Medical Encyclopedia

Penile Cancer

A rare male cancer with treatment options emphasizing function preservation. This guide explains HPV connection, symptoms, diagnosis, staging, and treatment strategies.

Medical researcher working in a clinical laboratory, representing evidence-based cancer research
Not medical advice. StopMyCancer is an educational resource. If you notice any persistent penile changes, discharge, or ulcers, consult your physician promptly.
At a Glance

Quick Overview

Rare Cancer

Approximately 2,000 cases in the United States annually, less than 1% of male malignancies. [NCI, 2024]

Squamous Cell Carcinoma

95% of penile cancers are squamous cell type. Some HPV-related, others develop independently. [ACS, 2024]

Typically Ages 50-70

Median age at diagnosis is 60-65 years, though can occur at younger ages. [NCI, 2024]

Function Preservation Possible

Modern surgical approaches prioritize partial resection and function preservation when possible. [NCCN, 2024]

Understanding the Basics

What Is Penile Cancer?

Penile cancer is a rare malignancy of the penis, most commonly squamous cell carcinoma. About 40% of cases are associated with HPV infection, similar to anal and cervical cancers. The remaining cases develop independently, often in men with phimosis (tight foreskin) or poor penile hygiene. [ACS, 2024]

Early lesions often appear as small ulcers, papules, or areas of discoloration on the glans (head) or shaft of the penis. Detection at an early stage dramatically improves outcomes and allows for function-preserving surgical approaches. Treatment emphasizes organ preservation while ensuring adequate cancer control.

Classification

Types of Penile Cancer

Squamous Cell Carcinoma (~95%)

Most common type. Includes keratinizing type (HPV-negative), basaloid type (often HPV-related), and warty type (HPV-associated). Different variants have different behaviors and treatment responsiveness. [NCI, 2024]

Melanoma & Other Rare Types

Melanoma accounts for 5-10% of penile cancers and has worse prognosis. Adenocarcinomas, basal cell carcinomas, and sarcomas are rare. [ACS, 2024]

Who Is at Risk

Risk Factors

HPV Infection

High-risk HPV types (HPV-16, HPV-31, HPV-33) increase penile cancer risk, accounting for about 40% of cases. [ACS, 2024]

Phimosis

Inability to retract the foreskin creates chronic irritation and increases risk. Circumcision may reduce risk. [NCI, 2024]

Age & Smoking

Most common after age 50. Smoking increases risk. [ACS, 2024]

Poor Penile Hygiene

Chronic inflammation from poor hygiene contributes to risk. [NCI, 2024]

Know the Signs

Symptoms of Penile Cancer

Persistent ulcer or sore that does not heal
Lump or bump on the penis
Discharge or bleeding from the penis
Pain or burning during urination or intercourse
Any persistent penile lesion, discharge, or change warrants prompt medical evaluation. Early detection allows for function-preserving treatment. [NCI, 2024]
Finding the Answer

Diagnosis & Staging

Biopsy

Tissue diagnosis is essential. A small sample is taken and examined under microscope. [ACS, 2024]

Imaging & Imaging Testing

MRI or ultrasound assess depth of invasion. CT may be used to evaluate for metastasis. Pelvic lymph nodes are assessed to determine staging. [NCI, 2024]

HPV Testing

HPV status guides prognosis and treatment decisions. HPV-positive cancers often respond better to chemotherapy and immunotherapy. [NCCN, 2024]

Sentinel Lymph Node Biopsy

For early-stage disease, helps determine if lymph nodes are involved without removing all groin lymph nodes (less morbidity). [ACS, 2024]

Your Options

Treatment for Penile Cancer

Laser Therapy & Topical Treatment

For very early lesions or penile intraepithelial neoplasia (PeIN), laser ablation or topical therapies (imiquimod, 5-FU) can be used, preserving function. [NCCN, 2024]

Mohs Micrographic Surgery

Margin-controlled excision under real-time microscopy allows precise removal of tumor while maximizing tissue preservation. Increasingly standard for penile cancer. [ACS, 2024]

Wide Local Excision (WLE)

Surgical removal of tumor with a margin of normal tissue. For early-stage disease on the glans, glansectomy (removing surface layer) may preserve function. [NCI, 2024]

Partial or Total Penectomy

For larger or invasive tumors, partial or total removal of the penis may be necessary. Modern techniques emphasize function preservation and quality of life. [NCCN, 2024]

Lymph Node Surgery

If nodes are involved, inguinal lymphadenectomy (removal of groin lymph nodes) may be needed. Sentinel lymph node biopsy preserves function for early-stage disease. [ACS, 2024]

Chemotherapy & Radiation

Neoadjuvant chemotherapy before surgery can shrink tumors. Adjuvant radiation may be used for high-risk features. [NCI, 2024]

What to Expect

Side Effects & Function

Surgical Function Impact

Extent depends on surgery type. Early lesions treated with glansectomy usually preserve sexual function. More extensive surgery may impact urination and/or sexual function.

Lymphedema

Groin lymph node removal may cause leg swelling (lymphedema) in 5-10% of patients. Compression stockings and exercise help manage.

Psychological Impact

Cancer and surgery affecting sexual organs affects body image and psychological well-being. Counseling and support are important.

Chemotherapy Toxicity

Nausea, fatigue, low blood counts, neuropathy, and reduced blood cell counts are common with cisplatin-based chemotherapy.

Evidence Base

Sources & References

  1. American Cancer Society (ACS). "Penile Cancer Overview." Cancer.org. Accessed 2024.
  2. National Cancer Institute (NCI). "Penile Cancer Treatment (PDQ)." Cancer.gov. Accessed 2024.
  3. National Comprehensive Cancer Network (NCCN). "NCCN Guidelines: Penile Cancer." Version 1.2024.

Last reviewed: February 2025. Not medical advice. Always consult your care team.