A cancer is a group of cells which grow uncontrollably. Penile cancer refers to a cancer found in the penis. Penile cancer is very rare, affecting about 1/100,000 men each year. It is much more common in men who have not been circumcised. The most common type of penile cancer is squamous cell cancer, named as it grows from the squamous skin cells covering the penis.
Penile cancer is usually caused by irritation. The two most common causes are a virus called HPV and inflammation under the foreskin, which does not retract. The HPV virus is passed on during sex and though not visible, can lead to penile cancer. It is extremely rare for penile cancer to begin in men who have been circumcised before they became sexually active.
Penile cancer is usually seen as either a lump (lesion) or a red patch on the end of the penis. These can weep and discharge and usually do not improve if treated with creams. Sometimes these patches can be difficult to see as they might be under a foreskin, which is stuck and will not pull back. Some red patches or lumps on the penis may not be cancer, but could be inflammation or an infection caused by fungi. Because it is a potentially embarrassing site to discuss and expose, some men don't see their doctor until the lump or ulcer is nasty looking and large.
The first step in diagnosis is a biopsy of the lump on the penis. If cancer is confirmed, additional tests such as an MRI, ultrasound or a CT scan, will be done to see if the cancer has spread to other areas of the body. With penile cancer, this need not necessarily be a concern as cancers that have spread to the lymph nodes can be treated.
Sometimes a cream can be used to treat penile cancer though surgery is most commonly used to remove the cancer from the penis. In surgery, we try and preserve as much of the penis as possible though what needs to be removed depends on how big and how deep the cancer goes. If the cancer has spread, then sometimes lymph nodes have to be removed too. Chemotherapy and radiotherapy are not usually necessary when treating penile cancer.
After treatment, you will have follow-up tests for the next 5 years to check if your cancer returns.