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Penile cancer

Overview

Penile cancer, or cancer of the penis, is when cells grow out of control on or in a man’s penis. Penile cancer is a rare cancer that mostly affects the skin of the penis and the foreskin (the skin covering the head of the penis). Treatment for most penile cancers caught very early includes creams and laser therapy. If not caught early, treatment may mean surgery.

Table of Contents:

Symptoms and causes

Causes of Penile cancer

Experts don’t know exactly what causes penile cancer. Research shows that it’s more common in men who:

  • Have the human papillomavirus (HPV)
  • Are over age 60
  • Smoke
  • Have a weakened immune system because of HIV or AIDS
  • Aren’t circumcised. Fluids and a thick build-up called smegma can collect under your foreskin and might make cancer growth more likely.
  • Have a condition called phimosis, which makes your foreskin tight and tough to clean. It can also lead to fluid build-up.
  • Had psoriasis treatment with the drug psoralen and ultraviolet (UV) light

Symptoms

The most common symptoms are:

  • a growth or sore that does not heal within 4 weeks
  • a rash
  • bleeding from the penis or under the foreskin
  • a smelly discharge
  • thickening of the skin of the penis or foreskin that makes it difficult to pull back the foreskin (phimosis)
  • a change in the colour of the skin of your penis or foreskin

Other symptoms of penile cancer include:

  • a lump in the groin
  • feeling tired
  • stomach pain
  • losing weight without trying

When to see a doctor?

See a general practitioner (GP) if you have:

  • any changes to how your penis looks
  • discharge or bleeding from your penis
  • any of the other symptoms of penile cancer
  • had treatment for your symptoms that has not helped in the time that it should

Having these symptoms does not definitely mean you have penile cancer. But it's important to get them checked by a GP. This is because if they're caused by cancer, finding it early can make it more treatable.

Diagnosis and treatment

Diagnosis

Your doctor will give you a physical exam and ask you about your symptoms. You may need more tests to check for penile cancer if a GP refers you to a specialist.

A biopsy is the main test to diagnose penile cancer. A specialist does this test by taking a sample of tissue from the affected area. It’s done under a local anesthetic, so you do not feel anything. A biopsy is usually done on the day of your appointment, hence you should be able to go home on the same day.

If you’ve been told you have penile cancer, you may need more tests. These tests, along with the tests you've already had, will help the specialists find out the size of the cancer and how far it's spread (called the stage).

You may need:

  • scans, like an MRI, CT scan, or PET scan
  • a test to see if the lymph nodes in your groin have been affected, which can happen with some penile cancers (called a lymph node biopsy)

You may not have all these tests or any of them. The specialists will use the results of these tests and work with you to decide on the best treatment plan for you.

Treatment

If your cancer is in the early stages, your treatment may include:

  • Cryotherapy is a procedure that uses an extremely cold liquid or a device to freeze and destroy cancerous tissue
  • Surgery, in which doctors remove affected skin one layer at a time until they reach healthy tissue
  • Lasers to cut and destroy areas that contain cancer
  • Circumcision, which is surgery to remove your foreskin. You would have this procedure if you had cancer only in your foreskin.

If your cancer is further along or more likely to spread, you might also have:

  • Surgery to remove some or all of the lymph nodes in your groin if your cancer has spread there
  • Radiation and/or chemotherapy to rid your body of cancer cells
  • A penectomy is a surgery to remove some or all of your penis

Coping and support

Being told you have penile cancer can feel overwhelming. You may be feeling anxious about what will happen next. If you're concerned or need support before and after your test, you may find it useful to talk to:

  • a trained counsellor
  • people in the same situation
  • friends and family

Preparing for your appointment

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all medications, vitamins, or supplements you're taking.
  • Write down questions to ask your doctor.

What to expect from your doctor

The GP may examine your penis and ask you to have a blood test.

They'll ask you:

  • what your symptoms are
  • when they started
  • if you’ve used anything to treat them, and if it’s made it better or worse

They may refer you to see a specialist in the hospital for more tests. This may be an urgent referral, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.

What can you do in the meantime?

To reduce your risk of penile cancer, consider the following:

  • Weigh the benefits of circumcision
  • Get the HPV vaccine
  • Practice safer sex
  • Don’t use tobacco products
  • Practice good hygiene
ABOUT THE AUTHOR
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Dr. Yudara Kularathne
AI & STIs | CEO HeHealth, Consultant Physician (EM), On a mission to impact one billion lives in the next 5 years, Developing AI-driven diagnostic tests for often unspoken diseases.

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