Spotlight on penile cancer

The penis is the male external genital organ. It is composed of three chambers of spongy tissue that contain smooth muscle and many blood vessels and nerves. The corpora cavernosa makes up two of the chambers located on both sides of the upper part of the penis. The corpus spongiosum is located below the corpora cavernosa and surrounds the urethra. The urethra is the tube through which semen and urine exit the body at an opening called the meatus. At the tip of the penis, the corpora cavernosa expands to form the head of the penis, or glans.

What is penile cancer?

Penile cancer is a rare type of cancer and occurs on the foreskin, on the skin of the penile shaft, or the glans (head) of the penis. It occurs mostly in uncircumcised men (men who still have foreskin around the head of the penis). Circumcision is the removal of the foreskin and may reduce the risk of penile cancer.

The stats*

Penile cancer is rare. In 2021 there were an estimated 155 cases of penile cancer diagnosed and 28 deaths from this disease. In 2013-2017, on average, 75.4% of males diagnosed with penile cancer survived 5 years after diagnosis. In 2021, the estimated agestandardised incidence rate of penile cancer is 1.1 cases per 100,000 males.

Penile cancer symptoms

People with penile cancer may experience a variety of symptoms. Symptoms may include:

• a growth or sore on the head of the penis (the glans), the foreskin or on the shaft of the penis that doesn’t heal in a couple of weeks • bleeding from the penis or under the foreskin • a hard lump on or under the foreskin • an odorous discharge under the foreskin • changes in the colour of the skin on the penis or foreskin

• thickening of the skin on the penis or foreskin that makes it hard to pull back the foreskin • pain in the shaft or tip of the penis • swelling at the tip of the penis • a rash on the penis or a constant red patch of skin that does not resolve

• lumps in the groin due to swollen lymph nodes.

155 men

Were estimated to be affected by penile cancer in Australia in 2021.

Spotlight on penile cancer

Causes of penile cancer

The cause of penile cancer is not known in most cases. However, there are several risk factors.

Infection with human papilloma virus is a risk factor for cancer of the penis. Some other conditions that affect the appearance of the skin of the penis can lead to cancer, so it’s important to see your doctor if you notice white, red or scaly patches.

Other risk factors for penile cancer include: • not being circumcised • smoking tobacco • increasing age • certain skin conditions such as psoriasis • HIV/AIDS • premalignant lesions/conditions • exposure to ultraviolet (UV) radiation.

Who treats penile cancer?

Based on your treatment options, you might have different doctors of various specialties on your treatment team. For penile cancer, the multidisciplinary team often includes a surgeon, a doctor called a urologist who specialises in urinary tract problems, a medical oncologist, and a radiation oncologist. Your healthcare team may also include a variety of other health care professionals, oncology nurses, social workers, pharmacists, counsellors and psychologists, dietitians, and others.

How is penile cancer treated?

Surgery is the main treatment for most men with penile cancers, but sometimes radiation therapy may be used, either instead of or in addition to surgery. Other local treatments might also be used for early-stage cancer. Chemotherapy may be given for some larger tumours or if the cancer has spread.

As well as medical treatment for penile cancer it is also important to adjust to living with the diagnosis. A specialist nurse, psychologist, social worker, a GP and support groups can all help and provide ways of coping.

Thinking about taking part in a clinical trial

Progress in treating penile cancer has been hindered by its rarity so it is difficult to recruit enough patients to penile cancer clinical trials.

Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to receive state-of-the art cancer treatment, management and care that is not yet available to the wider public. Clinical trials are also the best way for a multidisciplinary team to learn better methods to treat this rare form of cancer.

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor or contact ANZUP.

Although penile cancer is a relatively rare disease, its consequences can have profound effects for the men who experience it. Evidence supports the view that factors such as embarrassment, fear, the potential impact on sexuality and a cancer in a sexual organ all impact on patients’ seeking help, resulting in a delay in going to a healthcare professional. See your doctor early and ensure you talk about treatment and the effects on sexual health and fertility.