a partial or total penectomy, or surgery to remove lymph nodes in the groin along with chemotherapy to shrink the tumor before surgery.
- Stage 4: Because this stage can include different types of cancers, typical treatment includes a total penectomy and the removal of the scrotum and other structures in the groin where cancer spreads, such as the prostate. Chemotherapy and radiation therapy can help shrink tumors in the lymph nodes and distant organs.
According to the
|Stage||5-year relative survival rate|
|All stages combined||65%|
The 5-year relative survival rate refers to the number of people still alive 5 years after receiving a particular diagnosis.
Treatments continue to improve, helping improve people’s outlooks. Early detection and treatment are the most effective ways to improve the outlook of a person with penile cancer.
Penile cancer is when there is a cancerous growth in the soft tissue or skin of the penis.
Cancer stages depend on the extent of this growth and whether it reaches distant structures in a person’s body.
Treatment options differ depending on the stage of cancer at the time of diagnosis. Treatment can include surgery, chemotherapy, or radiotherapy.