Penile cancer is a rare malignancy. Just over 500 men are diagnosed with penile cancer in the UK each year. It is most common in men over the age of 50, although younger men are also at risk.
There are a number of risk factors for penile cancer. It is much less common in men who have had their foreskin removed (circumcision) soon after birth. Infection with the human papilloma virus (HPV) that can also cause penile warts also increases the risk of cancer of the penis, as does smoking.
A number of early skin changes on the penis can go on to develop penile cancer and these are referred to as pre-malignant lesions of the penis. These may present as white patches, red scaly patches, or red moist patches on the foreskin or head of the penis (glans penis).
Cancer of the penis is not infectious and cannot be passed on to your partner or others.
The first signs of a penile cancer are often a lump developing on the foreskin or head of the penis. Most penile cancers are painless, but you should keep an eye out for any of the following symptoms:
- Difficulty in drawing back the foreskin (phimosis)
- a growth or sore on the penis that doesn't heal within four weeks
- bleeding from the penis or from under the foreskin
- a foul smelling discharge from under the foreskin
- a change in the colour of the skin of the penis or foreskin
- a rash on the penis that persists despite treatment
Sometimes early cancers appear as flat growths that are bluish-brown in colour, or as a red rash, or small crusty bumps. Often the cancers are only visible when the foreskin is pulled back.
These symptoms may occur with conditions other than cancer. Like most cancers, cancer of the penis is easiest to treat if it is diagnosed early.
Once the cancer cells get into the lymphatic system they may travel to other areas of the body including the lymph nodes and lungs. These cancers are called secondary cancers or metastases.
Penile cancer has a stepwise predictable spread to the lymph nodes in the groins followed by the pelvic lymph nodes before travelling to other parts of the body. Spread to the lymph nodes in the groin results in enlarged lymph nodes in the groin.