Penile Cancer: Symptoms, Causes, and Treatment

Malignant cells in the penis grow out of control to cause penile cancer. The penis is a rod-shaped reproductive organ that enables men to urinate and engage in sexual activity. The head, also known as the glans, is composed primarily of the rod-like portion (shaft) that runs from the low belly to the tip of the penis. The foreskin, or top layer of skin, covers the head in people who have not been circumcised. The head of your penis is visible if you haven’t been circumcised.

Although cancer can develop anywhere in the penis, it typically begins on the head or foreskin (if you are an uncircumcised person).

Types

Squamous cell carcinoma makes up 95% of penile malignancies (SCC). The epithelium, the top layer of your skin, is where this type of cancer develops. Penile cancer can develop in various tissue types in less prevalent, alternative forms.

• Basal cell carcinoma (BCC): Cancer begins in the epithelium’s bottom layer. Penile cancer with a slow growth rate is known as BCC.
• Melanoma: This cancer starts in melanocytes, cells that determine how dark or light your skin is. Malignant melanoma is more dangerous.
• Sarcoma: Cancerous growths in connective or muscle tissue. It is a very rare type of penile cancer.
• Adenocarcinoma: It is a rare type of penile cancer that originates in the gland cells responsible for producing sweat in the skin.
• Squamous cell carcinoma (SCC) develops in the outermost layer of the skin (epithelium) and accounts for about 95% of all penile cancer cases.
• Urothelial carcinoma develops in the urothelium, the specialized lining that covers the bladder, kidneys, and other structures of the urinary tract.

Stages

Penile cancer progresses from surface abnormalities to deeper tissues, lymph nodes, and distant organs in advanced stages.

• Stage 0 – Abnormal cells or wart-like growths appear on the surface of the penis but have not invaded deeper tissues.
• Stage I – Cancerous cells form and spread to the connective tissues beneath the penile skin.
• Stage II – Cancer extends into the connective tissues and may also reach the lymph nodes, erectile tissue, or urethra, which carries urine from the bladder.
• Stage III – The cancer spreads beyond the penis to lymph nodes in the groin and may also invade connective tissue, erectile tissue, the urethra, or additional lymph nodes outside the groin.
• Stage IV – The cancer progresses to nearby areas like the prostate and may spread to pelvic lymph nodes or other parts of the body.

Causes and Risk Factors

Experts are unsure of what causes penile cancer. According to research, it is more common in men who:

• Have the papillomavirus (HPV).
• Are over the age of 60.
• Follow poor personal hygiene.
• Used to smoke and use tobacco products.
• Have a weakened immune system.
• Engage in sexual promiscuity.
• Have phimosis, a disorder that causes a tight, difficult-to-clean foreskin. Additionally, fluid accumulation may result.

Symptoms

Penile cancer typically alters the appearance of your penis, though not all malignancies result in visible changes. You might see a bulge and discolored skin on your penis. Signs and symptoms of penile cancer include:

• An unhurried lump or soreness (that may bleed)
• Swelling and itching, particularly in the penis’s head (balanitis)
• The penis skin may be infected and become thicker or change color
• Flat, blueish-brown-looking growths.
• Fluid beneath your foreskin that has a foul odor.
• Little crusty lumps
• Rashes

Less serious illnesses might also bring these symptoms, including infections and allergic responses.

Diagnosis

Your doctor could run the following tests to see if you have cancer:

Physical examination and medical history: During the physical examination, your doctor will look for unusual skin changes, such as a lump or discoloration on your penis. Additionally, they will enquire about your routines, past illnesses, and symptoms. Your doctor can use this information to decide whether the changes are most likely caused by cancer or a less serious condition like an infection or an allergic response.

Biopsy: Only a biopsy can definitively diagnose cancer. Your doctor takes out any suspicious-looking cells or tissues throughout the process. A pathologist, a specialist who works in a lab, examines the cells under a microscope to look for indications of malignancy. They can follow either an Incisional or an Excisional biopsy.

Imaging: Imaging may be required to determine how far the cancer has spread. Based on the nature of your cancer, your doctor may suggest various imaging tests, including MRI, CT scan, ultrasound, PET scan, or a chest X-ray.

Treatment

Your treatment plan will depend on the tumor’s size, how far it has spread, and the risk of the cancer returning after treatment. A care team that includes your primary doctor, an oncologist, a urologist, and a dermatologist may be involved in your treatment.

Early-stage cancer patients may receive the following treatments:

• A cream-based treatment for your skin
• The cancerous tissue is frozen and destroyed by using a very cold liquid or instrument known as cryotherapy.
• Mohs surgery involves removing cancerous skin layer by layer until only healthy tissue remains.
• Using lasers to cut and remove cancerous tissue
• Circumcision or foreskin removal procedure. If you had cancer in your foreskin, you would undergo this treatment.

You might also have the following if your cancer is more advanced or more prone to spread:

• If your cancer has spread to your groin, you may need surgery to remove some or all of the lymph nodes.
• Radiation and/or chemotherapy to remove cancer cells from your body
• A penectomy is a procedure in which your penis is partially or completely removed.
• Most early-stage penile cancer therapies have no effect on your ability to have sex, although chemotherapy and radiation may. Consult with your doctor about possible side effects.

(Consult with your oncologist; they will guide you and prescribe the right kind of treatment.)

Prevention

Cancer cannot be entirely avoided, although certain factors can reduce your risk:

• Get yourself circumcised. Maintaining cleanliness in the area is simpler when you don’t have a foreskin.
• If you have a foreskin, be sure to clean it well.
• Avoid using tobacco.
• To prevent contracting HIV and HPV, practice safe sex.

How Should I Care for Myself?

Discuss with your doctor how your cancer and treatment options may affect your way of life. The penile tissue is preserved in several cancer therapies. In other words, your penis eventually recovers to resemble its pre-treatment appearance almost exactly. Nevertheless, standing urination is still possible. Erections, intercourse, and orgasms are still possible. Your experience of sex and the way you urinate may be altered by surgery to remove all or a portion of your penis. There are numerous ways that penile cancer can manifest and be treated. You can better prepare for various potential events by knowing what to expect. Ask your doctors any questions you may have openly and honestly.

Who Treats Penile Cancer?

An expert in utilizing surgery to treat cancer is known as a surgical oncologist. Usually, urologists with additional training in cancer surgery are the surgical oncologists who treat penile cancer.

Frequently Asked Questions