The earlier penile cancer is found, the better. If it’s found early, there is a good chance for successful treatment and a cure. If diagnosis is delayed, the disease can get worse. Treatment for more advanced cancer may be less successful and more disfiguring.
Since you see and touch your penis when you urinate, you can help spot the disease early. Men who aren’t circumcised are at greater risk for penile cancer. But every man should be on the lookout for penile lesions.
Penile tumors are thought to be caused by body fluids that get trapped in the foreskin. If they aren’t washed away on a routine basis, they can have cancer-causing effects. Older men and smokers are more likely to get penile cancer. Conditions like AIDS can lead to penile cancer.
Another possible cause may be the human papilloma virus (HPV). HPV is a virus passed through sex. Antibodies to HPV-16 have been found in many patients with penile cancer. HPV is known to play a role in cervical cancer as well. For more information please review our Sexually Transmitted Disease article.
Men who keep clean with good genital hygiene and who are circumcised are much less likely to get penile cancer.
Penile cancer is diagnosed with a biopsy. This is when a small sample of tissue is removed from the penis and looked at under a microscope. If the cells look like cancer cells, they will be “staged.”
The TNM staging system is the system most often used. T stands for the main (primary) tumor (how far it has grown within the penis or nearby organs). N stands for spread to nearby lymph nodes (bean-sized groups of immune system cells). M is for metastasis (spread) to other organs.
The cells are also given a “grade”. This is a measure of how abnormal the cells look. The grade is often a number, from 1 to 4. The higher the number, the more abnormal the cells look. Higher-grade cancers tend to grow and spread more quickly than lower-grade cancers.
If your doctor believes that cancer has spread to nearby lymph nodes, other tests will be done. A lymph node biopsy will help determine the cancer’s stage and grade. If cancer is thought to spread to other parts of the body, imaging tests (such as a CT scan, or MRI) will be done.
If penile cancer is found early, it can be treated with success and low risk. If the tumor is on top of the skin, it may be treated with a skin cream. This cream has few side effects. External beam radiation is also a therapy for small lesions. If the lesion is larger, but still about the size of a pea, a small local excision or “Moh’s surgery” may be done. This is a type of surgery where layers of abnormal tissue are shaved off until normal tissue is reached. With both of these methods, the penis should still look normal and work as usual. But careful follow-up is vital to check for early recurrence. With small lesions, it’s not likely that cancer has spread to the lymph nodes. For this reason, it’s often not necessary to remove the lymph nodes.
With larger lesions, more tissue needs to be removed. Your surgeon will also consider taking out or draining lymph nodes in the groin. A mix of surgery, radiation, and chemotherapy may be needed. In cases where the cancer is more advanced, the whole penis may need to be removed.
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