Early detection offers the best chance for treatment…
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Our Penile Cancer Specialists
Dr. Korman, Howard
Dr. Kearney, David
Penile cancer is very rare in the U.S, affecting about 1,600 men a year.
Almost all penile cancers start in the skin, appearing as a tiny area of skin erosion, irritation, discoloration, an ulcer or a sore on the penis foreskin, the shaft or the surface of the head of the penis.
See a doctor if you find a new growth or other abnormality of your penis, even if it is not painful. In most cases, these areas are not cancerous and are caused by a bacterial or fungal infection or even an allergic reaction that can be easily treated.
The earlier penile cancer is found, the better. If it’s found early, there is a good chance for successful treatment and a cure. If diagnosis is delayed, the disease can get worse. Treatment for more advanced cancer may be less successful and more disfiguring.
Since you see and touch your penis when you urinate, you can help spot the disease early. Men who aren’t circumcised are at greater risk for penile cancer. But every man should be on the lookout for penile lesions.
You should see your health care provider if you notice any of these on the foreskin, or the shaft or head of your penis:
- An area of skin becoming thicker and/or changing color
- A lump on the penis
- An ulcer (sore) that might bleed
- A reddish, velvety rash
- Small, crusty bumps
- Flat, bluish-brown growths
- Smelly discharge (fluid) under the foreskin
Most of these signs may be from a bacterial or fungal infection, or even an allergic reaction. All of these will respond to antibacterial or antifungal ointments and creams. But growths that return or sores that don’t heal must be thought of as cancer until it’s proven they’re not.
Penile cancer is often, unfortunately, ignored until it is advanced. Patients are reluctant or embarrassed to talk about their genitals. Or, they may be afraid of treatment or surgery on the penis. If you notice any of these signs, it’s important to have them checked by a health care provider as soon as you can.
Penile cancer is diagnosed with a biopsy. This is when a small sample of tissue is removed from the penis and looked at under a microscope. If the cells look like cancer cells, they will be “staged.” The TNM staging system is the system most often used. T stands for the main (primary) tumor (how far it has grown within the penis or nearby organs). N stands for spread to nearby lymph nodes (bean-sized groups of immune system cells). M is for metastasis (spread) to other organs.
The cells are also given a “grade”. This is a measure of how abnormal the cells look. The grade is often a number, from 1 to 4. The higher the number, the more abnormal the cells look. Higher-grade cancers tend to grow and spread more quickly than lower-grade cancers.
If your doctor believes that cancer has spread to nearby lymph nodes, other tests will be done. A lymph node biopsy will help determine the cancer’s stage and grade. If cancer is thought to spread to other parts of the body, imaging tests (such as a CT scan, or MRI) will be done.
If tests suggest cancer, prompt care and regular follow-up will be very important.
Testing and Treatment
If the skin changes are cancerous, early detection offers the best chance for treatment. Your urologist will probably begin by treating the area of concern with an antibacterial or antifungal ointment. If the growths or areas do not heal or recur, your urologist may remove a tiny sample of the tissue to study it for signs of cancer.
If cancer is confirmed and the tumor is small, it may be treatable with a topical cream that has minimal side effects. If the lesion is larger, but still limited to about pea-size, your doctor may shave layers of abnormal tissue until normal tissue is reached. Long-term side effects from these types of treatments are rare, although regular monitoring for recurrence is important.
With larger lesions, it is necessary to remove greater amounts of tissue. In these circumstances, a combination of surgery, radiation and chemotherapy may be necessary.
Frequently Asked Questions
In most cases, the first sign of penile cancer is a change in the skin of the penis. The skin may change color, become thicker, or tissue may build up in one area. Some men might notice a sore or a lump on the penis. These are most likely to be found on the the head of the penis or foreskin, but could also develop on the shaft. The sore or lump is usually not painful.
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