Everything you need to know about penile cancer

Would you know the signs and symptoms of penile cancer? Penile cancer is one of the lesser-known male cancers, but since the 1990’s cases in the UK have increased by over a quarter. Although still relatively rare, knowing the signs and symptoms and getting these checked is key to earlier diagnosis - when the cancer is more likely to be cured. 

We spoke to Mr Arie Parnham, Consultant Urological Surgeon and Andrologist from The Wilmslow Hospital and The Christie Private Care, both part of HCA Healthcare UK, to get his expert insight and answers to some of the most common questions about penile cancer. 

Fortunately, penile cancer is rare, around 700 new penile cancer cases are diagnosed in the UK each year. It most commonly affects men over the age of 50, however it can be diagnosed in much younger men. Despite this relative rarity, it’s important that all men know the symptoms and risk factors for penile cancer, so that they can spot any changes to their penis and get them checked by a healthcare professional. It’s really important not to put off seeking this medical advice, an early diagnosis of penile cancer will make treatment less invasive and more effective.

There are several different types of penile cancer but the most common is squamous cell penile cancer. The cancer can develop anywhere on the penis but most often develops under the foreskin in men who haven’t been circumcised, or on the head or tip of the penis (glans).

A person’s risk of developing cancer can depend on many factors, including age, genetics, and exposure to risk factors, including some potentially avoidable lifestyle factors. Whilst the causes of penile cancer are still largely unknown, we do know that there are number of risk factors that can increase the chances of developing the disease.

HPV. The human papilloma virus (HPV) has been linked to penile cancer, with more than 60% of men diagnosed also showing signs of an HPV infection. Using condoms can reduce the risk of getting a genital HPV infection. It is also possible to be vaccinated against some types of HPV. If you are concerned about HPV speak to your doctor.

Age. As with many cancer types, age is a risk factor when it comes to penile cancer – with the disease being most common in men over 50. It is rare for men under the age of 40 to be diagnosed with penile cancer, however it is possible and no changes to your penis should be ignored no matter your age.

Phimosis. Another risk factor is a condition called phimosis, (where uncircumcised men have difficulty drawing back their foreskin). The reason this condition increases the risk of penile cancer is not currently known. However, it may relate to other known risk factors, including a build-up of secretions under the foreskin.

Treatment for psoriasis. Some treatments for psoriasis may increase your risk of developing penile cancer, medicines called psoralens and PUVA treatment which involves using an ultraviolet light source can be linked to an increased risk of penile cancer.

Smoking. Smoking is one of the most significant lifestyle factors linked to developing penile cancer, this is because tobacco exposes your body to many cancer causing chemicals.

The main penile cancer signs and symptoms to look out for include:

• A growth or sore on the penis that doesn’t heal within 4 weeks. It can look like a wart, ulcer or blister and may or may not be painful
• Bleeding from the penis or from under the foreskin 
• A foul-smelling discharge which can occur due to an infection or something irritating the skin of the penis. It is very important to see your doctor if you notice this type of discharge
• Thickening of the skin 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 or a rash

It is important to be aware of what is normal for you. If you notice any changes to your penis or you experience any of the symptoms above, please see your GP as soon as possible. In the majority of cases they will be attributed to other, non-cancerous conditions, but they need to be investigated. The sooner penile cancer is detected, the better the chances of treating it successfully.

Your doctor will ask you about your symptoms and examine your penis. After this physical examination they may refer you to a specialist for some tests.

These tests will usually include some blood tests and a biopsy, in which a small sample of tissue is removed and sent away for analysis. Depending on the results, you may then be referred for further tests, including a scan such as a CT, MRI or PET-CT scan, and a lymph node biopsy to investigate the results in more depth.

If you have been diagnosed with penile cancer there are a number of treatment options available. Your treatment will depend on your individual diagnosis, including the size of the affected area and the stage of penile cancer you have been diagnosed with.

Surgery is usually the primary treatment for penile cancer. Other treatment methods include radiotherapy and chemotherapy. You will be recommended one or more of these treatment methods depending on your individual diagnosis.

Surgery involves removing the cancerous cells and possibly some of the surrounding tissue. In many cases, any physical changes to your penis after an operation can be corrected with reconstructive surgery using skin and muscle from elsewhere in the body. However, with early diagnosis and modern techniques, we can often preserve most of the penile tissue.

As part of most treatment plans for penile cancer, the lymph glands (small organs that are part of the immune system) in the groin will also be assessed to determine if the cancer has spread. In some cases, the lymph glands may also need to be surgically removed.

If you have noticed any changes to your penis do not delay in getting these checked by your GP or a healthcare professional.