Penile Cancer Causes, Symptoms, Diagnosis, and Treatment Options Explained

Abstract

Penile cancer is a rare but serious type of cancer that develops on the skin or within the tissues of the penis. It most commonly affects men over the age of 50, but it can occur at any age. Early detection and timely treatment significantly improve outcomes. This article explains what penile cancer is, outlines the different types, explores known causes and risk factors, describes symptoms to watch for, and explains the diagnostic and treatment options available. It also includes detailed guidance on advanced stages, treatment side effects, supportive care, and what living with the condition involves. This is part of the 'Public Education Series' initiative by Exon Publications.

Cite as: Penile Cancer: Causes, Symptoms, and Treatment Options Explained Simply. Brisbane (AU): Exon Publications; 2025. Published on  15 May.

Introduction

Penile cancer is a rare form of cancer that affects the penis, most commonly the skin on the head or shaft. While it is uncommon in developed countries, it is more frequently seen in certain regions of Asia, South America, and Africa. Because of the personal nature of the disease, some men hesitate to seek help, resulting in delayed diagnosis and worse outcomes. This article provides clear, accurate information about penile cancer, helping readers understand its symptoms, risks, treatments, and what to expect throughout the journey (1-5).

Penile cancer is a rare form of cancer that affects the penis, most commonly the skin on the head or shaft. While it is uncommon in developed countries, it is more frequently seen in certain regions of Asia, South America, and Africa. Image: Retro styled word Penile Cancer written with alphabets. Image Credit: crazydiva from Getty Images via Canva.com

What is Penile Cancer?

Penile cancer occurs when abnormal cells begin to grow uncontrollably in the tissues of the penis. It most often starts in the thin, flat cells lining the surface of the penis, called squamous cells. These abnormal cells can form a tumor that may be visible as a growth, sore, or lump on the penis. If not treated early, the cancer can invade deeper tissues or spread to other parts of the body. Although rare, it is a life-threatening condition that requires medical attention.

Types of Penile Cancer

The most common type of penile cancer is squamous cell carcinoma, accounting for over 90 percent of cases. It usually begins on the foreskin or the glans, which is the head of the penis. Other less common types include basal cell carcinoma, which tends to grow slowly, and melanoma, which originates in the pigment-producing cells and may look like a dark spot. Adenocarcinoma arises from sweat glands and is extremely rare. Sarcomas, which begin in connective or muscle tissue, can also occur in the penis but are very uncommon.

Causes and Risk Factors for Penile Cancer

The exact cause of penile cancer is unknown, but several risk factors have been identified. Infection with human papillomavirus (HPV), particularly types 16 and 18, is a major risk factor. Men who are not circumcised may have a higher risk due to difficulty cleaning under the foreskin, which can lead to chronic inflammation or smegma buildup. Poor hygiene, phimosis (a condition where the foreskin cannot be retracted), smoking, and having multiple sexual partners also increase the risk. Chronic skin conditions like lichen sclerosus and a weakened immune system may contribute as well. Age plays a role, with most cases occurring in men over 50.

Signs and Symptoms of Penile Cancer

Early signs of penile cancer may include a lump, sore, ulcer, or thickened area on the penis that does not go away. The affected area may appear red, velvety, or wart-like, and can be painful or painless. Some men notice discharge, bleeding, or an unpleasant odor from the lesion. Swelling in the penis or the lymph nodes in the groin may be present, especially as the disease progresses. Because symptoms may resemble infections or other skin conditions, it is important to seek medical advice for any persistent changes.

Diagnosis of Penile Cancer Diagnosed

Diagnosis begins with a physical examination and medical history. A doctor will inspect the lesion and feel for swollen lymph nodes in the groin. A biopsy is typically performed, where a small tissue sample is taken from the affected area and examined under a microscope. Imaging tests like ultrasound, MRI, or CT scans may be used to determine if the cancer has spread to nearby tissues or lymph nodes. In some cases, a sentinel lymph node biopsy may be done to assess whether cancer has reached the lymphatic system.

Stages and Grades of Penile Cancer

Staging describes how far the cancer has progressed. Stage 0 is carcinoma in situ, meaning abnormal cells are confined to the surface. Stage I indicates that the cancer has grown into deeper tissue but not beyond the penis. Stage II and III involve spread to nearby lymph nodes or tissues. Stage IV means the cancer has spread to distant parts of the body. The grade refers to how abnormal the cells look under a microscope and how quickly they are likely to grow. Low-grade cancers grow slowly, while high-grade cancers may grow and spread rapidly. Both stage and grade guide treatment decisions.

Differences Between Benign and Malignant Penile Cancer

Benign growths on the penis, such as warts, cysts, or infections, are not cancerous and do not spread. These can often be treated with medication or minor procedures. Malignant growths, however, consist of cancer cells that can invade nearby tissues and metastasize to other parts of the body. Only a biopsy can confirm whether a lesion is benign or malignant. Any lump, sore, or change that persists should be evaluated by a healthcare professional to rule out cancer.

What is Metastatic Penile Cancer?

Metastatic penile cancer refers to cancer that has spread beyond the penis to other parts of the body, most often the lymph nodes in the groin or pelvis. It can also spread to distant organs such as the lungs, liver, or bones. Symptoms of metastatic cancer vary based on where it has spread and may include pain, swelling, fatigue, or unexplained weight loss. Treatment becomes more complex at this stage and usually involves a combination of therapies aimed at controlling the disease and improving quality of life.

Penile Cancer Spread

Penile cancer can spread in several ways. It may grow locally into surrounding tissues, such as the shaft or base of the penis. It can also spread through the lymphatic system to lymph nodes in the groin and pelvis. Once cancer enters the bloodstream, it may reach distant organs. Lymph node involvement is often the first sign of spread and is critical in determining the stage and prognosis. Monitoring these pathways helps doctors decide on the most effective treatment approach.

Treatment Options for Penile Cancer

Treatment depends on the type, stage, and grade of the cancer, as well as the patient’s overall health. Options include surgery, radiation therapy, chemotherapy, and sometimes newer approaches like targeted or immunotherapy. Early-stage cancer may be treated with topical medications or minor surgical procedures, while more advanced cases often require a combination of treatments. The goal is to remove or destroy cancer cells while preserving as much function and appearance as possible.

Surgery for Penile Cancer

Surgery is the most common treatment for penile cancer. Options range from minor procedures, such as laser surgery or circumcision, to more extensive surgeries like partial or total penectomy. If lymph nodes are affected, they may also need to be removed through a procedure called lymphadenectomy. While surgery is effective, it can impact body image and sexual function, so patients are encouraged to discuss reconstruction or counseling with their healthcare provider.

Chemotherapy for Penile Cancer

Chemotherapy uses drugs to kill cancer cells and may be used before surgery to shrink the tumor or after surgery to eliminate remaining cancer cells. It is also used in advanced or metastatic cases. Chemotherapy can be given by mouth, injection, or through a catheter directly into the affected area. Common side effects include fatigue, nausea, hair loss, and increased risk of infection, which are typically temporary but should be managed with supportive care.

Radiation Therapy for Penile Cancer

Radiation therapy uses focused beams of energy to destroy cancer cells. It may be used as the main treatment for early-stage cancer, as an alternative to surgery, or in combination with other treatments. Radiation can also be applied to lymph nodes if there is a risk of spread. Side effects may include skin irritation, fatigue, and urinary symptoms, but most resolve after treatment ends. It is a non-invasive option for some patients.

Managing Side Effects of Penile Cancer Treatments

Side effects vary depending on the treatment but may include pain, swelling, fatigue, changes in urination, or sexual function. Emotional effects, such as anxiety or depression, are also common. Doctors can provide medications, physical therapy, or counseling to help manage these symptoms. Good communication between patients and healthcare teams helps ensure that side effects are minimized and treated early.

Supportive Care for Penile Cancer

Supportive care involves addressing all aspects of the patient’s well-being, including physical symptoms, emotional health, and social needs. This may include pain management, nutrition support, psychological counseling, and help with daily tasks during recovery. Support groups and educational resources can also provide comfort and practical advice for patients and families. Supportive care complements active treatment and improves quality of life.

Prognosis and Survival Rate for Penile Cancer

The outlook for penile cancer depends on how early it is diagnosed and how far it has spread. When caught early, the five-year survival rate is around 85 percent. Survival drops if the cancer has spread to lymph nodes or distant organs. Regular follow-up appointments are crucial to detect any recurrence and monitor overall health. Advances in treatment are improving outcomes, especially when care is started early.

Living with Penile Cancer

Living with penile cancer involves physical, emotional, and psychological adjustments. Some men may experience changes in their sense of identity or body image, particularly after surgery. Others may face challenges related to sexual health or relationships. Open discussions with healthcare providers, partners, and support networks can help. Many men return to normal activities after treatment, but regular checkups and self-care remain important. With the right support, it is possible to live well and maintain a good quality of life.

Common FAQs and Answers about Penile Cancer
Can circumcision reduce the risk of penile cancer?

Yes. Circumcision, particularly when performed in infancy, is associated with a lower risk of penile cancer due to improved hygiene and lower rates of chronic inflammation.

Is penile cancer contagious?

No, penile cancer is not contagious. However, some of the viruses associated with increased risk, such as HPV, can be transmitted through sexual contact.

Can penile cancer affect younger men?

Although most cases occur in men over 50, penile cancer can develop at a younger age, especially in individuals with HPV infection or compromised immune systems.

Is there a screening test for penile cancer?

There is no routine screening test for penile cancer. Regular self-examination and early evaluation of any changes or symptoms are the best approach for early detection.

Can HPV vaccination help prevent penile cancer?

Yes. The HPV vaccine helps protect against the virus types most often linked to penile and other genital cancers, especially when given before exposure to the virus.

Does penile cancer affect fertility?

In most cases, penile cancer does not affect fertility directly. However, advanced treatment or surgery involving lymph nodes or the penis may have an impact.

Is laser treatment an option for penile cancer?

Yes. For small, early-stage tumors, laser therapy can be used to remove or destroy cancer cells while preserving penile structure and function.

What is the recovery time after surgery for penile cancer?

Recovery depends on the extent of the surgery. Minor procedures may require a few weeks, while more extensive surgery may need longer healing and rehabilitation.

Can penile cancer return after treatment?

Yes. Like other cancers, penile cancer can recur. Regular follow-up visits and imaging are important to monitor for any signs of return.

How can I support someone with penile cancer?

Offer emotional support, help with medical appointments, and encourage open communication. Respect their privacy and be patient during treatment and recovery.

Conclusion

Penile cancer, while rare, is a serious condition that requires awareness, prompt diagnosis, and effective treatment. Recognizing early symptoms and understanding the available treatment options can lead to better outcomes. Whether facing a minor lesion or advanced disease, men benefit from accurate information, expert medical care, and supportive services. By breaking the silence around this topic, more men can get the help they need and improve their chances of recovery and long-term health.

References

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2. Alemany L, Cubilla A, Halec G, et al. Role of human papillomavirus in penile cancers worldwide. Eur Urol. 2016;69(5):953-961. https://doi.org/10.1016/j.eururo.2015.12.007


3. Spiess PE, Dhillon J, Baumgarten AS, et al. Pathophysiological basis for contemporary management of penile cancer. Nat Rev Urol. 2021;18(5):298-314.


4. Misra S, Chaturvedi A, Misra NC. Penile carcinoma: a challenge for the developing world. Lancet Oncol. 2004;5(4):240-247. https://doi.org/10.1016/S1470-2045(04)01427-5


5. Maddineni SB, Lau MM, Sangar V. Identifying the needs of penile cancer sufferers: a systematic review of the literature. BJU Int. 2009;104(9):1175-1181. https://doi.org/10.1186/1471-2490-9-8

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This article is part of the 'Public Education Series' initiative by Exon Publications. It was written by professional medical writers for the general public in plain language, based on peer-reviewed articles indexed in PubMed, and further reviewed for scientific accuracy by experts. The views and opinions expressed in this article are believed to be accurate at the time of publication. However, the publisher, editors, and authors cannot be held responsible or liable for any errors, omissions, or consequences arising from the use of the information provided. The publisher makes no warranties, explicit or implicit, regarding the contents of this article or its use. The information in this article is intended solely for informational purposes and should not be considered medical advice.