MD Anderson’s experts use the latest technology and techniques, as well as remarkable skill, to accurately diagnose penile cancer. The earlier penile cancer is diagnosed, the higher the chances for successful treatment. This is why it is important to report any changes in your penis to your doctor.
Since penile cancer begins in the skin of the penis, men often notice them in the early stages. However, some men are hesitant to mention the changes to their doctors, which delays their treatment.
Penile Cancer Diagnosis
If you have penile cancer symptoms, your doctor will ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family medical history. The doctor will examine your penis.
If your doctor suspects you may have penile cancer, one or more of the following tests may be used to diagnose penile cancer and determine if it has spread. These tests also may be used to find out if treatment is working.
Biopsy: A biopsy usually is the first test performed to find out if you have penile cancer. The type of procedure depends on the type of tissue or lesion.
Incisional biopsy: A small part of abnormal tissue is removed. This procedure is used most often for lesions that are larger, ulcerated or that appear to have spread deep into the tissue.
Excisional biopsy: The whole growth or lesion is removed. Usually, this type of biopsy is performed for small abnormal areas. If the lesion is on the foreskin, you doctor may suggest circumcision.
Fine needle aspiration (FNA): This type of biopsy may be used to examine the tissue in lymph nodes. A thin needle is inserted into the groin area. Then cells are drawn out and looked at under a microscope.
Imaging tests, which may include:
- CT or CAT (computed axial tomography) scans
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
If you are diagnosed with penile cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer.
Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
(Some of the following is based on information from the National Cancer Institute)
Stage 0: Penile cancer has not grown into tissue below the top layers of skin and has not spread to lymph nodes or distant sites.
Stage 1: Penile cancer has grown into tissue just below the superficial layer of skin but has not grown into blood or lymph vessels. It has not spread to lymph nodes or distant sites.
Stage II: Any of the following:
- Penile cancer has grown into tissue just below the superficial layer of skin and is either high-grade or has grown into blood or lymph vessels. It has not spread to lymph nodes or distant sites.
- The cancer has grown into one of the internal chambers of the penis (the corpus spongiosum or corpora cavernosum). The cancer has not spread to lymph nodes or distant sites.
- The cancer has grown into the urethra (tube that urine passes through). It has not spread to lymph nodes or distant sites.
Stage IIIa: Penile cancer has grown into tissue below the superficial layer of skin. It also may have grown into the corpus spongiosum (tissue within the penis) or the urethra (the small tube through which urine passes from the bladder to the outside of the body). The cancer has spread to a single groin lymph node. It has not spread to distant sites.
Stage IIIb: Penile cancer has grown into the tissues of the penis and may have grown into the corpus spongiosum, the corpus cavernosum or the urethra. It has spread to two or more groin lymph nodes. It has not spread to distant sites.
Stage IV: Any of the following:
- The cancer has spread to lymph nodes in the pelvis or the cancer spread in the groin lymph nodes has grown through the lymph nodes' outer covering and into the surrounding tissue. The cancer has not spread to distant sites.
- Penile cancer has grown into the prostate or other nearby structures. It may or may not have spread to groin lymph nodes. It has not spread to distant sites.
- The cancer has spread to distant sites.
Recurrent penile cancer is cancer that went away with treatment but later came back. Recurrent penile cancer may return in the penis or any other part of the body.