Penile Cancer Overview

The penis is a rod-shaped organ that makes up part of the reproductive system of a man.  It allows urine and sperm to pass from the body. The penis contains special tissue that enables it to become enlarged and rigid (hard). The erectile tissue is wrapped in connective tissue and covered with skin. The head of the penis, also known as glans, is covered with loose skin called the foreskin.

Cancer of the penis, also known as penile cancer, is rare in the United States. It occurs more often in men who have a foreskin (skin which covers the head of the penis). Penile cancer occurs when normal cells begin to change and grow uncontrollably anywhere on the penis. It usually starts on the head (glans) of the penis, or the foreskin. It can also start anywhere along the shaft of the penis.

There are different types of cancer cells that can develop on the penis. The most common type of penile cancer is called squamous cell carcinoma. This type of cancer is similar to that found on the head and face. Melanoma may also grow on the penis. Melanoma starts in melanocytes. Melanocytes make melanin which give skin its color. This type of cancer cell can grow more rapidly than squamous cell carcinoma. Some penile cancers are sarcomas. Sarcomas are cancers that develop in tissues such as blood vessels, smooth muscle and fat and make up a small percentage of all penile cancers.

A risk factor is anything that increases a person’s chance of developing cancer. Cancer of the penis can be caused by several risk factors. Some of the most common risk factors are lack of circumcision (surgical removal of the foreskin) after birth, being unable to pull back the foreskin of the penis (known as phimosis), infections with the human papilloma virus (HPV), a history of genital warts, use and exposure to tobacco products, and ultraviolet radiation. 

Penile cancer has a common sign and symptom that can be easy to ignore by men with this disease. Most men will first experience a painless sore on the foreskin (sometimes the sore can cause pain) or a discolored spot on the glans or head of the penis that does not get better, does not heal, and does not disappear. When the foreskin cannot be pulled back, it can hide a cancerous tumor on the penis.  This hidden cancerous tumor can then grow to a large size, can stick out from the under the foreskin, and can start to bleed. If the cancerous tumor is not treated, it can become infected. An infection will produce a foul odor, discharge, and discomfort. 

The treatment options for penile cancer can vary depending on your overall health and whether the cancer has spread outside of the penis. Some treatments are standard of care which is the currently used treatment for this type of cancer. The standard treatment received will depend on the stage of disease.  Staging describes how severe a person’s cancer is based on the size of the original tumor and whether or not cancer has spread in the body. Standard of care might include surgery, application of chemotherapy creams, laser treatments, radiation, chemotherapy or a combination of these treatments. Patients may also have the option to be treated on a clinical trial which is meant to help improve current treatments (standard of care) or obtain information on new treatments for patients with cancer of the penis. It is important to discuss your treatment options with your medical oncologist to determine what is right for you.