Penile Cancer

Penile cancer is an uncommon but important cancer that occurs in men. It can develop anywhere on the penis but commonly tends to occur:

• on the under surface of the foreskin in men who are not circumcised
• on the head (or glans) of the penis

Risk Factors:

• Smoking
• Non-retractile foreskin
• Increasing age
• Presence of precancerous lesions
• Weakened immune system 
• Human Papilloma Virus (HPV)

The Human Papilloma Virus (HPV), which is also a cause of cervical, anal, vulval and vaginal cancers, is believed to heighten the risk of penile cancer in men.  Around 80% of people in the UK will be infected with the HPV virus at some time during their lifetime. For most people the virus causes no harm and goes away without treatment. But men with HPV have an increased risk of developing cancer of the penis.

A number of research studies have tried to establish the link between penile cancer and HPV. These studies show that the number of men with penile cancer who also have HPV varies from between 30% and 70%. 

Early detection signs:

• Red, white, or scaly patches on the penis, or a rash
• A change in the colour of the penis or foreskin
• Sores, growths, ulcers, warts or blisters that do not heal. These are not always painful.
• Bleeding from the penis or from under the foreskin
• Discharge from the foreskin
• Difficulty in drawing back the foreskin

These symptoms do not always mean that a man has penile cancer. They may be symptoms of other medical conditions, such as sexually transmitted diseases. But it is important that any of these symptoms are properly assessed by an expert.

Symptoms of advanced penile cancer:

• A lump in the groin, that is not painful 
• Feeling tired 
• Stomach pain
• Pain in the bones 
• Loss of weight

Unfortunately men with penile cancer are often embarrassed or frightened by their symptoms and may delay seeking medical advice for up to a year from the onset of their first symptoms.  Penile cancer has a much better prognosis if diagnosed and treated early and any delay may mean that their cancer becomes more advanced and more radical treatments are required.

As penile cancer is uncommon it is better to see a specialist who can expertly assess any penile problems and arrange for early investigations to establish a rapid diagnosis.

Treatments depend on the location and extent of the cancer, and may also involve treatment of the lymph nodes in the groin. The current mainstay of treatment is surgery.  In the past, this has involved radical surgery, such as partial or complete penile amputation.  However, medical developments have meant that surgery is now moving to more conservative treatments, such as reconstructive surgeries with better functional, cosmetic and psychological outcomes.

Consultation with Mr Brown:

• Includes a detailed history concerning your symptoms
• Physical examination
• Please note that some investigations and tests (including blood tests) would be billed in addition to your consultation

Further investigations may include blood and urine tests, a formal biopsy under anaesthetic often performed as a day case procedure and also radiological scans.
 
Once a diagnosis is made then a further consultation is arranged to discuss all the therapeutic options before undergoing treatment.

Mr Gareth Brown has a special interest is managing men with benign and malignant penile problems. In his clinic at Vale Healthcare he is able to provide expert assessment and treatment of penile problems. For men with penile cancers he can offer penile conserving surgeries when appropriate.