Cancer - penis

  • Definition
    • Cancer of the penis is cancer that starts in the penis, an organ that makes up part of the male reproductive system.

  • Alternative Names
    • Penile cancer; Squamous cell cancer - penis

  • Causes
    • The exact cause is unknown.

      Smegma, a cheese-like, foul-smelling substance found under the foreskin of the penis may increase the risk of penis cancer.

      Uncircumcised men who do not keep the area under the foreskin clean and men with a history of genital warts or human papillomavirus (HPV) are at higher risk for this rare disorder.

  • Symptoms
      • Sores on the penis
      • Penis pain and bleeding from the penis (may occur with advanced disease)
  • Exams and Tests
    • The health care provider will perform a physical exam, which may reveal a non-tender lesion that looks like a pimple or wart. This growth is typically near the end of the penis.

      A biopsy of the growth is needed to determine if it is cancer.

  • Treatment
    • Treatment depends on the size and location of the tumor and how much it has spread.

      In general, cancer treatment includes:

      • Chemotherapy -- uses medicines to kill cancer cells
      • Radiation -- uses high-powered x-rays to kill cancer cells
      • Surgery - cuts out and removes the cancer

      If the tumor is small or near the tip of the penis, surgery may be done to remove only the cancerous part of the penis. Depending on the exact location, this is called a glansectomy or partial penectomy. Laser surgery may be used to treat some tumors.

      For more severe tumors, total removal of the penis (total penectomy) is often necessary. A new opening will be created in the groin area to allow urine to exit the body. This procedure is called a urethrostomy.

      Chemotherapy may be used along with surgery. Cisplatin, ifosfamide, and paclitaxel are usually used for treating cancer of the penis.

      Radiation therapy is often recommended in combination with surgery. A type of radiation therapy called external beam therapy is often used. This method delivers radiation to the penis from outside the body. External beam radiation therapy is usually performed 5 days a week for 6 - 8 weeks.

  • Support Groups
    • Joining a support group where members share common experiences and problems may help relieve the stress associated with diagnosis and treatment of cancer of the penis.

      See: Cancer - support group

  • Outlook (Prognosis)
    • The outcome can be good with early diagnosis and treatment. The 5-year survival rate for cancer of the penis is 65%. Urination and sexual function can often be maintained, even when a large part of the penis is removed.

  • Possible Complications
    • Cancer of the penis frequently spreads to other parts of the body (metastasizes) early in the course of the disease.

  • When to Contact a Medical Professional
    • Call your health care provider if symptoms of penis cancer develop.

  • Prevention
    • Circumcision may decrease the risk. Men who are not circumcised should be taught at an early age the importance of cleaning beneath the foreskin as part of their personal hygiene.

      Safer sexual practices, such as abstinence, limiting the number of sexual partners, and using condoms to prevent HPV infection, may decrease the risk of developing cancer of the penis.

  • References
    • National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Penile cancer. 2012. Version 1.2012.

      Pettaway CA, Lance RS, Davis JW. Tumors of the penis. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 34.