Types of surgery
If the cancer is only on your foreskin, we treat it by removing the foreskin (circumcision). We usually carry out this procedure as a day case, under either local or general anaesthetic.
If the cancer is small and only on the surface of the penis, doctors can usually remove the affected part and a small bit around it. This reduces the risk of the cancer returning. You’ll have this operation under general anaesthetic and will stay in hospital for a while afterwards. Some people need a small skin graft, taken from their thigh, to cover the treated area.
If you have an early cancer that’s only on the surface, doctors may remove the top layer of tissue from the tip of penis. They’ll replace it with a skin graft from your thigh.
To help the wound heal and your penis look as normal as possible after the procedure, you’ll have a urethral catheter and special dressing in place. They normally stay in place for about ten days, and you can go home from hospital before they’re removed. We’ll arrange an outpatient appointment for your nurse specialist to remove them.
For larger cancers involving only the head of the penis, surgeons remove the bulbous part. This part is also called the glans. They’ll replace it with a skin graft from your thigh. This helps the penis work and look as normal as possible.
To help the wound heal and your penis look as normal as possible after the procedure, you’ll have a urethral catheter and special dressing in place. They normally stay in place for about twelve days, and you can go home from hospital before they’re removed. We’ll arrange an outpatient appointment for your nurse specialist to remove them.
After this procedure you should still be able to get erections. But you may no longer have sensitivity on the head of the penis.
If the cancer involves a large area of the penis, we may recommend that the penis is either partially or totally removed. This depends on where the cancer is. If it’s near the base of the penis, the only option may be total removal (amputation). This operation is now much less common, as doctors try to preserve as much penis as possible.
UCLH is the only centre in the country that currently offers total penile reconstruction. This is also called radial artery phalloplasty.
If there are no signs that the cancer has spread, surgeons may reconstruct a penis after they remove yours. This only happens once you’ve recovered from the first surgery and the doctors are sure that the cancer has not spread.
During the operation, the surgeon removes a flap of skin and muscle from your arm and uses it to make a new penis. Sometimes, the surgeon can also reconnect some of the nerves, to recreate sensation.
Lymph node removal procedures
The surgeon may remove lymph nodes from your groin to check if the cancer has spread. At UCLH, we do the following procedures to remove lymph nodes:
You may have this procedure if the doctor can’t feel your lymph nodes when they examine you. A sentinel lymph node is the first node that lymph fluid drains to from the penis. So, it is the first place cancer is likely to spread to. Doctors can remove and check it for cancer without taking out other nodes. If there is no cancer in the sentinel node, it is unlikely to have spread.
If a sentinel lymph node biopsy is not possible, your surgeon may remove a small group of lymph nodes from the groin. We check these under a microscope, and if we find cancer, remove the remaining lymph nodes.
If you have large lymph nodes in your groin, the surgeon will usually remove them all. The more nodes removed, the higher the risk of developing lymphoedema.
Other penile cancer treatments available at UCLH
We may recommend radiotherapy:
- if you choose not to, or can’t have, surgery
- if cancer has spread to the lymph nodes in the groin or pelvis and may have spread outside the lymph node
- to treat lymph nodes after surgery to reduce the risk of the cancer spreading
- to treat symptoms, such as pain, if the cancer has spread to other parts of the body, such as the bones
We have more information about this on our Radiotherapy for penile cancer page.
If your cancer has spread, we may use chemotherapy which is either given as tablets or injected into a vein. You may have chemotherapy along with surgery, radiotherapy, or both.
