Penile Cancer

Types

The following are common types of penile cancer:

• Squamous cell carcinoma
• Adenocarcinoma
• Melanomas
• Basal cell penile cancer
• Sarcomas

Symptoms

Penile cancer starts on the glans (head), or tip, of the penis and spreads from there. Some men may have obvious symptoms in the early stages, while others may not have any symptoms until the disease has advanced. Although it may not mean cancer, any abnormalities of the penis should be reported to your doctor as soon as possible. Unfortunately, many men are reluctant to discuss these issues with their physician, and may delay seeking treatment until the disease is advanced and harder to treat.

Men who have retained their foreskin need to examine the area underneath the foreskin regularly, as well as to keep the area clean to lower their risk. Penile cancer symptoms may include:

• A wart-like growth or lesion
• An open sore that won't heal
• A reddish rash
• Persistent, smelly discharge under the foreskin

Risk Factors

Cancer of the penis is extremely rare in the U.S., affecting only about 1,500 men each year. The penile cancer rate is much higher among men in India and some South American and African countries.

M. D. Anderson treats about 30 cases of penile cancer each year, as compared to one case every two to three years treated by urologists outside a major cancer center. The larger patient volume allows M. D. Anderson urologists to obtain crucial data that can improve current treatments and develop new therapies.

The risks for penile cancer include:

Age: Most cases are seen in men aged 50-70, although nearly a third of cases occur in men under 50.

Smoking: Men who either chew or smoke tobacco are more at risk for penile cancer.

Human Papillomavirus (HPV): This sexually transmitted disease has more than a dozen subtypes. HPV 16 and HPV 18 are most frequently linked to penile cancer.

Lack of circumcision at birth: Studies have shown that penile cancer rates are higher in populations where circumcision is done later or not at all.

Phimosis: A condition in which it's difficult to pull back the foreskin, which can lead to the buildup of body oils, bacteria and other debris known as smegma.

Most cases of penile cancer are first detected as a change in color of the skin of the penis.   A doctor should examine the penis to check for other lesions or abnormalities as well as to screen for benign conditions which might be confused with penile cancer.  After the physical examination of the penis, a biopsy is needed to confirm an accurate diagnosis of the cancer.

Treating penile cancer depends on the stage of disease. Surgery is the most common form of therapy, but laser therapy and radiation can be used for smaller tumors. 

Surgery

Surgery to remove all or part of the penis is called penectomy:

Partial penectomy is a frequently used form of therapy. The tumor is removed along with a margin of normal tissue. Historically, a two-centimeter margin was obtained in all cases, but more recent data suggest that such wide margins may not be necessary. Surgeons are currently attempting to spare as much of the glans (head) and shaft as possible to retain urinary and sexual function.

Total penectomy involves removal of the entire penis for large tumors. The surgeon reroutes the urethra behind the testicles and a urethrostomy (hole) is created so the patient can urinate. Penile reconstruction surgery using a flap of skin from the forearm to create a new penis has been done, but the procedure is still extremely rare.

Other Treatments

For very small superficial tumors, penile cancer may be treated with a laser beam that destroys the tumor, radiation therapy and, in some cases, a cream containing the chemotherapy drug fluorouracil applied to the skin. These treatments offer the best opportunity to spare the glans, penis and sexual function. That is why it is important to find penile tumors early by seeking immediate medical attention for any abnormalities on the penis.

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, help is available in many forms. Listed below are just some of the ways to find help...and hope.

Learn more about patient and family support programs

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting. 

Find a support group

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression and traditional Eastern medicine such as acupuncture. 

Find complementary therapies at M. D. Anderson

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers. 

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.