Penile Cancer Is Rare but All-too-Real

Penile cancer accounts for just 1 percent of cancer cases in men in the United States, affecting about 1 in every 100,000 males each year in North America and Europe. It is more common in underdeveloped areas of the world, though some risk factors such as smoking, being uncircumcised or having HPV aren't based on geography. Despite its relative rarity, men should remain vigilant by learning the symptoms of penile cancer and what they can do to have it correctly diagnosed and treated.

Types of penile cancer

Penile cancer has many different types, however, most of them start in the various layers of the epidermis, the outermost layer of skin, which may or may not display highly visible symptoms. The types of penile cancer include:

• Squamous cell carcinoma: The most common type of penile cancer, it's found in 95 percent of cases. It can occur anywhere on the penis, but most commonly it's found under the foreskin
• Melanoma: This type of penile cancer occurs in about 2 percent of patients and forms in the deepest layers of the skin. Melanoma penile cancer is also the most serious type.
• Basal cell carcinoma: Forming in the lower epidermis, basal cell carcinoma is a type of skin cancer that accounts for 2 percent of penile cancers.
• Sarcoma: Sarcoma is the rarest form of penile cancer, afflicting 1 percent of patients. It develops in the connective tissue and blood vessels of the penis.

Typical symptoms of penile cancer

Penile cancer may show no symptoms at all or you might notice warty lesions on your penis. Symptoms that do appear vary considerably from patient to patient or may be the result of a different ailment or a sexually transmitted disease (STD). Thus, a diagnosis from a doctor is imperative. Consult your doctor if you're experiencing any of the following:

• Blood from the tip of the penis or under the foreskin
• Swelling of the penis, especially the glans (tip)
• Constant discharge from under the foreskin accompanied by a foul odor
• Flat, bluish lesions occurring on the penis and growing in size
• Changes in the color of the penis or thickening of the skin
• Red rashes
• Swelling of lymph nodes in the groin area

Keep in mind that these symptoms could all have different causes—including easy-to-treat conditions such as balanitis—but knowing whether or not the cause is penile cancer can help you obtain better treatment options with higher success rates.

Diagnosing penile cancer

If your doctor suspects you may have penile cancer, they'll first conduct a thorough examination of the affected area. This is usually a visual exam, but it may also include some touching to determine the level of irritation in the penis. They may recommend various diagnostics based on your age, the type of penile cancer they suspect, your general health and a review of the symptoms. The most common types include:

• A biopsy, which may be a lymph node biopsy or a tissue sample from the affected area
• X-ray
• CT (computer tomography) scan
• MRI (magnetic resonance imaging)
• Lymph node dissection

After your doctor reviews these options with you and suggests the best course of action, you'll undergo one of these methods. If the result comes back positive for penile cancer, your doctor will discuss different treatment options.

Treatment options for penile cancer

In the same manner as diagnosis, doctors will use your age, the severity of the case and your overall health to determine the best treatment choice. Most treatments are successful, as men with localized penile cancer (confined to the penis) have an 80 percent five-year relative survival rate.

Surgery is the most common type of treatment for penile cancer. Penile-sparing techniques are used as much as possible. If the tumor is small and hasn't spread, the penis can be spared; in more advanced cases, part or all of the penis might need to be removed. If the cancer is limited to the foreskin, circumcision can be performed.

Nonsurgical treatments for early-stage, low-grade penile cancer include cryosurgery and laser ablation.

Radiation therapy, which uses high-energy rays or particles to destroy cancer cells, and chemotherapy, which uses drugs, are also typically part of the treatment process. Topical chemo can be used on the skin in the early stages of penile cancer. Systemic chemo, in which drugs are injected or taken orally, is most often used on penile cancer that has spread to lymph nodes or organs.

Early diagnosis can help you beat penile cancer

Because of the rarity of penile cancer, no recommended screening processes or regularity of testing are suggested by the medical community. Therefore, doing your visual tests—maybe as a part of the testicular self-exams you're hopefully already doing—and remaining cognizant of potential symptoms can lead to early diagnosis. In many cases, symptoms of penile cancer are indications of something else entirely, but erring on the side of caution could help you detect and treat the cancer before it becomes a life-threatening issue.