Penile Cancer: Key Symptoms & Treatment Options

Penile cancer, though relatively rare, is a serious condition that can profoundly impact the health and well-being of those affected. Although this type of cancer typically occurs in older men, it can develop at any age. While it accounts for only a small percentage of cancers in men, raising awareness about its signs, risk factors, and treatment options can aid in early diagnosis. Read on as we share everything you need to know about penile cancer, helping you face this challenging journey with hope and strength.

What is Penile Cancer?

Penile cancer is a rare malignancy that develops on the skin or within the tissues of the penis. It typically begins in the cells of the skin and can occur in different areas of the penis, including the glans (head), foreskin, or shaft. The most prevalent type of penile cancer is squamous cell carcinoma, which starts in the flat skin cells. Early indicators of penile cancer may include changes to the penile skin, such as lumps, sores, or unusual growths that do not heal. Early diagnosis and treatment are vital for achieving the best possible outcomes.

What are the Types of Penile Cancer?

Penile cancer can be classified into several types, each originating from different kinds of cells within the penis. The main types include:

• Squamous Cell Carcinoma: This is the most common type, accounting for around 95% of penile cancer cases. It begins in the flat skin cells called squamous cells and can occur anywhere on the penis, most often on the glans or foreskin.
• Adenocarcinoma: This rare type develops in the glandular cells that produce mucus and other fluids. Paget's disease of the penis is a form of adenocarcinoma.
• Basal Cell Carcinoma: Another rare type, basal cell carcinoma starts in the basal cells at the base of the epidermis. It tends to grow slowly and is less likely to spread than squamous cell carcinoma.
• Melanoma: This type arises from the pigment-producing cells called melanocytes. Although rare, melanoma of the penis can be aggressive and spread quickly.
• Sarcoma: Sarcomas originate in the connective tissues, such as blood vessels, smooth muscle, or fat. This type of penile cancer is extremely rare.

Each type of penile cancer may require different treatment approaches, and early detection is crucial for effective management.

What are the Symptoms of Penile Cancer?

The symptoms of penile cancer can vary, but common signs to watch for include:

• Lumps or Growths: The appearance of a lump, sore, or growth on the penis, particularly on the glans or foreskin, which does not heal.
• Changes in Skin Colour or Thickness: Areas of the penile skin may become discoloured or thicker.
• Ulcers or Sores: Persistent ulcers or sores on the penis that may bleed or discharge.
• Rashes: Unusual rashes, particularly under the foreskin.
• Foul-Smelling Discharge: An odorous discharge from under the foreskin.
• Bleeding: Unexplained bleeding from the penis or under the foreskin.
• Pain: Pain or discomfort in the penis, which might become more noticeable during urination or sexual activity.
• Swollen Lymph Nodes: Swelling of the lymph nodes in the groyne area.

If any of these symptoms are observed, it is important to seek medical advice promptly for proper diagnosis and treatment. Early detection significantly improves the chances of successful treatment.

What Causes Penile Cancer?

The exact cause of penile cancer is not fully understood, but there are several risk factors that are associated with its development, such as:

• Human Papillomavirus (HPV) Infection: A significant number of penile cancer cases are linked to HPV, a sexually transmitted infection that can cause changes in penile cells.
• Poor Hygiene: Inadequate cleaning, especially in uncircumcised men, can lead to the accumulation of smegma, which can irritate the penis and increase cancer risk.
• Smoking: Tobacco use is associated with an increased risk of many cancers, including penile cancer, due to the harmful chemicals in cigarettes.
• Phimosis: A condition where the foreskin cannot be fully retracted over the glans can lead to chronic inflammation and increase cancer risk.
• Age: Penile cancer is more common in men over the age of 50.
• Ultraviolet (UV) Light Treatment: Previous UV light treatment for psoriasis may increase the risk.
• Weakened Immune System: Men with a weakened immune system, such as those with HIV/AIDS or those taking immunosuppressive drugs, are at higher risk.
• History of Precancerous Lesions: Conditions like penile intraepithelial neoplasia (PeIN) can increase the risk of developing penile cancer.
• Multiple Sexual Partners: Having multiple sexual partners can increase the likelihood of contracting HPV, which is a risk factor for penile cancer.
• Uncircumcised Men: Men who are not circumcised have a higher risk, possibly due to difficulties in maintaining proper hygiene.

Understanding these risk factors can help in taking preventive measures and recognising early signs, which is crucial for effective treatment and better results.

How is Penile Cancer Diagnosed?

Diagnosing penile cancer involves several steps to accurately identify the presence and extent of the disease. Here are the common methods used:

• Medical History and Physical Examination: The doctor will take a detailed medical history and perform a thorough physical examination of the penis to look for any abnormalities, such as lumps, sores, or changes in skin colour or texture.
• Biopsy: If a suspicious area is found, a biopsy will be performed. This involves taking a small sample of tissue from the affected area, which is then examined under a microscope to check for cancerous cells.
• Imaging Tests: To determine if the cancer has spread, imaging tests such as ultrasound, MRI, or CT scans may be used. These tests provide detailed images of the internal structures and can help identify the extent of the disease.
• Cystoscopy: In some cases, a cystoscopy might be performed. This involves inserting a thin, flexible tube with a camera into the urethra to examine the inside of the bladder and urethra for any signs of cancer spread.
• Lymph Node Examination: The doctor may also check the lymph nodes in the groyne area for swelling or signs of cancer spread. A fine needle aspiration (FNA) biopsy may be done on swollen lymph nodes to collect cells for examination.
• Blood Tests: Blood tests can help assess overall health and detect any abnormalities that might suggest the presence of cancer or other underlying conditions.

Early diagnosis is crucial for effective treatment, so it is important to seek medical advice as soon as you notice any symptoms.

What are the Stages of Penile Cancer?

The stages of penile cancer describe the extent of the disease and how far it has spread. Knowing these stages also helps determine the most appropriate treatment plan for the patient with penile cancer. Penile cancer is typically staged using the TNM system, which stands for Tumour, Nodes, and Metastasis. Here is an overview of the stages:

Stage 0 (Carcinoma in Situ)

Tis: The cancer is found only on the surface of the skin of the penis and has not invaded deeper tissues.

Stage I

T1: The cancer has grown into the connective tissue just below the skin but has not spread to lymph nodes or distant sites. The cancer cells are not high-grade (not likely to grow and spread quickly).

Stage II

T2: The cancer has grown into the corpus spongiosum or corpus cavernosum (erectile tissues) but has not spread to lymph nodes or distant sites.

T3: The cancer has grown into the urethra or prostate but has not spread to lymph nodes or distant sites.

Stage III

T1 to T3, N1: The cancer has grown into nearby tissues (as in stages I and II) and has spread to one or two inguinal (groyne) lymph nodes.

T1 to T3, N2: The cancer has spread to multiple inguinal lymph nodes but has not spread to distant sites.

Stage IV

T4: The cancer has grown into nearby structures such as the bladder, abdominal wall, or other nearby organs.

Any T, N3: The cancer has spread to pelvic lymph nodes or has caused a large growth in inguinal lymph nodes.

Any T, Any N, M1: The cancer has spread to distant parts of the body, such as the lungs, liver, or bones.

Understanding the stage of penile cancer is crucial for developing an effective treatment plan and determining the prognosis. 

How is Penile Cancer Treated?

Treating penile cancer depends on the stage and extent of the disease, as well as the patient's overall health. Here are the common treatment options:

Surgery

• Circumcision: Removing the foreskin if the cancer is confined to this area.
• Wide Local Excision: Removing the tumour along with some surrounding healthy tissue.
• Partial Penectomy: Removing part of the penis when the cancer is more advanced but confined to a specific area.
• Total Penectomy: Removing the entire penis if the cancer is extensive. A new opening (urethrostomy) may be created for urine to pass.

Radio Therapy

• External Beam Radiotherapy: Using high-energy radiation beams directed at the tumour from outside the body.
• Brachytherapy: Placing radioactive sources directly into or near the tumour to deliver targeted radiation.

Chemotherapy

• Topical Chemotherapy: Applying chemotherapy drugs directly to the skin for early-stage cancers.
• Systemic Chemotherapy: Administering drugs intravenously or orally to treat advanced cancer that has spread beyond the penis.

Laser Therapy

Using a high-intensity light beam to destroy cancer cells, often used for very early-stage cancers.

Biological Therapy (Immunotherapy)

Using the body’s immune system to fight cancer. This might involve medications that boost the immune response against cancer cells.

Lymph Node Dissection

Surgically removing lymph nodes in the groyne or pelvis if cancer has spread to these areas.

Note: Each treatment plan is tailored to the individual, considering the type, stage, and location of the cancer, as well as the patient's overall health and preferences. 

How to Prevent Penile Cancer?

Preventing penile cancer involves adopting healthy practices and reducing risk factors associated with the disease. Here are some effective strategies:

• Practise Good Hygiene: Regularly clean the penis, including under the foreskin, to prevent the build-up of smegma, which can irritate the skin and increase cancer risk.
• Consider Circumcision: Circumcision, particularly if performed in infancy, can reduce the risk of penile cancer by lowering the chance of chronic infections and phimosis.
• Avoid HPV Infection: Human papillomavirus (HPV) infection is a major risk factor for penile cancer. Getting vaccinated against HPV and practising safe sex, such as using condoms and limiting the number of sexual partners, can help reduce this risk.
• Quit Smoking: Smoking is linked to a higher risk of penile cancer. Quitting smoking can significantly reduce this risk and improve overall health.
• Be Mindful of UV Light Treatments: Avoid excessive use of UV light treatments, especially on the genital area, as this can increase cancer risk.
• Maintain a Healthy Immune System: A strong immune system can help prevent infections and diseases, including penile cancer. Eat a balanced diet, exercise regularly, get adequate sleep, and manage stress to support immune health.
• Regular Medical Check-Ups: Regular check-ups with a healthcare provider can help detect any early signs of penile cancer or other health issues. Report any unusual symptoms, such as lumps, sores, or changes in the skin of the penis, to your doctor promptly.
• Be Aware of Precancerous Conditions: Conditions such as penile intraepithelial neoplasia (PeIN) can increase the risk of developing penile cancer. Early detection and treatment of these conditions can help prevent progression to cancer.

By incorporating these preventive measures into your lifestyle, you can significantly reduce your risk of penile cancer and promote overall genital health.

Wrap Up

Maintaining good hygiene, practising safe sex, quitting smoking, and staying vigilant about any changes in your health are essential steps in preventing penile cancer. Additionally, early detection and regular medical check-ups can help ensure the best course of treatment. If you notice any of the aforementioned symptoms in yourself or if you are seeking treatment for a loved one dealing with penile cancer, Max Hospitals has you covered. At Max Hospitals, our dedicated team of specialists is here to provide comprehensive care and support at every step of your healthcare journey. Schedule a consultation with us today to take proactive steps towards your health and well-being.