THE CHESTNUT APPEAL

Penile Cancer.

A Guide to symptoms, diagnosis and treatment

What is penile cancer?

Penile Cancer is rare, but needs to be caught early to be treated successfully. It occurs on the skin of the penis or within the penis. There are around 760 cases in the UK each year, and it’s mostly diagnosed in men over 60. Men in their 30’s and 40’s can also be affected.

There are several types of penile cancer, depending on the type of cell the cancer developed from.

The most common types include:

squamous cell penile cancer – this accounts for more than 90% of cases, and starts in the cells that cover the surface of the penis
carcinoma in situ (CIS) – a particular type of squamous cell cancer where only the cells in the skin of the penis are affected and it hasn’t spread any deeper
adenocarcinoma – cancer that starts in the glandular cells of the penis that produce sweat
melanoma of the penis – this is where the cancer develops in the skin cells that give the skin its colour.

Please consult your GP for advice or diagnosis.

Who is at risk from penile cancer?

It isn’t always possible to prevent penile cancer, but you can reduce your chances of getting it.

One of the main ways you can reduce your chances of developing penile cancer is to give up smoking if you smoke.

It’s also important to maintain good penis hygiene to prevent the bacterial and viral infections that can increase the risk of penile cancer.

This is easier if you were circumcised as a child, but there are steps you can take if you haven’t been circumcised.

Simple penis hygiene can include:

using condoms to reduce the risk of catching HPV
regularly washing your penis with warm water, including under the foreskin

There’s little evidence to suggest that being circumcised as an adult will reduce your chances of developing penile cancer.

But if you have sores that don’t heal or it’s becoming increasingly difficult to clean under your foreskin, seek advice from your GP about the possibility of circumcision.

Penile cancer symptoms

You should be aware of any abnormalities or signs of penile cancer, including:

a growth or sore on the penis that doesn’t heal within 4 weeks
bleeding from the penis or from under the foreskin
a foul-smelling discharge
thickening of the skin of the penis or foreskin that makes it difficult to draw back the foreskin (phimosis)
a change in the colour of the skin of the penis or foreskin
a rash on the penis

If you experience these symptoms, it’s important to see your GP as soon as possible. It’s unlikely they’ll be caused by penile cancer, but they need to be investigated.

Any delay in diagnosing penile cancer could reduce the chances of successful treatment.

Penile cancer diagnosis

Your GP will ask you about any symptoms you have and when they occur. They’ll also examine your penis for signs of penile cancer.

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 anaesthetic, so you do not feel anything.

Penile cancer treatments

Treatment for penile cancer depends on the size of the affected area and the rate at which the cancer has spread.

For example, in most cases of carcinoma in situ (CIS), where only the skin cells of the penis are affected, treatment usually involves either using a chemotherapy cream or having laser surgery to remove the affected area of skin.

You’ll usually have a skin graft after surgery.

The main treatments for later-stage penile cancer are:

surgery
radiotherapy
chemotherapy