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Cancer - penis

Definition

Cancer of the penis is cancer that starts in the penis, an organ that makes up part of the male reproductive system.

Alternative Names

Penile cancer; Squamous cell cancer - penis

Causes, incidence, and risk factors

The exact cause is unknown.

Smegma, a cheese-like, foul-smelling substance found under the foreskin of the penis may increase the risk of penis cancer.

Uncircumcised men who do not keep the area under the foreskin clean and men with a history of genital warts or human papillomavirus (HPV) are at higher risk for this rare disorder.

Symptoms

• Genital lesions on the penis
• Painless sore on penis (occasionally, the lesion may cause pain)
• Penis pain and bleeding from the penis (may occur with advanced disease)

Signs and tests

The health care provider will perform a physical exam, which may reveal a non-tender lesion that looks like a pimple or wart. This growth is typically near the end of the penis.

A biopsy of the growth is needed to determine if it is cancer.

Treatment

Treatment depends on the size and location of the tumor and how much it has spread.

In general, cancer treatment includes:

• Chemotherapy -- uses medicines to kill cancer cells
• Radiation -- using high powered x-rays to kill cancer cells
• Surgery - cuts out and removes the cancer

If the tumor is small and near the tip of the penis, surgery may be done to remove only the cancerous part of the penis. This is called a partial penectomy.

For more severe tumors, total removal of the penis (total penectomy) is often necessary. A new opening will be created in the groin area to allow urine to exit the body. This procedure is called a urethrostomy.

Chemotherapy may be used along with surgery. Bleomycin, cisplatin, or methotrexate alone or together are usually used for treating penile cancer.

Radiation therapy is often recommended in combination with surgery. A type of radiation therapy called external beam therapy is often used. This method delivers radiation to the penis from outside the body. External beam radiation therapy is usually performed 5 days a week for 6 - 8 weeks.

Support Groups

Joining a support group where members share common experiences and problems may help relieve the stress associated with diagnosis and treatment of penile cancer.

See: Cancer - support group

Expectations (prognosis)

The outcome can be good with early diagnosis and treatment. The 5-year survival rate for penile cancers is 65%. Urination and sexual function can often be maintained even when a significant portion of the penis is removed.

Complications

Cancer of the penis frequently spreads to other parts of the body (metastasizes) early in the course of the disease.

Calling your health care provider

Call your health care provider if symptoms of penis cancer develop.

Prevention

Circumcision may decrease the risk. Men who are not circumcised should be taught at an early age the importance of cleaning beneath the foreskin as part of their personal hygiene.

Good personal hygiene and safer sexual practices, such as abstinence, limiting the number of sexual partners, and use of condoms to prevent HPV infection, may decrease the risk of developing penile cancer.

References

Pettaway CA, Lynch DF, Davis JW. Tumors of the penis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.