Penile Cancer

The earlier penile cancer is found, the better. If it’s found early, there is an increased chance for successful treatment and cure. If diagnosis is delayed, the disease can get worse. Treatment for more advanced cancer may be less successful and more disfiguring.

Since you see and touch your penis when you pass urine, you can help spot the disease early. Men who aren’t circumcised are at greater risk for penile cancer. But every man should be on the lookout for penile lesions.

You should see your health care provider if you notice any of these on the foreskin, the shaft or head of your penis:

• An area of skin becoming thicker and/or changing color
• A lump on the penis
• An ulcer (sore) that might bleed
• A reddish, velvety rash
• Small, crusty bumps
• Flat, bluish-brown growths
• Smelly discharge (fluid) under the foreskin
• Swelling
• Enlarged lumps (lymph nodes) in your groin

Most of these signs may be due to bacterial or fungal infection, sexually transmitted infection or even an allergic reaction. All of these will respond to antibacterial or antifungal ointments and creams, or antibiotics. But growths that return or sores that don’t heal must be thought of as cancer until it’s proven they’re not.

Penile cancer is often, unfortunately, ignored until it is advanced. Patients are reluctant or embarrassed to talk about their genitals. Or, they may be afraid of treatment or surgery on the penis. If you notice any of these signs, it is of great value to have them checked by a health care provider as soon as you can.

The exact cause of penile cancer remains unknown. The most common type is squamous cell carcinoma. Poor genital hygiene, being uncircumcised, older age and smoking are potential risk factors for this type of penile cancer.

Another possible cause may be the human papilloma virus (HPV). HPV is a virus passed through sex. Antibodies to HPV-16 have been found in many patients with penile cancer. HPV is known to play a role in cervical cancer as well. For more information please review our Sexually Transmitted Disease article. Conditions such as HIV and AIDS can also be a risk factor for penile cancer.

Men with good genital hygiene, who practice safe sex and who are circumcised are less likely to get penile cancer.

Other types of penile cancer include basal cell carcinoma, melanoma and sarcoma.

Penile cancer is diagnosed with a biopsy. This is when a small sample of tissue is removed from the penis and looked at under a microscope. If the cells look like cancer cells, they will be “staged.” The TNM staging system is the system most often used. T stands for the main (primary) tumor (how far it has grown within the penis or nearby organs). N stands for spread to nearby lymph nodes (bean-sized groups of immune system cells). M is for metastasis (spread) to other organs.

The cells are also given a “grade”. This is a measure of how abnormal the cells look. The grade is often a number, from 1 to 4. The higher the number, the more abnormal the cells look. Higher-grade cancers tend to grow and spread more quickly than lower-grade cancers.

If your doctor believes that cancer has spread to nearby lymph nodes, other tests will be done. A lymph node biopsy may be used to help determine the cancer’s stage and grade. If cancer is thought to spread to other parts of the body, imaging tests (such as a CT scan, or MRI) will be done. 

Sometimes additional blood work will also be ordered by your doctor.

If tests suggest cancer, prompt care and regular follow-up will be of great value. Early and aggressive treatment are also important.

If penile cancer is found early and is low grade and/or stage, it can be treated with success and low risk. If the tumor is on top of the skin, it may be treated with a skin cream. This cream has few side effects. External beam radiation is also a therapy for small lesions. Other options can include thing such as lasers.

If the lesion is larger, but still about the size of a pea, a small local excision or “Moh’s surgery” may be done depending on the where the lesion is found. This is a type of surgery where layers of abnormal tissue are shaved off until normal tissue is reached. With both of these methods, the penis should still look normal and work as usual. But careful follow-up is vital to check for early recurrence. With small lesions, it’s not likely that cancer has spread to the lymph nodes. For this reason, it’s often not necessary to remove the lymph nodes.

With larger lesions, more tissue needs to be removed. Your surgeon will also consider taking out or draining lymph nodes in the groin. A mix of surgery, radiation, and chemotherapy may be needed. In cases where the cancer is more advanced, part or even the whole penis may need to be removed.

Early detection is very important. It not only ensures better results, but there are more treatment options.

After treatment your doctors will want to watch you closely. During follow-up visits, your doctor will look for new signs of cancer and help you manage treatment side effects. Almost any cancer treatment has side effects. Some may last a short time, others may last the rest of your life.

Your post-treatment experience depends mostly on the stage of cancer when it was found, the location and if the cancer has spread to the lymph nodes or somewhere else in the body. Talk to your health care team about any problems you notice, and any questions or concerns you have.

Frequently Asked Questions

Is penile cancer contagious? Can I pass it on to others?

Penile cancer itself is generally not contagious. But HPV, which is a contagious infection, is linked to both penile and cervical cancers. Thus, it is of great value to practice safe and protected sex. You should also be aware of any lesions. Women should have cervical examinations often. It is of great value to eliminate or minimize the infection. It’s also of great value to talk with your urologist if you have further questions about HPV’s link to penile cancer.

Does an operation on the penis mean that I won’t be able to stand to empty my bladder?

If your cancer is found early, the surgery needed shouldn’t affect your ability to stand when you pass urine. The surgeries needed for more advanced cancer may cause you to have to sit when you pass urine.

Will the treatment affect my ability to have sex?

Early detection and minimal surgeries shouldn’t interfere with normal sex. More extensive procedures might, though.

Should all male children be circumcised soon after birth to prevent penile tumors?

This question is a matter of much debate. Studies point to a lower incidence of urinary tract infections and penile cancer in men who’ve been circumcised. Parents should discuss the risks and benefits of circumcision with their child’s doctor.

If a male has not been circumcised soon after birth, will later circumcision as a teen or young adult protect him from penile cancer?

Circumcision soon after birth is the best protection from getting penile cancer later. A procedure done in young adults doesn’t have nearly the same protective effect.

For example, penile cancer is very rare in Jewish males, for whom circumcision at birth is the accepted ritual. Penile cancer is more common in Muslim males, for whom the accepted ritual is circumcision at puberty. Overall, it isn’t as common as in men who haven’t been circumcised.

Updated October 2024.