Some men who develop penile cancer have obvious symptoms in the early stages. Others may not have signs until the disease has spread. Symptoms vary from man to man. They may include:
- Change in the skin of the penis
- Wart-like growth or lesion that may or may not be painful
- Open sore that won't heal
- Reddish rash
- Small, crusty bumps
- Flat bluish-brown growths
- Swelling at the end of the penis
- Persistent, smelly discharge under the foreskin
- Swollen lymph nodes in the groin if the cancer has spread
You may not be able to see these changes unless the foreskin is pulled back.
Unfortunately, many men do not want to talk about these symptoms with their doctors. This may delay them from seeking treatment until penile cancer is advanced and harder to treat.
Although these symptoms may not mean you have penile cancer, you should report any changes in the penis to your doctor as soon as possible. They may be signs of another health problem.
Penile Cancer Treatments
If you are diagnosed with penile cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer and your general health.
Surgery is the most frequent form of treatment for penile cancer, but topical chemotherapy, laser therapy and radiation may be used for smaller tumors. The type of treatment usually depends on how far the cancer has spread.
Your treatment for penile cancer will be customized to your particular needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Surgery to remove all or part of the penis is called penectomy. Penile preservation surgery (the penis is not removed) is used to treat penile cancer whenever possible.
Circumcision: Surgical removal of the penis foreskin and some of the nearby skin. This procedure may be done if the penile cancer has not spread beyond the foreskin. It also may be done before radiation therapy.
Partial penectomy: The tumor is removed along with a margin of healthy tissue. In the past, a 2-centimeter margin was removed in all cases of penile cancer. Recent research suggests such wide margins may not be needed. Surgeons try to spare as much of the glans (head) and shaft as possible to keep urinary and sexual function.
Total penectomy: Removal of the entire penis for treatment of large penile cancer tumors. The surgeon reroutes the urethra (the tube that urine passes through) behind the testicles, and an urethrostomy (opening for the urethra) is created so you can urinate. Penile reconstruction surgery using a flap of skin from the forearm to create a new penis has been done, but the procedure is rare.
Mohs surgery (microscopically-controlled surgery): The surgeon surgically removes a thin layer of skin and looks at it right away under a microscope. This process is repeated until the cells are free of cancer.
Laser surgery: Light from a laser vaporizes penile cancer cells.
In penile cancer, radiation therapy may be used to treat early stage tumors, with surgery to remove lymph nodes, and, in advanced cancers, to control spread and help relieve symptoms.
Topical chemotherapy: An anti-cancer medicine, usually 5-fluorouracil or 5-FU, is applied as a cream for several weeks. This generally is used only for precancerous or very early penile cancer.
Systemic chemotherapy: Medicine injected into a vein or given by mouth.
Imiquimod: A drug in a cream form that boosts the body's immune system. It sometimes is used to treat very early stage penile cancer.