PENIS CANCER

General Information

DEFINITION--An uncommon malignant tumor of the penis.

BODY PARTS INVOLVED--Penis, including the glans (tip), corona (rounded border of the glans) or prepuce (foreskin covering the glans).

SEX OR AGE MOST AFFECTED--Men over age 50.

SIGNS & SYMPTOMS

Early stages:

• A small circular lesion (resembles a pimple) or persistent, painless sore on the penis. The lesion is easily visible in a circumcised male but it may go unnoticed in an uncircumcised male.

Later stages:

• Pain, bleeding or discharge from the tumor.
• Discomfort with urination.
• Enlarged lymph nodes in the groin.

CAUSES--Unknown, but penile cancer is rare in men circumcised at birth or shortly thereafter. This may explain why it is rare among Jews, Muslims and other cultures where early circumcision is customary.

RISK INCREASES WITH

• Previous leukoplakia of the penis, balanitis or epithelial horn on the penis.
• Personal uncleanliness, especially of the genitals, in uncircumcised males.

HOW TO PREVENT

• Consider having male children circumcised soon after birth.
• Examine the penis and testicles monthly to detect possible cancers early, when treatment is most successful. Seek medical treatment for any sign of infection or sore on the penis.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as culture of the tumor discharge, urinalysis and blood tests.
• Biopsy (See Glossary)
• CT scan (See Glossary) and a lymph node biopsy may be necessary to see if the cancer has spread.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Treatment will depend on stage of the cancer.
• Hospitalization and surgery to remove the tumor. Local tumors of the foreskin may require circumcision only. Invasive tumors require total removal of the penis and regional lymph nodes.
• Radiation therapy may be recommended if the cancer has not spread.
• Psychotherapy or counseling after surgery to learn to cope with an altered self-image.

POSSIBLE COMPLICATIONS--This spreads quickly to nearby lymph nodes but slowly to distant sites or organs. Many men delay treatment due to denial or fear of disfigurement and loss of sexual function. This increases the likelihood the cancer will spread and cause death.

PROBABLE OUTCOME--The 5 year survival rate is about 50%, even with treatment. Recurrence remains a possibility after treatment.

How To Treat

GENERAL MEASURES--

• A bladder catheter will be necessary for a prolonged period--sometimes permanently--after surgery and irradiation treatment.
• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Pain relievers, if necessary.
• Anticancer drugs for widespread cancer. However, the effectiveness of presently available drugs is only temporary.

ACTIVITY--Resume your normal activities as soon as possible after treatment. Sexual relations are possible if enough penile tissue remains following surgery.

DIET--No special diet.

Call Your Doctor If

• You have any lump or sore on the penis.
• Excessive bleeding occurs at the surgical site.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.