Penile cancer, or cancer of the penis, is a relatively rare form of cancer that affects the skin and tissues of the penis. It occurs when normally healthy cells in the penis become cancerous and begin to grow out of control, forming a tumor.

The cancer may eventually spread to other areas of the body, including the glands, other organs, and lymph nodes. The American Cancer Society estimates approximately 2,070 cases of penile cancer will be diagnosed in the United States in 2022.

Types of penile cancer

Cancer of the penis begins as a type of skin cancer. It can occur in the following forms:

The first noticeable symptom of penile cancer is typically a lump, mass, or ulcer on the penis. It may look like a small, insignificant bump or a large, infected sore. In most cases, it’ll be located on the head or foreskin instead of on the shaft of the penis.

Other symptoms of penile cancer can include:

  • itching
  • burning
  • discharge
  • changes in the color of the penis
  • thickening of the penile skin
  • bleeding
  • redness
  • irritation
  • swollen lymph nodes in the groin

Make an appointment with a doctor right away if you’re experiencing any of these symptoms. Getting an early diagnosis and treatment are critical for increasing the chances of a positive outcome.

What does penile cancer look like?

Cancer on the penis can look like a lump, mass, sore, or discoloration, depending on the type of skin cancer that’s causing it. It’s most commonly located on the foreskin or the head of the penis.

A urologist can perform diagnostic tests to determine whether the lump is cancerous.

People with uncircumcised penises are more likely to develop penile cancer. This may be because people with uncircumcised penises are at risk of other conditions that affect the penis, such as phimosis and smegma.

Phimosis is a condition in which the foreskin becomes tight and difficult to retract. People with phimosis have a high risk of developing smegma.

Smegma is a substance that forms when dead skin cells, moisture, and oil collect underneath the foreskin. It may also develop if the area under the foreskin is not cleaned properly, which can cause inflammation.

People may also be at an increased risk of penile cancer if they:

  • are over age 60
  • smoke cigarettes
  • do not clean the area under the foreskin properly
  • live in a region with poor sanitation and hygiene practices
  • have a sexually transmitted infection (STI), such as the human papillomavirus (HPV)

A doctor can make a penile cancer diagnosis by performing certain diagnostic tests, including:

  • Physical examination. During a physical exam, a doctor will look at your penis and inspect any lumps, masses, or sores that are present.
  • Biopsy. A biopsy involves the removal of a small sample of skin or tissue from the penis. The sample is then analyzed to determine whether cancer cells are present. If cancer is found, the doctor will likely perform other imaging tests to determine if and where the cancer has spread.
  • MRI. An MRI of the penis is sometimes conducted to make sure that cancer hasn’t spread to the deeper tissues of the penis.
  • CT scan. A CT or CAT scan makes detailed images of the body from different angles. Sometimes, dye is injected or swallowed to help a doctor see certain areas more clearly.
  • PET scan. This test uses a small amount of injectable radioactive glucose to find cancerous tumor cells in the body. Cancer cells show up brighter on this imaging test since they use more glucose. A PET scan may be performed with a CT scan.
  • Cystoscopy. During a cystoscopy, a doctor will gently insert a thin tube with a camera on the end into the penis opening and through the bladder. This allows them to view the different areas of the penis and the surrounding structures.
  • Ultrasound. This test uses high energy sound waves to form a picture of body tissues.

The stage of the cancer describes how far it has spread. Based on the results of the diagnostic tests, a doctor will determine which stage the cancer is currently in. This will help them determine the best treatment plan for you and allow them to estimate your outlook.

The staging criteria for penile cancer are outlined as follows:

Stage 0

  • Cancer is only on the top layer of the skin.
  • Cancer hasn’t to spread any glands, lymph nodes, or other parts of the body.

Stage 1

  • Cancer has spread into the connective tissue just below the skin.
  • Cancer hasn’t spread to any glands, lymph nodes, or other parts of the body.

Stage 2

  • Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels, or cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
  • Cancer hasn’t spread to any other parts of the body.

Stage 3A

  • Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels, or cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
  • Cancer has spread to one or two lymph nodes on the same side of the groin.
  • Cancer hasn’t spread to any other parts of the body.

Stage 3B

  • Cancer has spread to the connective tissue below the skin and to lymph vessels or blood vessels.
  • Cells look very different from normal cells, or cancer has spread to erectile tissues or the urethra.
  • Cancer has spread to three or more lymph nodes on one side of the groin or multiple lymph nodes on both sides of the groin.
  • Cancer hasn’t spread to any other parts of the body.

Stage 4

  • Cancer has spread to nearby areas, such as the pubic bone, prostrate, or scrotum, or cancer has spread to other areas and organs of the body.

The two main types of penile cancer are invasive and noninvasive. Noninvasive penile cancer is a condition in which the cancer hasn’t spread to deeper tissues, lymph nodes, or glands.

Invasive penile cancer is a condition in which the cancer has moved deep into the penis tissue and surrounding lymph nodes and glands.

Some of the main treatments for noninvasive penile cancer include:

  • Circumcision. The foreskin of the penis is removed.
  • Laser therapy. High intensity light is focused to destroy tumors and cancer cells.
  • Chemotherapy. An aggressive form of chemical drug therapy helps eliminate cancer cells in the body.
  • Immunotherapy. A biological therapy created in a lab boosts, directs, or restores the body’s immune system against cancer cells.
  • Radiation therapy. High energy radiation shrinks tumors and kills cancer cells.
  • Cryosurgery. Liquid nitrogen freezes tumors and removes them.

Treatment for invasive penile cancer requires major surgery. Surgery may involve the removal of the tumor, entire penis, or lymph nodes in the groin and pelvis.

Surgery options include the following:

Excisional surgery

Excisional surgery may be performed to remove the tumor from the penis. You’ll be given a local anesthetic to numb the area so you don’t feel any pain. Your surgeon will then remove the tumor and affected area, leaving a border of healthy tissue and skin. The incision will be closed with stitches.

Moh’s surgery

The goal of Moh’s surgery is to remove the least amount of tissue possible while still getting rid of all the cancer cells.

During this procedure, your surgeon will remove a thin layer of the affected area. They’ll then examine it under a microscope to determine whether it contains cancer cells. This process is repeated until there are no cancer cells present in the tissue samples.

Partial penectomy

A partial penectomy removes part of the penis. This operation works best if the tumor is small. For larger tumors, the entire penis may be removed. Full removal of the penis is called a total penectomy.

Regardless of the type of surgery performed, you’ll need to follow up with your doctor every 2 to 4 months during the first year after your surgery. If your entire penis is removed, you can talk with a doctor about whether penis reconstructive surgery may be an option.

Many people who receive diagnoses of early stage penile cancer often make a full recovery.

According to the American Cancer Society, the 5-year survival rate for people with tumors that never spread to the glands or lymph nodes is approximately 85 percent.

Once the cancer reaches the lymph nodes in the groin or nearby tissues, the 5-year survival rate is approximately 59 percent.

It’s important to note that these are general statistics. Your outlook may differ depending on your age and overall health. The most important thing you can do to increase your chances of recovery is to stick with the treatment plan suggested by your doctor.

It’s important to have a strong support network that can help you deal with any anxiety or stress you may be feeling. You may also want to consider joining a cancer support group to discuss your concerns with others who can relate to what you’re going through.

Ask your doctor about support groups in your area. You can also find information on support groups on the National Cancer Institute and the American Cancer Society websites.

Doctors and researchers are studying new opportunities for treating penile cancer. Clinical trials study treatments that have not yet been approved by the Food and Drug Administration (FDA). If you’re interested in participating in a clinical trial, talk with the doctor in charge of your treatment, or search for trials near you.

People may choose to participate in a clinical trial for many reasons, including not seeing the results they want through traditional therapies and cancer that has come back. If costs are covered by a trial’s sponsor, the cost of treatment in a clinical trial may be free.

Many of today’s treatments began as past clinical trials.

Some treatments that may be available include radiostabilizers, which may make cancer cells more sensitive to radiation, and sentinel lymph node biopsy followed by surgery, in which a lymph node containing cancer is removed.

Signs of penile cancer may include a lump, sore, or discoloration on the penis and symptoms of swelling, burning, discharge, and bleeding. If you have symptoms of penile cancer, schedule an appointment with a doctor or urologist to diagnose and treat it.

An early diagnosis and prompt treatment may improve outcomes for those with penile cancer.