Penile Cancer: Symptoms, Causes, Diagnosis & Treatment

Updated in April 2023

Penile cancer is associated with a rare tumor that can emerge within the penis or on the skin that covers it. Cancer in the penis can cause changes in the skin color or texture, and may lead to the appearance of nodules or lesions that take a long time to heal.

This type of cancer is more frequent in older men over 60 years old, although it can appear in younger men. Risk factors include smoking, poor genital hygiene and unprotected sex. 

Penile cancer is curable, although surgery may be necessary to remove affected tissue. The larger the tumor or the later the diagnosis, the higher the probability for surgical removal of a larger area. 

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Common symptoms

The most common symptoms of penile cancer are: 

  1. Red sores that do not heal 
  2. Penile pain that does not improve within 4 weeks and gradually worsens over time 
  3. Penis nodules, on the shaft or head
  4. Penis skin or foreskin that is thicker, making retraction more difficult 
  5. Changes to penis skin or foreskin color 
  6. Foul smelling discharge from the urethra 
  7. Penile bleeding 
  8. Penile swelling 
  9. Pain and swelling in the groin lymph nodes 
  10. Weight loss for no apparent reason 
  11. Fatigue

Some of these symptoms, particularly sores that do not heal, may be a sign of other diseases, like herpes, syphilis or an autoimmune condition. Therefore, it is best to see a urologist for diagnostic testing, which will confirm the underlying cause and prompt appropriate treatment. Learn more about what causes sores on the penis and what to do. 

Is blood in the urine a sign of penile cancer? 

Generally, the presence of blood in the urine is not a characteristic symptom of penile cancer. However, it can be a sign of prostate cancer or a urinary tract infection. Therefore, you are advised to consult a urologist for a more thorough assessment and treatment as necessary. Check out the most common causes of blood in the urine and how it is treated. 

Confirming a diagnosis

A diagnosis of penile cancer is confirmed by a urologist through evaluation of the signs and symptoms reported by the patient. The doctor will likely order a biopsy to determine if any signs of malignancy are noted in the cells. 

What causes penile cancer? 

The exact cause of penile cancer is not known, although there are risk factors associated with its development. The main risk factors are: 

  • Tobacco use 
  • Poor genital hygiene habits in which discharge starts to accumulate over the foreskin 
  • HPV infection 
  • Lack of circumcision, or circumcision completed in adulthood
  • Over 60 years of age

Having these risk factors does not mean you will necessarily develop penile cancer, however you should participate in regular screening after the age of 60. 

Treatment options

Treatment should be guided by an oncologist or urologist. It usually involves surgery to remove the maximum amount of affected tissue possible, followed by chemotherapy or radiation therapy to eliminate any remaining tumor cells. 

Depending on the surgery and cancer stage, men may experience post-surgical complications, like erectile dysfunction. In these cases, the doctor may recommend a penile prosthesis that can help men maintain an erection during sex. 

In more serious cases, in which the cancer has reached a very advance stage, the doctor may recommend total penis and testicle removal. In these cases, the doctor may contemplate whether the patient is a candidate for a penile transplant so that full sexual function can be restored. 

How a penis transplant works

This treatment approach is still being studied as a way to restore urinary and sexual functioning in patients who have undergone full genital removal for cancer treatment. This surgery is still not globally available to all patients and is still under clinical evaluation. The trial surgeries that have occurred took about 15 hours, as all nerves and blood vessels need to be manually linked. 

The transplant should come from a donor with structurally similar characteristics to reduce the risk for infections, hemorrhage and rejection. Although it is not yet possible to determine the success of a transplant for erectile dysunfction treatment, ahich can negatively affect the patient’s mental health. 

Prevention measures

To prevent penile cancer, you can consider the following measures: 

  • Ensure daily penile hygiene, particularly beneath the foreskin, to prevent bacterial or viral infections 
  • Use a condom during sex
  • Avoid smoking

Although there is no specific cause that triggers the development of penile cancer, these considerations can help to prevent some risk factors, like poor hygiene and HPV.  

How to perform hygiene correctly 

To wash the penis adequately, you should pull back the skin the covers the head and cleanse with mild soap and water. Be sure to retract the skin and pat the area dry after showering.