Penile cancer happens when malignant cells in your penis grow out of control. Penile cancer in the U.S. is rare, but you should see your healthcare provider if you notice changes in your penis, like a lump or discoloration. Treatment in the early stages can keep the cancer from progressing. Penile cancer that’s spread to other parts of your body is harder to treat.
Penile cancer develops when malignant cells in your penis grow out of control. Your penis is a rod-shaped reproductive organ that allows you to pee and have sex. Its main parts include the rod-like part (shaft) that extends from your low belly to the tip of your penis, called the head, or glans. If you’re uncircumcised, a layer of skin called the foreskin covers the head. If you’re not circumcised, the head of your penis is exposed.
Cancer can form anywhere in your penis, but it most commonly starts on the head or foreskin (if you’re uncircumcised).
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Ninety-five percent of penile cancers are squamous cell carcinoma (SCC). This type of cancer forms in the top part of your skin layer called the epithelium. Other, less common types of penile cancer form in different types of tissue:
Penile cancer is rare in the United States, accounting for less than 1% of cancers among people with penises. However, it’s more common in other countries. Penile cancer accounts for more than 10% of cancers among people assigned male at birth (AMAB) in Africa, Asia and South America.
Cancer is most commonly diagnosed in people over 55, but people under 40 can also get it. The average age of diagnosis is 60.
Not all cancers cause changes you can see, but penile cancer usually causes your penis to look different. The skin on your penis may become discolored, and you may notice a lump.
Signs and symptoms of penile cancer include:
Less serious conditions like infections and allergic reactions also cause these symptoms. Still, don’t leave things to chance. It’s better to have your healthcare provider take a look so early-stage cancer doesn’t go untreated.
With penile cancer, a healthy cell in your skin changes to become a cancer cell. Cancer cells multiply out of control, forming a mass called a tumor. These cells can crowd out healthy cells. Over time, cancer cells can spread to other parts of your body, damaging healthy tissue and organs.
Researchers don’t know what causes the change that transforms a healthy cell into a cancer cell, but they’ve discovered several risk factors. A risk factor doesn’t cause penile cancer, but it increases the possibility.
The most significant risk factor for penile cancer is age. About 80% of penile cancer diagnoses in the U.S. occur in people 55 or older. Not being circumcised when you were an infant may also increase your risk. Circumcision removes the foreskin of your penis, exposing the head. Many risk factors related to penile cancer are likely related to having a foreskin.
Phimosis is common in uncircumcised infants but rare in uncircumcised adults. It’s a condition that causes your foreskin to become so tight that you can’t retract it (pull it back) to access the head of your penis. It’s possible that phimosis lasting into your adulthood increases the risk of infection and inflammation beneath your foreskin. Both may increase your cancer risk.
Many of the same high-risk strains of the human papillomavirus (HPV) that cause cervical cancer have been found in people with penile cancer. The HPV associated with cervical and penile cancer is a sexually transmitted virus (STI). Although HPV is present in nearly all instances of cervical cancer, it’s present about half the time in people with penile cancer. Still, HPV infection is a significant risk factor for penile cancer.
Penile cancer is more common in people with HIV(human immunodeficiency virus). Researchers aren’t sure why. It’s possible that the same sexual behaviors that increase a person’s risk of HPV (for example, unprotected sex, multiple partners, etc.) also increase the risk of HIV infection. It’s possible, too, that HIV infection alone increases cancer risk. Research is ongoing.
Smoking cigarettes, chewing tobacco or using snuff increases your penile cancer risk. Tobacco may slow your body’s ability to fight infection, raising your risk. Tobacco use may damage cells, causing changes that lead to cancer.
PUVA stands for psoralen and ultraviolet A photochemotherapy. It’s a type of treatment for psoriasis that uses radiation. Receiving this treatment can increase your risk of penile cancer. More radiation exposure means greater risk.
Lichen sclerosis (LS) is an inflammatory disorder that may cause the head of your penis or your foreskin to feel painful, irritated or itchy. If you have LS, you’re at an increased risk of penile cancer. Lichen sclerosus may also increase your risk of HPV infection.
Not washing your penis frequently or thoroughly may increase your risk of smegma. Smegma is a build-up of fluids your body secretes naturally. If you’re uncircumcised, smegma can collect beneath your foreskin and become thick and smelly. Researchers once thought that smegma had cancer-causing properties, but this isn’t the case. It’s more likely that smegma leads to irritation and inflammation that may increase cancer risk.
Penile cancer isn’t contagious. However, HPV — one of the risk factors for penile cancer — is transmitted through skin-to-skin contact (most often) during unprotected sex. HPV spreads through vaginal sex, oral sex and anal sex.
Your healthcare provider may perform the following to determine whether you have cancer:
Imaging helps your healthcare provider stage your cancer. Cancer staging allows them to classify how serious cancer is, based on the size of a tumor and how much it’s spread throughout your body. This information guides treatment decisions.
Penile cancer is staged using the TNM staging system. Each letter provides unique information about your cancer.
Numbers following the letters (TNM) provide additional information about the tumor, lymph nodes affected and whether the cancer has metastasized. The numbers range from 1 to 4, with 1 meaning less cancer spread and 4 meaning the most spread (metastasis).
Cancer staging can be complex, but it communicates important information about how serious your condition is. Talk to your healthcare provider about what stage of cancer you have. Ask about what your cancer stage means for your treatment and likely outcomes.
Your treatment will depend on the size of the tumor, whether it’s spread and how likely it is that the cancer will return (recur) after treatment. Treatment may involve a care team that includes your primary care provider, a cancer specialist (oncologist), a urinary tract specialist (urologist) and a skin specialist (dermatologist).
For cancer that’s in earlier stages, your healthcare provider may recommend one or a combination of the following treatments:
For cancer that’s more advanced, your healthcare provider may recommend:
Your healthcare provider may use radiation, chemotherapy or both to shrink cancer cells before performing surgery.
To reduce your risk of penile cancer, consider the following:
Your chance of recovery and care plan depend on the following:
Catching cancer early means that it’s easier to treat and cure. Catching it later means there’s a greater chance that it’s spread beyond your penis. At this point, penile cancer becomes much harder to treat.
Penile cancer can be fatal, especially if it’s spread beyond your penis. You can reduce your risk by putting good habits into place, like practicing safer sex and avoiding tobacco products. See your healthcare provider at the first sign of a change in your penis, like a lump or discoloration.
Talk to your healthcare provider about how your cancer and treatment plan may impact your everyday life. Many cancer treatments preserve the penile tissue. This means that your penis eventually heals to look the same after treatment, or very similar, as it did before. You can still pee standing. You can still get an erection, have sex and orgasm.
Surgery to remove part or all of your penis may change the way you pee and your experience of sex.
Penile cancer and penile cancer treatment can unfold in various ways. Knowing what to expect can help you prepare for various potential scenarios. Speak openly with your healthcare provider about any questions you have.
A note from Cleveland Clinic
Penile cancer develops when malignant cells in your penis grow out of control. If you notice changes in your penis, schedule a visit with your healthcare provider. It’s easy to postpone making an appointment when you know the visit will involve a close examination of your genitals. But delays only give cancer time to progress. Catching cancer early means there’s a much better chance that your healthcare provider can treat it. There’s also a much better chance that these treatments won’t change how your penis looks and functions. If the changes aren’t related to cancer, your healthcare provider can put your mind at ease.
Last reviewed by a Cleveland Clinic medical professional on 05/19/2022.
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