Penile Cancer Symptoms, Diagnosis, and Treatment Explained
Learn about penile cancer, early cancer symptoms, diagnosis, treatments, and prevention. Clear, trustworthy guidance to help you take action.
Written by Dr. J T Hema Pratima
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 18th Nov, 2025
Introduction
Penile cancer is a rare but serious condition that can often be detected early because changes on the penis are usually visible. Recognising the early cancer symptoms and seeking medical care promptly can make a significant difference in outcomes. Since the penis is external and easy to examine, many cases can be caught early—when treatment is most effective and organ-preserving options are possible.
This comprehensive guide explains what penile cancer is, what symptoms to look for, how it is diagnosed, and the range of treatment options available today. It also includes prevention tips, information about prognosis, and answers to common questions, all supported by trusted medical sources.
What Is Penile Cancer?
Penile cancer begins when abnormal cells in the penis start growing uncontrollably. Most cases are squamous cell carcinomas (SCC), which means they originate from the flat skin cells covering the penis. The cancer can appear on the glans (head), foreskin, or shaft, and its severity varies based on how deeply it has invaded surrounding tissue.
While it is uncommon in many Western countries, penile cancer remains more frequent in regions with limited access to healthcare or poor genital hygiene practices. Acting early when symptoms appear allows for simpler treatments, often preserving both the penis and normal urinary and sexual function.
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Early Cancer Symptoms to Watch For
Recognising early changes is essential, as many penile cancers begin as minor, painless lesions. See a healthcare professional if you notice any of the following symptoms that last for more than two weeks or keep coming back:
- A sore, ulcer, or lump on the penis that does not heal
- A patch of skin that appears red, velvety, warty, thickened, or scaly
- Changes in skin colour or texture on the glans, foreskin, or shaft
- Bleeding, oozing, or foul-smelling discharge under the foreskin
- Persistent itching, burning, or pain in one area
- Tight foreskin (phimosis) or new difficulty pulling it back
- Swollen, firm lumps in the groin (enlarged lymph nodes)
Not all skin changes indicate cancer—conditions like infections or dermatitis can look similar—but persistent lesions should always be examined by a doctor.
When to See a Doctor?
You should seek medical evaluation if you experience:
- A sore, spot, or growth that does not improve within two weeks
- Bleeding, discharge, or rash on the penis
- Lumps or swelling in the groin area
- Increasing difficulty retracting the foreskin or phimosis
When in doubt, it’s better to get checked early. A urologist—a doctor specialising in the urinary tract and male reproductive organs—typically leads the diagnosis and treatment process.
Causes and Risk Factors of Penile Cancer
Penile cancer occurs when normal cells undergo genetic mutations that cause them to grow uncontrollably. Several factors increase the risk:
- Human papillomavirus (HPV) infection, particularly high-risk types such as HPV 16 and 18
- Smoking, which damages DNA and weakens the immune defences in the penile tissue
- Chronic inflammation due to long-standing phimosis or poor hygiene
- Lichen sclerosus and other chronic skin conditions affecting the foreskin or glans
- Advancing age, with most cases appearing after age 50
- Weakened immune system, for example, from HIV infection or immunosuppressive drugs
- Prior light therapy (PUVA) was used for skin conditions like psoriasis, though this is rare
HPV and Prevention
HPV is a common sexually transmitted infection that plays a major role in many penile cancer cases. Although most HPV infections resolve naturally, persistent infection with high-risk types can lead to cancer.
HPV Vaccination and Safer Practices
- Routine HPV vaccination is advised for boys and girls aged 11–12 years.
- Catch-up vaccination is available up to age 26 if not previously immunised.
- Adults aged 27–45 can discuss potential benefits with their clinician.
- Using condoms, limiting sexual partners, and avoiding tobacco use further lowers risk.
- Maintaining good genital hygiene and treating phimosis early also helps prevent chronic inflammation.
How Penile Cancer Is Diagnosed
1. Medical Evaluation
Diagnosis begins with a detailed physical examination and medical history. The clinician will assess the penis and groin for visible lesions or lumps and ask about:
- Duration of symptoms
- Sexual history and HPV vaccination status
- Smoking habits
- Previous penile skin problems or infections
2. Biopsy
A biopsy is the only way to confirm penile cancer. During this procedure, a small sample of the suspicious tissue is removed and examined under a microscope to determine the cancer’s type and grade.
3. Imaging Tests
Depending on findings, tests such as ultrasound, MRI, CT, or PET/CT scans may be done to see how deeply the cancer has spread and whether it has reached nearby lymph nodes.
4. Lymph Node Assessment
If lymph nodes are enlarged, doctors may perform a needle biopsy. For patients with higher-risk tumours but no visible swelling, a sentinel lymph node biopsy can detect microscopic spread.
Staging and Grading
The staging and grading of penile cancer include:
- Stage: Describes how far the cancer has spread—from the surface of the skin to deeper tissues or other organs.
- Grade: Indicates how abnormal the cancer cells look, which predicts how fast they may grow or spread.
These two factors guide treatment planning and prognosis.
Treatment Options for Penile Cancer
Treatment is individualised and aims to remove cancer while preserving as much normal tissue and function as possible. The treatment options include:
For Very Early Disease (Precancer or Carcinoma in Situ)
- Topical therapies: Prescription creams such as imiquimod or 5-fluorouracil (5-FU) can treat superficial lesions.
- Laser or photodynamic therapy: Destroys abnormal cells while sparing healthy tissue.
- Circumcision: Curative for lesions confined to the foreskin, while improving hygiene.
Penis-Sparing Surgery
- Wide local excision: Removes the tumour with a small margin of healthy tissue, aiming to preserve penile shape and function.
- Mohs micrographic surgery: Removes cancer layer by layer while examining tissue immediately, reducing unnecessary removal of healthy tissue.
- Glansectomy or partial glansectomy: Involves removing part or all of the glans (penile head), with reconstructive surgery if possible.
Partial or Total Penectomy
- Partial penectomy: Removes the affected section while keeping enough tissue for normal urination and potential sexual activity.
- Total penectomy: Required for large or deeply invasive tumours. Surgeons create a new urinary opening (perineal urethrostomy) for comfort and hygiene.
With proper rehabilitation and reconstructive surgery, many patients maintain a good quality of life.
Lymph Node Evaluation and Treatment
Lymph nodes in the groin are key indicators of prognosis.
- If nodes are enlarged or imaging shows cancer spread, lymph node dissection is usually recommended.
- In early cases with no obvious node involvement, sentinel lymph node biopsy helps detect hidden cancer cells.
Removing affected nodes can prevent further spread but may cause swelling (lymphoedema), which physiotherapy can help manage.
Radiation Therapy
- External beam radiation therapy (EBRT) or brachytherapy (internal radiation) can destroy tumour cells while preserving penile structure in selected cases.
- Radiation may also follow surgery (adjuvant therapy) if there is a higher risk of recurrence.
- Side effects can include skin irritation, fatigue, and long-term scarring.
Chemotherapy and Systemic Therapy
- Chemotherapy is used before surgery (neoadjuvant) to shrink large tumours or after (adjuvant) to target residual disease.
- Common regimens include cisplatin-based combinations.
- Immunotherapy may benefit advanced or recurrent cancers, especially those with specific genetic markers.
- Clinical trials provide access to emerging therapies and should be considered where available.
Side Effects and Recovery
Side effects and recovery tips include:
Treatment side effects vary depending on the type and extent of therapy:
- Surgery: Pain, swelling, wound issues, and potential changes in sexual or urinary function.
- Radiation: Skin redness, fatigue, and scarring over time.
- Chemotherapy: Nausea, fatigue, hair loss, and lowered immunity.
Supportive care—including counselling, pelvic floor therapy, and sexual rehabilitation—plays an important role in recovery and restoring confidence.
Living Well During and After Treatment
Tips for living well during and after treatment include:
Practical Steps
- Communicate openly: Discuss concerns about appearance, sexuality, or emotional well-being.
- Join support groups: Sharing experiences can ease anxiety and isolation.
- Follow medical advice: Keep all follow-up appointments for early detection of recurrence.
- Skin care: Maintain gentle hygiene and follow wound-care instructions carefully.
Long-Term Health
Regular follow-ups may include physical exams, imaging, and laboratory tests, depending on cancer stage and treatment type. Early detection of recurrence significantly improves survival.
Prevention Tips You Can Act On
The prevention tips include:
- Get vaccinated against HPV if you are eligible.
- Avoid smoking and seek professional help to quit.
- Practise safer sex using condoms and by limiting partners.
- Maintain genital hygiene, especially if you are uncircumcised.
- Seek care for phimosis, chronic irritation, or rashes that don’t heal.
- Manage chronic skin diseases of the penis under medical supervision.
Simple preventive steps can substantially reduce your risk of penile cancer.
Outlook and Prognosis
When diagnosed early, penile cancer has a high cure rate. Localised cancers confined to the penis often respond well to conservative surgery or topical therapy. Once lymph nodes are involved, treatment becomes more complex, but combined therapies—such as surgery plus chemotherapy or radiation—can still achieve long-term remission.
Your prognosis depends on tumour stage, lymph node status, and overall health. Regular medical follow-up and adherence to treatment plans are key to maintaining good outcomes.
Conclusion
Penile cancer is rare but highly treatable when detected early, making awareness and prompt medical attention essential. Recognising unusual skin changes, maintaining good hygiene, and seeking care for persistent sores or lumps can save lives. HPV vaccination, smoking cessation, and safe sexual practices significantly lower the risk. Advances in surgery, radiation, and targeted therapies now allow many men to recover while preserving function and quality of life. With early detection and proper treatment, the outlook for penile cancer continues to improve worldwide.
Consult a Top Oncologist for Personalised Advice
Consult a Top Oncologist for Personalised Advice
Dr Sunita Samleti
Oncologist
18 Years • M.D. (Pathology)- TN Medical College, Mumbai University, Mumbai, Mar 2005 M.B.B.S. Grant Medical College, Mumbai University, Mumbai, Oct 1999
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr. Sanchayan Mandal
Medical Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr.sanchayan Mandal
Medical Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Ruquaya Ahmad Mir
Surgical Oncologist
20 Years • MBBS, DNB
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Consult a Top Oncologist for Personalised Advice
Dr Sunita Samleti
Oncologist
18 Years • M.D. (Pathology)- TN Medical College, Mumbai University, Mumbai, Mar 2005 M.B.B.S. Grant Medical College, Mumbai University, Mumbai, Oct 1999
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr. Sanchayan Mandal
Medical Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr.sanchayan Mandal
Medical Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Ruquaya Ahmad Mir
Surgical Oncologist
20 Years • MBBS, DNB
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
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Frequently Asked Questions
1) Is penile cancer contagious?
No. Penile cancer is not infectious. However, HPV infection, a key risk factor, is sexually transmissible. Vaccination and safe sexual practices help reduce risk.
2) What do early penile cancer symptoms look like?
Early signs include small sores, red or scaly patches, warty growths, or thickened skin areas that do not heal. Any lesion lasting more than two weeks warrants medical review.
3) Can circumcision prevent penile cancer?
Circumcision—particularly if performed in infancy—may reduce risk by preventing chronic inflammation and infections. Nonetheless, good hygiene and HPV vaccination remain vital for all men.
4) Will treatment affect my sexual function?
It depends on treatment type and tumour size. Many patients treated with penis-sparing surgery retain normal sexual function. Rehabilitation and counselling can further improve the quality of life.
5) Should I get the HPV vaccine if I’m over 26?
Adults aged 27–45 can consider vaccination after discussing individual benefits with a clinician. Even if you are older, it may still offer protection against some HPV types.