What is penile cancer?
Although rare, penile cancer develops in the penis when abnormal cells multiply uncontrollably. It can affect any part of the penis, including the head (glans), foreskin, or shaft. In addition, this cancer has several subtypes based on the type of cell where it begins. According to the American Cancer Society, it accounts for fewer than one percent of cancers in the United States and typically affects men between the ages of 50 and 70.
Symptoms and risk factors
What are common penile cancer symptoms?
The signs of penile cancer will vary among men. The most notable symptom is a lump on the head (glans) or foreskin, or sometimes on the shaft. It's also possible for the skin of the penis to change in color or thickness. In more advanced cancers that spread to lymph nodes, patients may also notice enlarged lymph nodes in the groin or leg swelling.
These symptoms may also be signs of non-cancerous conditions. Many men may feel embarrassed and want to avoid discussing changes to their genitals. However, it's essential that men don't delay seeking care, as advanced cancer is harder to treat. It's always best to talk to a doctor immediately if you notice something unusual.
Who is at risk for this cancer?
The exact cause is unknown, but certain factors can increase your risk of developing penile cancer, including:
- Having an HPV infection: Certain strains of the human papillomavirus infection (HPV) are associated with penile cancer.
- Being uncircumcised: Men who have not had their foreskin removed after birth may have an increased risk.
Screening and prevention
Can I prevent penile cancer?
Although there are related risk factors, we don't know definitively what causes this cancer. As a result, there's no way to prevent it altogether. However, performing monthly self-exams can help you notice any unusual changes. Men should also get annual physical exams and skin checks, which may help with early detection. Seek care right away if you notice any lumps or concerning signs.
Diagnosis
How do doctors diagnose penile cancer?
When there is a concern for penile cancer, your doctor will likely refer you to a urologist or, sometimes, a dermatologist. A biopsy is usually the first step in the diagnostic process. Other conditions, such as genital warts, may look like cancer but be non-cancerous (benign) growths, so a biopsy is necessary to confirm the diagnosis. Further investigation using advanced imaging (CT or PET scans) may be necessary to see if cancer has spread to the lymph nodes or other parts of the body.
Types of cancer
What are the types of penile cancer?
There are different types of this rare cancer based on the cell type where the cancer begins. Most penile cancers start in squamous cells (squamous cell cancer), which tend to grow slowly. In its earliest precancerous stage, where cancer is only found in the top layers of skin, it is sometimes called carcinoma in situ (CIS).
Other rare types of penile cancer may include:
- Melanoma, which begins in the melanocytes that protect the skin from the sun
- Basal cell carcinoma, which starts in the basal cells
- Adenocarcinoma, which develops in the sweat glands of the penile skin
- Sarcoma, which begins in the connective tissue of the penis
Types of Skin Cancer
Treatments
What is the best penile cancer treatment?
This type of cancer appears different for everyone, varying in size, shape, and depth. As a result, treatment depends on the characteristics unique to each individual. When determining the right treatment approach, we also consider how far the cancer has spread.
Depending on the stage of the cancer, treatment may include topical treatments (ointment), laser therapy, circumcision, chemotherapy, radiation, or surgery. As with all of our cancer patients, we employ a multidisciplinary approach that involves the expertise of urologic oncologists, medical oncologists, radiation oncologists, pathologists, radiologists, dermatologists, and reconstructive surgeons to determine the full spectrum of treatment options most suitable for each individual patient.
Surgery
When surgery is the most appropriate option for penile cancer treatment, we work alongside a team of surgeons with expertise in urologic surgery, reconstructive surgery, and dermatology to offer a range of surgical options with the goal of sparing patients from a deformative surgery. For example, skin grafts and flaps may be used to minimize the extent of surgery and result in as natural a cosmetic result as possible. Some men may be candidates for Mohs micrographic surgery ("Mohs Surgery"), which uses microscopic guidance to remove cancer layer-by-layer.
For cancer that has spread to the lymph nodes, we're one of few cancer centers in the mid-Atlantic region that offers minimally-invasive robotic surgery for lymph node removal. Performing this procedure (inguinal lymphadenectomy) robotically typically leads to less blood loss, fewer complications, and faster recovery than traditional open surgery. In other instances, we may offer sentinel lymph node biopsy, which uses nuclear medicine to locate the lymph nodes draining the cancer. This allows us to remove fewer lymph nodes and potentially reduce the risk of developing lymphedema. Your doctor will discuss the pros and cons of all of your options so you can feel equipped to make the best possible decision.
Chemotherapy
Chemotherapy uses cancer-fighting medications to kill cancerous cells located throughout the body. For very early-stage cancer and precancerous forms of the disease, topical chemotherapies may be applied in cream form.
For more advanced penile cancers, chemotherapy may be used to shrink tumors before surgery. This is called "neoadjuvant therapy." Chemotherapy drugs are typically given by mouth or injected into a vein. Your cancer team may involve medical oncologists who will determine if this treatment option is right for you. They'll also work closely with you to monitor and manage any side effects that may arise throughout treatment.
Immunotherapy and targeted therapy
Immunotherapy harnesses the body's own immune system to target and change how cancer cells grow. In some instances, topical immunotherapy may be used to treat cancer that is contained to the penis. We continue exploring the role of immunotherapy in treating penile cancer cases that aren't responding to standard therapies.
Learn More About Targeted Therapy
Learn More About Immunotherapy
Radiation therapy
Radiation therapy uses high-energy beams to kill cancerous cells. The role of this cancer treatment will vary based on the stage of your cancer and your overall health. At times, it may be used in place of surgery, in combination with chemotherapy before surgery, or after surgery to reduce the risk of recurrence.
If it's an appropriate treatment for you, a radiation oncologist specializing in urologic cancers will determine the right type of radiation that will be most effective while limiting the impact on healthy tissue.
Looking for expert care?
With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.
Our providers
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Urologic Oncology
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Mohit Gupta, MD
Urologic Oncology & Urology
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Jonathan J Hwang, MD
Urology & Urologic Oncology
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Keith John Kowalczyk, MD
Urologic Oncology
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Ross E. Krasnow, MD
Urologic Oncology & Urology
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Lambros Stamatakis, MD
Urologic Oncology & Urology
Show All Urologic Oncology
Medical Oncology
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Kevin Y. Chen, MD
Gastrointestinal Medical Oncology, Medical Oncology & Hematology Oncology
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Nancy Ann Dawson, MD
Medical Oncology
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Paul Leger, MD
Medical Oncology
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Charles A. Padgett, MD
Gastrointestinal Medical Oncology & Medical Oncology
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George K. Philips, MD
Medical Oncology
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Kristen D Whitaker, MD
Hematology Oncology & Medical Oncology
Show All Medical Oncology
Radiation Oncology
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Andrew Satinsky, MD
Radiation Oncology
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Paul Byron Fowler, MD
Radiation Oncology
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Kelly Orwat, MD
Radiation Oncology
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Stephen Krystjan Ronson, MD
Radiation Oncology
Show All Radiation Oncology
Our locations
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MedStar Health: MedStar Georgetown Cancer Institute at MedStar Montgomery Medical Center
18105 Prince Philip Dr. TG100 Olney, MD 20832
MedStar Georgetown Cancer Institute at MedStar Georgetown University Hospital
3800 Reservoir Rd. NW Washington, DC 20007
MedStar Georgetown Cancer Institute at MedStar Washington Hospital Center
110 Irving Street, NW Washington, D.C., 20010
MedStar Franklin Square Cancer Center at Loch Raven Campus
5601 Loch Raven Blvd. Russell Morgan Building First Floor Baltimore, MD 21239
MedStar Georgetown Cancer Institute at MedStar Franklin Square Medical Center
9103 Franklin Square Dr. The Harry and Jeanette Weinberg Cancer Institute Suite 220 Baltimore, MD 21237
MedStar Georgetown Cancer Institute at MedStar Health Bel Air Medical Campus
12 MedStar Blvd. Ste. 180 Bel Air, MD 21015
MedStar Georgetown Cancer Institute at MedStar St. Mary’s Hospital
25500 Point Lookout Rd. First Fl. Leonardtown, MD 20650
MedStar Georgetown Cancer Institute at MedStar Southern Maryland Hospital
7501 Surratts Rd. Ste. 101 Clinton, MD 20735
Why choose us
When treated at MedStar Health, you can expect personalized care from the region's top urologic oncology experts. You'll benefit from the most advanced penile cancer treatment available today, delivered by specialists in different fields who work together to ensure your best possible results.
Patients choose us because:
Our doctors and surgeons see more patients with penile cancer than most oncologists in the region. Because this is such a rare cancer, other oncologists in the area may only see patients with this type of cancer once a year. In contrast, our urologic, radiation, and medical oncologists exclusively treat patients with urologic cancers, which means we regularly diagnose and treat men with penile cancer. This level of experience allows us to deliver the latest surgical and medical options that will lead to your most successful outcome.
Our specialists work together to maximize your chance for a cure while minimizing the impact of treatment on your sexual and urinary function. Our team of experts in urology, radiation oncology, medical oncology, dermatology, reconstructive surgery, pathology, radiology, and more work closely to determine the right treatment approach with the least possible impact on your body and quality of life. We strive to consider options that effectively target your cancer while preserving your body's cosmetic appearance and natural abilities, whenever possible.
We're pioneers in urologic surgery, including minimally invasive surgeries leading to less blood loss and faster recovery. If cancer spreads, we have exceptional expertise in performing robotic-assisted surgeries that allow us to precisely identify and remove affected lymph nodes using smaller incisions. As a result, many men benefit from fewer complications, shorter hospital stays, and a quicker return to their personal lives.
Awards and recognition
Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons’ Commission on Cancer (CoC)
Numerous surgeons, medical oncologists, and surgical oncologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian
Magnet® designation from the American Nurses Credentialing Center (ANCC)
Clinical trials and research
Clinical trials
Clinical trials allow doctors and researchers to investigate better, safer ways to diagnose and treat urologic cancers. For example, we continue exploring the role of immunotherapy in treating this type of cancer. Your doctors may recommend a clinical trial if other treatments are ineffective.
Research
Georgetown Lombardi Comprehensive Cancer Center, the region's only comprehensive cancer center designated by the National Cancer Institute, serves as our research engine.. This allows our doctors to participate in and lead studies that help us detect, diagnose, and treat urologic cancers.
Support services
Our entire team of surgeons, cancer specialists, nurses, and support staff are dedicated to helping you thrive during and after your treatment. We offer a wide range of services and programs designed to address any physical, emotional, and spiritual needs that may arise throughout your cancer journey.
Learn More About Cancer Support Services
Genetic counseling
While these cancers are not passed down from parent to child, genetic counselors can help you understand and manage your risk for other inheritable cancers. Our genetic services involve assessing your cancer risk, weighing the pros and cons of testing, and providing individualized recommendations for cancer prevention, screening, or treatment, when appropriate.
Learn More About Genetic Counseling
Personalized rehabilitation
MedStar Health patients have access to renowned rehabilitation experts in physical therapy, occupational therapy, counseling, and nutrition. This wide range of services can help you regain strength, manage late effects, and improve your quality of life following treatment.
Learn More About Cancer Rehabilitation
Survivorship
After successful treatment, cancer survivors benefit from regular follow-up care to look for any signs of recurrence and help manage any lingering side effects. As part of your comprehensive care, you'll receive an individualized survivorship plan that details recommendations for regular exams and tests, when to seek additional care, and other suggestions for managing your overall health and wellness.