Penile Cancer: What are the Types, Symptoms and Risk Factors?

Sometimes, after a diagnosis of a sexually transmitted disease such as the human papillomavirus (HPV), a common question many men ask is whether or not HPV leads to other complications—specifically, whether there are any symptoms to watch for that would point to penile cancer.

Penile cancer is a rare but devastating disease that usually develops when cells begin to grow out of control in or on the penis. These cells can become cancerous in nearly every part of the body and they can also spread to other areas. Almost all penile cancers start in skin cells of the penis and occur in less than 1 in 100,000 men. Penile cancer accounts for less than 1% of cancers in men in America. The cancer is more common in parts of Asia, Africa, and South America.

Yes, penile cancer is associated with HPV, a sexually transmitted infection that increases the risk of cancers of the genitalia, anus, and throat. However, penile cancer is extremely rare, even in men who are infected with HPV. It is most commonly diagnosed in men who are over 55 and have other risks, such as smoking.

Penile Cancer Types

The penis has different types of tissue, each containing several different types of cells. The different cells can develop into particular cancers, some more serious than others and each type requiring a different treatment. There are seven different types of cancers of the penis, according to the American Cancer Society:

1. Squamous cell carcinoma. Develops from flat skin cells on the glans (the head) or foreskin (on non-circumcised men) called squamous cells. Almost 95% of all penile cancers are squamous cell carcinoma. These tumors grow slowly and if detected in the early stages, can usually be cured.
2. Verrucous carcinoma. An uncommon form of squamous cell cancer, it can occur in the skin and looks a lot like a large genital wart. This type tends to grow slowly and rarely spreads to other parts of the body, but can sometimes get very deep and very large.
3. Carcinoma in situ (CIS). The earliest stage of squamous cell cancer where the cancer cells haven’t yet grown into deeper tissues and are only found in the top layers of the skin. If the CIS is located on the glans, it is sometimes referred to as erythroplasia of Queyrat. However, the disease is ​called Bowen disease if the CIS is on the shaft of the penis (or other parts of the genitals).
4. Melanoma. A dangerous type of skin cancer that tends to grow and spread quickly. Most often found in sun-exposed skin, only a tiny fraction of penile cancers are melanomas.
5. Basal cell carcinoma. Making up only a small portion of penile cancers, it is another type of skin cancer (this one is slow-growing and rarely spreads to other parts of the body). Also referred to as basal cell cancer.
6. Adenocarcinoma (Paget disease of the penis). Develops from sweat glands in the skin of the penis and can be very hard to tell apart from CIS. A very rare type of penile cancer.
7. Sarcoma. Making up only a small portion of penile cancer, sarcomas develop from blood vessels, smooth muscle, or other connective tissue cells.

Symptoms of Penile Cancer

Symptoms of penile cancer are most commonly noticed in the form of:

• Sores
• Ulcers
• Lesions
• Growths on or within the penis
• Bleeding or discharge from the penis
• Changes in skin color
• Rash or bumps under the foreskin
• Swollen lymph nodes in the groin

There are also benign conditions of the penis, where abnormal but noncancerous growths or lesions on the penis can develop. These lesions can look like warts or irritated patches of skin. Like penile cancer, they are most often found on the glans or on the foreskin, but they can also occur along the shaft of the penis. There are 2 types of benign conditions:

1. Condylomas look a lot like tiny cauliflowers and are caused by infection of some types of HPV.
2. Bowenoid papulosis is also linked to infection with HPV and can also be mistaken for CIS. It is seen as small red or brown spots or patches on the shaft of the penis and doesn’t usually cause any problems and can even go away on its own after a few months. Rarely it can progress to Bowen disease if symptoms don’t subside and if left untreated.

If you have the symptoms of penile cancer, do not delay in seeing a healthcare provider. Like with any condition, early detection is key. Symptoms like sores, lesions, and penile discharge aren’t likely to go away on their own, so do not wait for them to do so.

Risk Factors

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some cancer risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But having a risk factor or even several does not mean that you will get the disease. On the other hand, some men who develop penile cancer have no known risk factors.

Scientists have found certain risk factors that make a man more likely to develop penile cancer:

• HPV infection
• Not being circumcised, particularly in men with phimosis (a tight foreskin that is difficult to retract), which leads to a buildup of smegma
• Tobacco use
• UV light treatment of psoriasis
• Age (chances of having penile cancer go up with age)
• AIDS

Seeking Treatment for Penile Cancer

You should book an appointment to see a practitioner immediately if you notice any abnormalities or find a new growth on your penis (even if it is not painful). Warts, blisters, sores, ulcers, white patches, or other abnormalities need to be looked at by your healthcare provider.

Cancer can often be removed with little or no damage to the penis if detected early. Putting off a diagnosis can mean more invasive treatments or having to remove a part or all of the penis to treat cancer.