Penile Cancer

Cancer of the penis, a rare kind of cancer in the United States, is a disease in which cancer (malignant) cells are found on the skin and in the tissues of the penis. (Read about "Cancer: What It Is") The American Cancer Society (ACS) estimates that less than 1,500 men develop penile cancer each year and 200 die in the United States. The rate in this country is 1 in 100,000 men, according to ACS. In other some parts of the world, the rate tends to be higher. In some parts of South America and Africa, up to 10 percent of the cancers in men are penile cancer, according to ACS statistics.

The National Cancer Institute (NCI) says men who are not circumcised (Read about "Circumcision") at birth may have a higher risk for getting cancer of the penis. A circumcision is an operation in which the doctor takes away part or all of the foreskin from the penis. The foreskin is the skin that covers the tip of the penis. A circumcision is done on many baby boys before they go home from the hospital. Other risk factors, according to ACS include:

• Infection with certain types of human papillomavirus (HPV), which also causes genital warts (Read about "STD's")
• Smoking (Read about "Quit Smoking")
• Treatment for psoriasis (Read about "Psoriasis") with a drug called psoralen and exposure to ultraviolet light
• Age - most penile cancers occur in men over 50 but about 20 percent of cases happen to men under 40

Possible symptoms

A doctor should be seen if there are any of the following problems:

• growths or sores on the penis
• any unusual liquid coming from the penis (abnormal discharge)
• bleeding

If there are symptoms of cancer, the doctor will examine the penis and feel for any lumps. If the penis doesn't look normal or if the doctor feels any lumps, a small sample of tissue (called a biopsy) will be cut from the penis and looked at under a microscope to see if there are any cancer cells. (Read about "Biopsy")

ACS says that 95 percent of penile cancers come from flat, scale-like skin cells called squamous cells. They tend to develop slowly and when caught early are most easily cured. ACS says they can develop anywhere on the penis but tend to show up on the foreskin or the glans. This may be one reason circumcision provides some protection since when there is no foreskin present, cancer cannot develop there.

Another 2 percent of penile cancers develop in the pigment producing cells of the skin on the penis. These are called melanomas, according to ACS. Basel cell cancers are the most common form of skin cancer (Read about "Skin Cancer") and account to the vast majority of skin cancers found on places that are exposed to the sun, but account for less that 2 percent of penile cancers. The last 1 percent of penile cancers, according to ACS, involves sarcomas that arise from the blood vessels, smooth muscles and other parts of the penis.

Treatments Options and Stages

The prognosis (chance of recovery) and choice of treatment (Read about "Cancer Treatments") depend on the stage of the cancer (whether it is just in the penis or has spread to other places), and the patient's general state of health.

Once cancer of the penis is found, more tests will be done to find out if the cancer has spread from the penis to other parts of the body (staging). A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the penis, according to NCI:

• Stage I

  In stage I, cancer has formed and spread to connective tissue just under the skin of the penis. Cancer has not spread to lymph vessels or blood vessels.

• Stage II

  In stage II, cancer has spread to connective tissue just under the skin of the penis or through connective tissue to erectile tissue or beyond erectile tissue to the urethra.

• Stage III

  In stage III, cancer has spread to at least one lymph node near the groin, and may have spread beyond that as well. (Read about "The Lymph System")

• Stage IV

  In stage IV, cancer has spread to tissues near the penis such as the prostate, or to one or more lymph nodes or to distant parts of the body.

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the same area or in another place.

There are treatments for all patients with cancer of the penis. NCI says there are four kinds of treatment used:

• Surgery - removing the cancer in an operation
• Radiation therapy - using high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors (Read about "Radiation Therapy")
• Chemotherapy - using drugs to kill the cancer cells
• Biological therapy - using the immune system to fight cancer (Read about "The Immune System")

Surgery is the most common treatment of all stages of cancer of the penis. A doctor may remove the cancer using one of the following operations:

• Wide local excision removes only the cancer and some normal tissue on either side.
• Microsurgery is an operation that removes the cancer and as little normal tissue as possible. During this surgery, the doctor uses a microscope to look at the cancerous area to make sure all the cancer cells are removed.
• Laser surgery uses a narrow beam of light to remove cancer cells.
• Circumcision is an operation that removes the foreskin.
• Amputation of the penis is an operation that removes all or part of the penis. It is the most common and most effective treatment of cancer of the penis. In a partial penectomy, part of the penis is removed. In a total penectomy, the whole penis is removed. Lymph nodes in the groin may be removed during surgery.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation) or from putting materials that contain radiation through thin plastic tubes into the area where the cancer cells are (internal radiation). Radiation may be used alone or after surgery.

Chemotherapy uses drugs to kill cancer cells. Fluorouracil cream (a chemotherapy drug put on the skin of the penis) is sometimes used for very small surface cancers of the penis. Chemotherapy may also be given by pill or by a needle in a vein. When chemotherapy is given in this way, it is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the penis.

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological treatment is sometimes called biological response modifier (BRM) therapy.

More Cancer Information:

    Prostate Cancer

    Testicular Cancer

    Cancer Check-ups

    Cancer Support

    Cancer Treatments

    Reduce Cancer Risks

    Cancer Glossary

For a list of individual types of cancer, see Cancer: What It Is

Related Information:

    Microorganisms

    Genital Health - Male