Penile Cancer – Cancer of the Penis – Causes, Symptoms & Treatment

Types of penile cancer

1. Squamous cell or epidermoid carcinoma – Most common type of penile cancer found in 95% of the patients. This starts in the foreskin due to the accumulation of body fluids in the penis’ foreskin. Occasionally this can be found on other parts of the penis.
2. Sarcoma – This type of cancer usually starts or is found in the blood vessels, fat or muscle tissues of the penis.
3. Melanoma – Melanin is the pigment that gives colour to the skin in a human. Cancer that starts in these cells is called ‘Melanoma’.
4. Basal Cell Carcinoma – This type of cancer starts deep inside the skin and typically doesn’t spread beyond its place of origin.

Causes of Penile Cancer

1. As you have read, most of the times, the cancer of the penis is caused by the build up body fluids in the foreskin. If the foreskin is not cleaned properly, they can help in the growth of cancer cells.
2. Men aged over 60 are at the risk of developing penile cancer.
3. HPV – Human Papilloma Virus is one of the major cause of penile cancer. HPV is a Sexually Transmitted Infection. Antibodies for HPV were found in majority of patients diagnosed with penile cancer.
4. Smoking
5. Uncircumcised men are at higher risk of acquiring penile cancer.
6. Men with weak immune system, especially those suffering from HIV Infection or AIDS.
7. Due to medications that are used to treat psoriasis.

Symptoms of penile cancer

Penile cancer typically starts with a small lump or a bump (or sometimes a big sore) on the foreskin of the penis. If you find any bump on the shaft or on any other parts of your penis, you can worry a little less but if you find any lumps on the foreskin of your penis, make sure you get it checked by your sexologist.

Typical symptoms of penis cancer include:

1. A lump or rash or a bump on the foreskin of the penis
2. Stinky discharge from the foreskin
3. Changes in the thickness or colour of foreskin
4. A bleeding sore on the penis
5. Swelling at the end of the penis
6. Lumps (tumors like) growth in the groin area

Thought every lump or bump doesn’t mean cancer. There can be an infection at times. However, it is best if you get it diagnosed by your sexologist.

Diagnosing penile cancer

Your doctor will start with a physical examination of your penis. If he/she suspects that it could be cancer, a biopsy may be done. A biopsy is a simple test in which a small sample of tissue is taken from the affected area and observed under a microscope to detect cancer cells.

If the biopsy reveals cancer, then the next step would be to know how far the cancer has spread in the body. Your doctor may then perform cystoscopy. A Cystoscope is a small tube like device with light and a camera that is inserted from the penile opening into the bladder. This device allows your doctor to look for growth of tumors inside the body. An MRI may also be required to complete the diagnosis.  MRI gives a complete picture of the inner parts of the body and enables your doctor to see the spread of cancer.

Stages of penile cancer

Depending on the areas to which the cancer has spread, penile cancer is categorized in to different stages.

Stage 0 – Penile cancer has not spread beyond the place of origin, the foreskin.

Stage 1 – Penile cancer has spread from foreskin to the underlying tissues.

Stage 2 – Penile cancer has spread to the underlying tissues and the blood vessels or the lymph vessels.

Stage 3A – Penile cancer has spread beyond the lymph vessels into one or two lymph nodes.

Stage 3B – Penile cancer has spread to multiple lymph nodes

Stage 4 – Penile cancer has spread beyond lymph nodes to the nearby areas of the body such as prostate, scrotum etc.

Treatment of Penile Cancer

Treatment of Penile Cancer depends on the stage of the cancer. If the penile cancer has not spread to the inner tissues or lymph nodes, non invasive procedures are used to treat it. If the penile cancer has spread to the inner tissues or lymph nodes or if in later stages, then invasive procedures are used.

Non invasive procedures to treat penile cancer:

1. Circumcision – a simple procedure where the foreskin of the penis is removed.
2. Laser therapy – High intensity laser beam is used to kill the cancer cells in the tumour.
3. Chemotherapy – Drugs are administered to kill the cancer cells.
4. Radiation therapy – High energy, focused radiation is used to shrink and destroy cancer cells.
5. Cryosurgery – Liquid nitrogen is used to freeze the tumours and remove them.

Invasive procedures to treat penile cancer:

Invasive procedures may involve removal of tumour, lymph nodes that are affected and in some cases; even penis may also have to be removed. Surgical options to treat penile cancer include:

1. Excisional Surgery – Done under local anesthesia. The affected tissues and tumors will be removed by making an incision. Once the removal process is complete, the incision will be closed with stitches.
2. Moh’s Surgery – The aim of this surgery is to remove the least amount of tissues possible. Affected tissue and tumor is removed and examined under the microscope. If the tissues are found to have cancer cells, then more tissue is removed. This process is continued until the tissue removed does not have any cancer cells present.
3. Partial Penectomy or Total Penectomy – In partial penectomy, only a part of the penis is removed and in total penectomy, complete penis is removed. In case when complete penis is removed, your surgeon may provide you with option of penis reconstruction surgery.