Penile cancer

What is it?

This is a rare cancer with over 600 new cases diagnosed every year in the UK. It usually affects men aged over 60 years although younger men are being increasingly diagnosed. As it’s a rare cancer, its treatment is in dedicated specialist centres. The prognosis can be good if the cancer is picked up and treated early.


How does it present?

It can affect any part of the penis but usually starts at the part of the penis furthest away from the body.
Symptoms may include:
• Painful lump/redness patch/ulcer
• Discharge with foul odour from under the foreskin
• Discharge/blood from tip of the penis or in urine
• Problems with passing urine including pain
• Abnormality of the foreskin
• Lumps/pain in the groin
• Rare: weight loss


What are the risk factors?

• Age: risk rises with age
• Pre-cancerous lesions of the penis
• Smoking
• Presence of foreskin: extremely rare in men circumcised prior to puberty
• Tight foreskin
• Human Papilloma Virus (HPV): this is a very common sexually transmitted virus. Certain types are associated with the development of some cancers including penile cancer.


What else could the penile abnormality be?

• Pre-malignant lesion
• Chronic inflammation
• Sexually transmitted infection


How will I be assessed?

You will be seen in a clinic by a penile cancer Surgeon. A full history and examination will be undertaken. The following will be part of this assessment:
• An ultrasound scan or MRI scan of the penis will be arranged to assess the penis and determine how much of the penis is involved with the cancer.
• An ultrasound scan of the groin will be undertaken to determine if the lymph nodes in the groin may be involved with the cancer.
• A CT scan may be organised to check for cancer outside the penis and groin.


What treatments are available?

The treatments can be divided into 3 parts:
• Penis
• Groin
• Pelvis


What are the Penis treatment options? (please see individual leaflets)

• Penile biopsy
• Circumcision: if cancer only involves the foreskin
• Wide local excision
• Glansectomy with/without skin graft
• Partial penectomy with/without skin graft
• Subtotal/total penectomy with perineal urethrostomy


What are the Groin treatment options? (please see individual leaflets)

• Fine needle aspiration
• Dynamic Sentinel Lymph node biopsy
• Modified/radical groin lymph node dissection


What are the pelvis treatment options? (please see individual leaflets).

• Pelvic lymph node dissection
• Chemotherapy +/- radiotherapy

To learn more about treatments for penile cancer, please visit our specialist andrology clinic, Birmingham Penis Clinic

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