Understanding Penile Cancer: Symptoms, Diagnosis, Causes & Treatment

Talking about cancer of the penis isn't easy. Many men feel embarrassed or scared to discuss problems with their private parts. But knowing about penile cancer can save lives. When caught early, this cancer is highly treatable. This guide explains everything you need to know about penile cancer in simple, clear language.

What Is Penile Cancer?

Penile cancer happens when cells in the penis grow out of control and form a tumor. The penis is the male reproductive organ used for passing urine and sexual activity. Cancer can develop anywhere on the penis, but it most often starts on the tip (called the glans) or under the foreskin.

According to the National Cancer Institute, penile cancer is rare, especially in developed countries like the United States. About 2,100 men are diagnosed with penile cancer in the U.S. each year. However, it's more common in some parts of South America, Africa, and Asia.

The good news is that when found early, penile cancer can often be cured completely. The key is recognizing symptoms early and not delaying medical care due to embarrassment or fear.

Types of Penile Cancer

Not all penile cancers are the same. Understanding the type helps doctors choose the right treatment.

Squamous Cell Carcinoma

This is the most common type, making up about 95% of all penile cancers. It starts in the flat skin cells covering the penis. This cancer usually begins on the head of the penis or under the foreskin and can slowly grow deeper into tissues.

Basal Cell Carcinoma

This type starts deep in the skin and grows slowly. It rarely spreads to other parts of the body, making it less dangerous than other types.

Melanoma

This cancer starts in the cells that give skin its color. Though rare on the penis, melanoma can be aggressive and spread quickly if not treated early.

Sarcoma

These cancers form in deeper tissues like blood vessels, muscles, or fat. They are very rare but can be serious.

Adenocarcinoma

This extremely rare type develops in the glands that produce fluid (sweat glands).

Most cases are squamous cell carcinoma, so this type receives the most attention in treatment and research.

Warning Signs and Symptoms

Recognizing penile cancer early dramatically improves treatment success. Many symptoms start small and don't cause pain at first, which is why men sometimes ignore them.

Early Warning Signs

Skin Changes: The most common first sign is a change in the skin of your penis. This might appear as a discolored patch—red, white, or darker than the surrounding skin. These patches can develop on the foreskin, the head of the penis, or the shaft.

Lumps or Thickening: You might notice a small lump or an area where the skin feels thicker than normal. This lump might be on the surface or just under the skin.

Sores That Won't Heal: A sore, ulcer, or wound that doesn't heal within four weeks needs medical attention. This might look like a small cut or scrape that stays the same or gets worse instead of healing.

Unusual Growths: Any new growth, whether it looks like a wart, bump, or crusty patch, should be checked by a doctor.

Advanced Symptoms

If cancer grows or spreads, you might notice:

Bleeding or Discharge: Unusual bleeding from the penis or a smelly discharge from under the foreskin.

Pain: While early penile cancer is usually painless, more advanced cancer can cause pain or discomfort.

Swollen Lymph Nodes: Hard lumps in your groin area might mean cancer has spread to lymph nodes.

Foreskin Problems: Difficulty pulling back the foreskin or a tight, thick foreskin that wasn't there before.

Changes in Appearance: The penis might change shape or look different than before.

According to the Urology Care Foundation, any man should see a doctor if he notices these changes on his foreskin, shaft, or head of the penis. Don't assume it's just an infection—get it checked.

What Causes Penile Cancer?

Doctors don't know exactly what causes penile cancer, but they've identified several risk factors that increase the chances of developing it.

Major Risk Factors

Not Being Circumcised: Men who aren't circumcised have a higher risk of penile cancer. This is because fluids and dead skin cells can collect under the foreskin, creating an environment where cancer might develop. However, this doesn't mean circumcision guarantees you won't get penile cancer, or that being uncircumcised means you will.

Human Papillomavirus (HPV): HPV is a sexually transmitted virus. Certain types, especially HPV 16 and HPV 18, are linked to penile cancer. According to research from the Cleveland Clinic, HPV is found in many penile cancer cases. The same virus causes cervical cancer in women.

Poor Hygiene: Men who don't clean under their foreskin regularly may develop a buildup of smegma—a thick, cheese-like substance made of dead skin cells and body oils. This chronic irritation might increase cancer risk.

Phimosis: This condition makes the foreskin too tight to pull back over the head of the penis. It makes cleaning difficult and can lead to chronic inflammation, increasing cancer risk.

Smoking: Tobacco use doubles or triples the risk of penile cancer. Harmful chemicals from smoking circulate throughout your body, including in your genital area.

Age: Most penile cancer cases occur in men over 50, with the highest rates in men between 50 and 70 years old. However, about one-third of cases happen in men under 50.

Chronic Inflammation: Repeated infections, irritation, or other inflammatory conditions of the penis increase cancer risk over time.

Weakened Immune System: Men with HIV/AIDS or those taking immune-suppressing medications have a higher penile cancer risk.

Psoriasis Treatment: Men who received PUVA treatment (psoralen plus ultraviolet A light) for psoriasis have an increased risk.

It's important to understand that having risk factors doesn't mean you'll definitely get cancer. Many men with multiple risk factors never develop penile cancer, while some men with no known risk factors do develop it.

How Penile Cancer Is Diagnosed

If you notice any concerning symptoms, your doctor will perform several tests to determine if you have penile cancer and, if so, how advanced it is.

Physical Examination

Your doctor will carefully examine your penis, looking for any unusual changes, lumps, sores, or discoloration. They'll also check the lymph nodes in your groin to see if they're swollen, which might indicate cancer has spread.

Don't feel embarrassed during this exam. Doctors examine many patients and are focused on helping you, not judging you.

Biopsy

A biopsy is the only way to definitively diagnose cancer. During this procedure, your doctor removes a small piece of tissue from the suspicious area and sends it to a laboratory. A specialist examines the tissue under a microscope to see if cancer cells are present.

There are different biopsy methods:

• Excisional biopsy: Removing the entire suspicious area

• Incisional biopsy: Removing just a small piece of the abnormal tissue

• Fine needle aspiration: Using a thin needle to remove cells, usually from a lymph node

Imaging Tests

If cancer is confirmed, your doctor orders imaging tests to see if it has spread beyond the penis. These tests might include:

CT Scan (Computed Tomography): Detailed X-ray images show whether cancer has spread to lymph nodes or other organs.

MRI (Magnetic Resonance Imaging): Uses magnets and radio waves to create detailed pictures of soft tissues.

Ultrasound: Sound waves create images that help see how deep the cancer has grown into the penile tissue.

Chest X-ray: Checks if cancer has spread to the lungs.

PET Scan: Sometimes used to see if cancer has spread throughout the body.

Cancer Staging

Once all tests are complete, doctors "stage" the cancer. Staging describes how large the tumor is and how far it has spread. According to the American Cancer Society, the TNM staging system is most commonly used:

T (Tumor): How far the cancer has grown into the penis

• T1: Cancer only in the skin surface

• T2: Cancer has grown into deeper tissues

• T3: Cancer has reached the urethra or prostate

• T4: Cancer has spread to nearby structures

N (Nodes): Whether cancer has spread to nearby lymph nodes

• N0: No lymph node involvement

• N1-N3: Cancer in lymph nodes (increasing numbers mean more involvement)

M (Metastasis): Whether cancer has spread to distant organs

• M0: No distant spread

• M1: Cancer has spread to distant organs

Stages range from 0 (earliest) to IV (most advanced). Early-stage penile cancer (Stages 0-I) has excellent cure rates, while advanced stages are more challenging to treat.

Treatment Options for Penile Cancer

Treatment depends on the cancer's stage, location, and size, as well as your overall health. The goal is to eliminate cancer while preserving as much normal function as possible.

Surgery

Surgery is the main treatment for most penile cancers. The type of surgery depends on how large and advanced the cancer is.

Circumcision: If cancer is only on the foreskin, removing the foreskin might be the only surgery needed. This is the least invasive option and preserves normal penis function.

Wide Local Excision: The surgeon removes the cancer and a margin of healthy tissue around it. This preserves most of the penis and usually doesn't affect sexual or urinary function.

Mohs Surgery: A specialized technique where thin layers of cancer-containing skin are removed one at a time until only cancer-free tissue remains. This preserves the maximum amount of healthy tissue.

Laser Surgery: For very small, early-stage cancers, lasers can destroy cancer cells while preserving healthy tissue.

Glansectomy: Removing the head (glans) of the penis while keeping the shaft. This preserves urinary and often sexual function.

Partial Penectomy: Removing part of the penis. Surgeons try to leave enough penis for standing urination and, when possible, sexual function.

Total Penectomy: In advanced cases, the entire penis must be removed. A new urinary opening is created in the area between the scrotum and anus. While life-changing, this surgery can be life-saving for advanced cancer.

Lymph Node Surgery: If cancer has spread to lymph nodes in the groin, these nodes must be removed. This is called an inguinal lymphadenectomy and is crucial for preventing further spread.

Radiation Therapy

Radiation uses high-energy beams to kill cancer cells. It might be used instead of surgery for small cancers or combined with surgery for larger ones.

External Beam Radiation: A machine directs radiation at the cancer from outside your body.

Brachytherapy: Radioactive seeds are placed inside or near the tumor for concentrated radiation treatment.

Radiation can cause side effects like skin irritation, fatigue, and urinary problems, but these usually improve after treatment ends.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells throughout the body. It's typically used when cancer has spread beyond the penis or when there's high risk of spread.

Topical Chemotherapy: For very early cancers, chemotherapy cream (like 5-fluorouracil or imiquimod) applied directly to the skin might work.

Systemic Chemotherapy: Drugs given through an IV or as pills travel through your bloodstream to reach cancer cells anywhere in your body.

Common chemotherapy drugs for penile cancer include cisplatin, 5-fluorouracil, and paclitaxel. Side effects can include nausea, fatigue, hair loss, and increased infection risk, but these typically resolve after treatment.

Immunotherapy

Immunotherapy is a newer treatment that helps your own immune system recognize and attack cancer cells. Drugs like cemiplimab (Libtayo) have shown promise for advanced penile cancer that hasn't responded to other treatments.

According to research, immunotherapy can benefit some patients with advanced disease, though it doesn't work for everyone.

Clinical Trials

Clinical trials test new treatments that aren't yet available to everyone. If standard treatments haven't worked or you have advanced cancer, ask your doctor about clinical trials. These studies give you access to cutting-edge therapies while helping researchers develop better treatments for future patients.

Living with and After Penile Cancer Treatment

Physical Recovery

Recovery time depends on your treatment. After surgery, you'll need several weeks to heal. Your doctor will give specific instructions about wound care, activity restrictions, and when you can return to work.

Many men worry about sexual function after treatment. With early-stage cancers treated with organ-preserving techniques, most men maintain sexual function. Even after partial penectomy, many men can still achieve erections and orgasms, though sensation might be different.

Emotional Support

A penile cancer diagnosis is emotionally difficult. You might feel scared, angry, embarrassed, or depressed. These feelings are completely normal.

Don't face this alone. Talk to your healthcare team about counseling services. Many hospitals offer support groups where you can connect with other men who've been through similar experiences. According to the Merck Manual, psychological support is an important part of comprehensive cancer care.

Follow-Up Care

After treatment, regular follow-up appointments are crucial. Your doctor will examine you and possibly order tests to ensure cancer hasn't returned. Most recurrences happen within the first two years after treatment, so follow-up is most intensive during this time.

Typical follow-up includes:

• Physical examination every 3-4 months for the first two years

• Every 6 months for years 3-5

• Annually after five years

• Imaging tests as needed

Prevention: Reducing Your Risk

While you can't prevent all cancers, you can take steps to reduce your risk of penile cancer.

Practice Good Hygiene

If you're uncircumcised, clean under your foreskin daily. Gently pull back the foreskin and wash with mild soap and water. This prevents smegma buildup and reduces chronic irritation.

Get the HPV Vaccine

The HPV vaccine protects against the virus types most likely to cause cancer. It's most effective when given before sexual activity begins (typically to preteens), but can still benefit adults. Talk to your doctor about whether HPV vaccination is right for you.

Practice Safe Sex

Using condoms reduces your risk of HPV and other sexually transmitted infections. While condoms don't provide complete protection against HPV, they significantly reduce risk.

Don't Smoke

If you smoke, quit. If you don't smoke, don't start. Smoking increases penile cancer risk and worsens outcomes if you do develop cancer.

Consider Circumcision

Circumcision in infancy or childhood dramatically reduces penile cancer risk. Adult circumcision also provides some protection. However, circumcision is a personal decision involving medical, cultural, and religious factors. Discuss the benefits and risks with your doctor.

Treat Phimosis

If you have a tight foreskin that won't retract, see a doctor. Treating phimosis reduces cancer risk and improves hygiene.

Regular Self-Examination

Examine your penis regularly. Notice what's normal for you so you can recognize any changes early. If you notice anything unusual, see your doctor promptly.

When to See a Doctor

See your doctor if you notice:

• Any lump, growth, or sore on your penis

• Changes in skin color or texture

• A sore that doesn't heal within four weeks

• Bleeding or unusual discharge

• Difficulty retracting your foreskin

• Persistent pain or discomfort

• Swelling in your groin area

Don't delay care due to embarrassment. Doctors are professionals who examine many patients. Early diagnosis saves lives and preserves function.

Prognosis and Survival Rates

Survival depends heavily on the stage at diagnosis. According to medical research, early-stage penile cancer (confined to the penis) has a five-year survival rate exceeding 80%. When cancer has spread to nearby lymph nodes, survival drops to around 50%. If cancer has spread to distant organs, five-year survival is below 30%.

These statistics show why early detection is so important. Most men diagnosed early can be cured completely and maintain a good quality of life.

Conclusion

Penile cancer is rare but serious. The disease is most treatable when caught early, so don't ignore symptoms or delay seeing a doctor due to embarrassment. Changes in your penis—lumps, sores, discoloration, or anything unusual—deserve medical attention.

Understanding risk factors helps you make informed decisions about prevention. Good hygiene, HPV vaccination, safe sex practices, and not smoking all reduce your risk. If you're diagnosed with penile cancer, remember that effective treatments exist, especially for early-stage disease.

Work closely with your healthcare team, ask questions, and seek support from family, friends, or support groups. You're not alone in this journey. With proper treatment and care, many men with penile cancer go on to live long, fulfilling lives.

If you notice any concerning symptoms, make an appointment with your doctor today. Your health and well-being are worth it.

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Disclaimer

Important Medical Notice:

The information provided in this blog is for general educational purposes only and should not be considered medical advice. While we strive to provide accurate and up-to-date information about penile cancer, this content is not a substitute for professional medical consultation, diagnosis, or treatment.

Please note:

• Consult Healthcare Professionals: Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding penile cancer, its symptoms, diagnosis, or treatment options.

• Individual Cases Vary: Every patient's situation is unique. Treatment plans, outcomes, and prognosis vary based on individual factors, including cancer stage, overall health, age, and other medical conditions.

• Not Diagnostic: The symptoms described in this blog can be caused by many conditions besides cancer. Only a qualified medical professional can provide an accurate diagnosis through proper examination and testing.
  
  

• Emergency Situations: If you experience severe symptoms or medical emergencies, seek immediate medical attention by calling emergency services or visiting the nearest emergency room.

• Treatment Decisions: All treatment decisions should be made in consultation with your healthcare team. Do not start, stop, or modify any treatment based solely on information from this blog.

• Current Information: Medical knowledge and treatment options evolve continuously. The information in this blog reflects current understanding as of 2025, but may change as new research emerges.

• External Links: We provide links to reputable medical sources for reference. We are not responsible for the content of external websites or any changes to their information after publication.
  
  

By reading this blog, you acknowledge that you understand this disclaimer and will seek professional medical advice for any health concerns. Early consultation with healthcare professionals is crucial for the best possible outcomes in cancer care.

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References

1. National Center for Biotechnology Information - StatPearls. (2024). Penile Cancer and Penile Intraepithelial Neoplasia. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499930/

2. Urology Care Foundation. (2024). Penile Cancer - Symptoms, Diagnosis & Treatment. Retrieved from https://www.urologyhealth.org/urology-a-z/p/penile-cancer

3. Cleveland Clinic. (2025). Penile Cancer: Symptoms, Causes & Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/6181-penile-cancer

4. WebMD. (2024). Penile Cancer: Symptoms, Causes, Treatment, and Prevention. Retrieved from https://www.webmd.com/cancer/penile-cancer-overview

5. Merck Manual Consumer Version. (2025). Penile Cancer - Kidney and Urinary Tract Disorders. Retrieved from https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/cancers-of-the-kidney-and-genitourinary-tract/penile-cancer

6. MD Anderson Cancer Center. (2025). Penile Cancer Treatment and Diagnosis. Retrieved from https://www.mdanderson.org/cancer-types/penile-cancer.html