Cancer of the penis

Overview

Penile cancer is a rare cancer that mostly affects the skin of the penis and the foreskin (the skin covering the head of the penis)

Treatment for most penile cancers caught very early include creams and laser therapy

If not caught early, treatment may mean surgery

Get your symptoms checked

It's important to get any symptoms of penile cancer checked as soon as possible

Finding cancer early can make it more treatable

There are several types of penile cancer, depending on the type of cell the cancer developed from.

Main Symptoms of penile cancer

Most cancers of the penis affect the skin covering the penis (foreskin), or the head or tip (glands) of the penis

The most common symptoms are:

a growth or sore on the penis that doesn't heal within 4 weeks
bleeding from the penis or from under the foreskin
a smelly discharge
thickening of the skin of the penis or foreskin that makes it difficult to draw back the foreskin (phimosis)
a change in the colour of the skin of the penis or foreskin
a rash on the penis

Other symptoms of penile cancer include:

a lump in the groin
feeling tired
stomach pain
losing weight without trying

See a GP if you have:

any changes to how your penis looks
discharge or bleeding from your penis
any of the other symptoms of penile cancer
had treatment for your symptoms that has not helped in the time that it should

Important

Having these symptoms does not definitely mean you have penile cancer. But it's important to get them checked by a GP.

This is because if they are caused by cancer, finding it early can make it more treatable

What happens at the GP appointment

The GP may examine your penis and ask you to have a blood test.

They'll ask you:

What your symptoms are
When they started
If you’ve used anything to treat them, and if it’s made it better or worse

They may refer you to see a specialist in hospital for more tests.

This may be an urgent referral, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.

Find out more

Cancer Research UK: referral to a specialist for symptoms that could be caused by penile cancer

Main causes of penile cancer

Roughly half of all penile cancers are caused by certain types of a virus called human papillomavirus (HPV).

There are different types of HPV and some affect the genital area.

You can get HPV from:

Any skin-to-skin contact of the genital area
Vaginal, anal or oral sex
Sharing sex toys

Most people affected by HPV will not get penile cancer.

Who is more likely to get penile cancer:

Anyone with a penis can get penile cancer. This includes men, trans women, non-binary people and intersex people with a penis.

You might also be more likely to get penile cancer if you:

Are over 50
Smoke
Have problems pulling back your foreskin (the skin covering your penis) to keep your penis clean (a condition called phimosis)
Have or had treatment for psoriasis with medicines called psoralens and an ultraviolet (UVA) light source (called PUVA treatment)
Have a weakened immune system because of a condition like HIV

Find out more:

Cancer Research UK: causes of penile cancer
Macmillan Cancer Support: causes of penile cancer

How to lower your chance of getting penile cancer:

Protect yourself from getting HPV by getting the HPV vaccination if you can

Use condoms when having any kind of sex, to lower your chances of getting HPV

Stop smoking

Have a circumcision if you have phimosis and this is recommended to treat it

Make sure you regularly and thoroughly clean your penis and foreskin

It is imporyant to get any symptoms of penile cancer checked by a GP

Main test for penile cancer

You may need more tests to check for penile cancer if a GP refers you to a specialist.

A biopsy is the main test to diagnose penile cancer.

A specialist does this test by taking a sample of tissue from the affected area. It’s done under a local anaesthetic, so you do not feel anything.

A biopsy is usually done on the day of your appointment. You should be able to go home on the same day.

Getting your results

You should get the results of your tests within a few weeks.

You can call the hospital or GP if you're worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

Get support when testing for cancer

If you're concerned or need support before and after your test, you may find it useful to talk to:

A trained counsellor: get advice on how to find a counsellor from Cancer Research UK
People in the same situation: join a Cancer Research UK online forum
friends and family

You can get more information and advice on coping with penile cancer on Cancer Research UK

If you are told you have penile cancer

Being told you have penile cancer can feel overwhelming. You may be feeling anxious about what will happen next.

A team of specialists will look after you throughout your diagnosis, treatment and beyond.

Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Next steps

If you’ve been told you have penile cancer, you may need more tests.

These tests, along with the tests you've already had, will help the specialists find out the size of the cancer and how far it's spread (called the stage).

You may need:

Scans, like an MRI, CT scan, or PET scan
A test to see if the lymph nodes in your groin have been affected, which can happen with some penile cancers (called a lymph node biopsy)

You may not have all these tests or any of them.

The specialists will use the results of these tests and work with you to decide on the best treatment plan for you.

Find out more

Orchid: types of penile cancer

Orchid: tests and staging for penile cancer

Treatment for penile cancer

Penile cancer is more treatable if it's found early.

The treatment you need will depend on:

The size and type of penile cancer you have
Where it is
If it has spread
Your age and general health

Treatment for early cancer often involves non-surgical treatments, for example, a chemotherapy cream such as 5-fluorouracil (5-FU), and laser therapy.

If the cancer is found later, treatment may include surgery, chemotherapy and radiotherapy.

Support during treatment

You’ll have a specialist team made up of doctors and nurses, and other health professionals if needed.

Your team will explain your treatments including all your regular check-ups during and after treatments, plus tests and scans if you need them. They will support you throughout.

If you're worried about anything, talk to your team. You do not need to wait for your next check-up to ask any questions.

Treatment for cancer at an early stage

Penile cancer is more treatable if it’s found early when it has not spread.

Treatment can include destroying the cancer cells with:

Chemotherapy creams
Laser treatments
Cold therapy to freeze the cells (cryotherapy)

You may also have an operation to remove either:

The affected area of your penis
The skin that covers the tip of your penis (the foreskin), which is called a circumcision

Surgery for penile cancer

Surgery for penile cancer can include removing:

The cancer and a small area around it to reduce the risk of it coming back
The top layer of skin from the head (glans) of the penis
The head of the penis
Part or sometimes all of the penis, but this is only offered if no other treatment is possible
Some lymph nodes, which are part of the body’s system that helps fight off infections

Recovery from some of these surgeries may take time.

Surgery may affect how your penis looks, such as the size or shape.

This may affect how you feel about your body. You may have many questions and worries about how you'll pee or have sex.

The specialist team looking after you can answer any questions you have about your surgery.

They'll explain exactly what surgery means for you, how it will affect you and what your options are.

Reconstructive surgery may be possible if your penis needs to be removed. This uses skin and muscle from other parts of the body to create a working penis.

Find oput more

Macmillan cancer: Support: after your operation

Cancer Research UK: after surgery

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for penile cancer:

With radiotherapy (chemoradiotherapy)
Before surgery to help make the cancer smaller
After surgery to kill any cancer cells that might be left behind
If the cancer has spread to other parts of your body

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

You may have radiotherapy for penile cancer:

With chemotherapy (chemoradiotherapy)
Instead of surgery
After surgery if there’s a risk that cancer cells are left in the groin
To treat the lymph nodes in the pelvis if there's a high risk of the cancer coming back

Talking about your treatment

Your team should include support staff and a counsellor or therapist who you can talk to.

The men’s cancer charity Orchid has a national helpline on 0808 802 0010 (Monday, Wednesday and Friday 9.30 am to 5.30 pm).

Help and support

You and your loved ones will be supported by a team of specialists throughout your treatment for penile cancer.

The clinical nurse specialist, or another member of your specialist team, will be able to give you information on local support services that you may find helpful.

There are also national cancer charities that offer support and information about penile cancer.

Macmillan Cancer Support

Information and support for anyone affected by cancer

Website: www.macmillan.org.uk/cancer-information-and-support

Helpline: 0808 808 00 00

Macmillan Cancer Support:online forum

Macmillan Cancer Support: find local services

Cancer Research Uk

Information and support for anyone affected by cancer.

Website:www.cancerresearchuk.org

Nurse helpline: 0808 800 4040

Cancer research UK: ask a nurse service