Early symptoms of penile cancer

The early symptoms of penile cancer are most evident when they start in the skin, as most cancers of this type are wont to do. On the other hand, cancers that begin under the foreskin may not be detected early, especially if there is foreskin constriction (phimosis) involved. The signs of penile cancer may be thought to be caused by a different condition; conversely, the patient may not immediately think of cancer even if he notices an anomaly. And last but not least important, men may put off seeking medical attention for a problem that affects their privates – when they should in fact do the complete opposite.

Therefore, a man should see a doctor immediately if he experiences any of these penile cancer symptoms:

·         A growth, ulcer or sore on the penis, particularly on the glans or foreskin, but also on the shaft.

·         The skin of the penis changes color or becomes thicker.

·         Repeated, foul-smelling discharge beneath the foreskin.

·         Bleeding from the tip of the penis or from underneath the foreskin.

·         Pain of unknown origin in the shaft or tip of the penis.

·         Bluish/brown flat lesions beneath the foreskin.

·         Reddish, velvet-like rash beneath the foreskin.

·         Small, crusty bumps beneath the foreskin.

·         Enlarged lymph nodes in the groin.

·         Abnormal swelling at the end of the penis.

All men should keep an open eye for warts, blisters, sores, ulcers, white patches, or other abnormalities on the penis, even if they are painless, and even more so those who have any of these risk factors:

·         HPV infection

Human papillomavirus is the single greatest risk factor for penile cancer.

·         Smoking

This habit may contribute to the development of cancer in the penis, particularly in men with HPV.

·         Age

Most common after 50 years of age, though 20% of the time patients are under 40.

·         Smegma

A thick substance that can accumulate under the foreskin and which may contain cancer-causing elements.

·         Phimosis

A tightening of the foreskin that causes smegma to build up.

·         HIV/AIDS


·         Psoriasis treatment

The drug psoralen in combination with ultraviolet light.


The sum of these risk factors does not necessarily equal cancer; often people develop penile cancer without experiencing any risk factors. The bottom line is that men should pay attention both to the risks and the symptoms and seek medical attention at the first warning sign. An early diagnose is fundamental to removing the cancer with as little damage to the organ as possible. There are no specific tests to screen for penile cancer, but there are tests, procedures, and scans that can help identify a problem and assess its extent. A doctor will factor in the patient’s medical history – including age and medical condition, type of cancer suspected, symptoms, and previous tests results – when conducting a physical exam. If all the signs point to a tumor (early symptoms of penile cancer, risk factors, etc.), the physician will order more diagnostic procedures, mostly biopsies and/or imaging tests:

·         Biopsy

-        Incisional.

-        Excisional.

-        Lymph node.

·         Imaging tests

-        Computed tomography.

-        Positron emission tomography.

-        Magnetic resonance.

-        Ultrasound.

These tests help doctors stage the cancer. Cancer staging concerns the number and size of tumors – if there is more than one – as well as whether or not cancer has spread to near or distant parts of the body (metastasis).

Penile cancer stages


Cancer is only in the superficial layers of the skin.


Cancer has grown below the surface of the skin or into one of the internal chambers of the penis, but has not spread to lymph nodes or distant organs.


Cancer has grown into blood or lymph vessels or one of the internal chambers of the penis but has not spread to lymph nodes or distant organs.


Cancer has not grown beyond the urethra and has spread to a lone groin lymph node but not to distant organs.


Cancer has not grown beyond the urethra and has spread to more than one groin lymph node but not to pelvic lymph nodes or distant organs.


Cancer has invaded regional tissues, one or more groin lymph nodes (and from there into surrounding tissue), or at least one pelvic lymph node and /or lymph nodes beyond the pelvis or other parts of the body.


The five-year survival rate for cancers that haven’t spread beyond the penis (stages I and II) is around 85%; around 59% for cancers that have invaded regional tissues or lymph nodes (III and some IV); and 11% for cancers that grown into distant organs (IV). Treatment also varies depending on the extent of the penile cancer.

Treatment options for penile cancer include:

·         Surgery

-        Mohs surgery.

-        Cryosurgery.

-        Circumcision

-        Penectomy (partial and total).

-        Lymph node dissection.

·         Laser therapy.

·         Radiation therapy.

·         Chemotherapy.

Circumcisions can not only treat penile cancer but also prevent it. Foreskin removal helps keep the area free of smegma. Moreover, circumcised men almost never develop epidermoid/squamous cell carcinoma of the penis. However, circumcision is not a silver bullet against penile cancer. Other prevention measures are not smoking, limiting the number of sexual partners, and practicing good penile hygiene.