School of Medicine

Wayne State University School of Medicine

Penile Cancer

Penile carcinoma constitutes less than one percent of all malignancies among United States' male population. It is most commonly diagnosed during the sixth and seventh decades of life. The incidence of carcinoma of the penis varies markedly with the hygienic standards and the cultural and religious practices of different countries. Circumcision has been well established as a preventive measure that virtually eliminates the occurrence of penile carcinoma. Development of penile carcinoma among the uncircumcised has been attributed to the chronic irritative effects of smegma, a by-product of bacterial action under the foreskin. When good hygiene is practiced among uncircumcised men, the risk of penile carcinoma is greatly reduced.

Carcinoma of the penis usually begins with a small lesion, which gradually extends to involve a larger area. It may appear as a hardness, bump, pimple, wart, or ulcer the fails to heal. Pain is usually not a presenting symptom. While many men may be embarassed by problems affecting the penis, it is important to seek care from a urologist as rapidly as possible as this disease can be cured when found early. Biopsy of the lesion is mandatory before treatment is considered. Malignant lesions may resemble benign lesions. It is important to determine the depth of invasion and the aggressiveness of the cells in the biopsy before treatment.

Treatment is determined by extensiveness of the lesion and the characterization of the biopsy under the microscope. In certain selected cases of small lesions involving the foreskin, complete tumor excision with tumor free margins may be accomplished by circumcision. Occasionally, alternative treatments involving topical medications or laser surgery is performed. Larger lesions may require partial amputation or total removal of the penis. Imaging studies are used to estimate the extent of disease and the possibility of spread of the disease within the body to lymph nodes. Some patients are advised to undergo further surgery involving removal of lymph nodes in the groin and pelvis in order to control the cancer. Other patients may receive combinations of chemotherapy, radiation therapy, and surgery. All patients receive evaluations through our Genitourinary Oncology Multidisciplinary Treatment Clinic. In this clinic, patients have the opportunity to be evaluated by our team of urologic oncologists, radiation oncologists, and medical oncologists.