Penile cancer

Carcinoma of the penis
Classification and external resources
Specialty Oncology
ICD-10 C60
ICD-9-CM 187
DiseasesDB 29392
MedlinePlus 001276
MeSH D010412

Penile cancer is a malignant growth found on the skin or in the tissues of the penis. Around 95% of penile cancers are squamous cell carcinomas. Other types of penile cancer such as Merkel cell carcinoma, small cell carcinoma, melanoma and other are generally rare.[1]


Around 95% of penile cancers are squamous cell carcinomas. They are classified into the following types:

Other types of carcinomas are rare and may include small cell, Merkel cell, clear cell, sebaceous cell or basal cell tumors. Non-epithelial malignancies such as melanomas and sarcomas are even more rare.[1]


Like many malignancies, penile cancer can spread to other parts of the body. It is usually a primary malignancy, the initial place from which a cancer spreads in the body. Much less often it is a secondary malignancy, one in which the cancer has spread to the penis from elsewhere. The staging of penile cancer is determined by the extent of tumor invasion, nodal metastasis, and distant metastasis.[2]

The T portion of the AJCC TNM staging guidelines are for the primary tumor as follows:[2]

Anatomic Stage or Prognostic Groups of penile cancer are as follows:[2]

HPV positive tumors

Human papillomavirus prevalence in penile cancers is high at about 40%. HPV16 is the predominant genotype accounting for approximately 63% of HPV-positive tumors. Among warty/basaloid cancers the HPV prevalence is 70–100% while in other types it is around 30%.[1]

Signs and symptoms

Risk factors


Hygiene and injury



Penile cancer arises from precursor lesions, which generally progress from low-grade to high-grade lesions. For HPV related penile cancers this sequence is as follows:[1]

However, in some cases non-dysplastic or mildly dysplastic lesions may progress directly into cancer. Examples include flat penile lesions (FPL) and condylomata acuminata.[1]

In HPV negative cancers the most common precursor lesion is lichen sclerosus (LS).[1]



There are several treatment options for penile cancer, depending on staging. They include surgery, radiation therapy, chemotherapy, and biological therapy. The most common treatment is one of five types of surgery:

Radiation therapy is usually used adjuvantly with surgery to reduce the risk of recurrence. With earlier stages of penile cancer, a combination of topical chemotherapy and less invasive surgery may be used. More advanced stages of penile cancer usually require a combination of surgery, radiation and chemotherapy. In addition to all the above, treatment of the underlying disease like brucellosis, is important to limit disease recurrence.


Prognosis can range considerably for patients, depending where on the scale they have been staged. Generally speaking, the earlier the cancer is diagnosed, the better the prognosis. The overall 5-year survival rate for all stages of penile cancer is about 50%.[2]


Penile cancer is a rare cancer in developed nations with annual incidence varying from 0.3 to 1 per 100,000 per year accounting for around 0.4–0.6% of all malignancies.[1] The annual incidence is approximately 1 in 100,000 men in the United States,[18] 1 in 250,000 in Australia,[19] and 0.82 per 100,000 in Denmark.[20] In the United Kingdom, fewer than 500 men are diagnosed with penile cancer every year.[11][21]

However, in the developing world penile cancer is much more common. For instance, in Paraguay, Uruguay, Uganda and Brazil the incidence is 4.2, 4.4, 2.8 and 1.5–3.7 per 100,000, respectively.[1][7] In some South American countries, Africa, and Asia, this cancer type constitutes up to 10% of malignant diseases in men.[1] The lowest incidence is in Israeli Jews—0.1 per 100,000.

The lifetime risk has been estimated as 1 in 1,437 in the United States and 1 in 1,694 in Denmark.[22]

See also


  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 Bleeker, M. C. G.; Heideman, D. A. M.; Snijders, P. J. F.; Horenblas, S.; Dillner, J.; Meijer, C. J. L. M. (2008). "Penile cancer: Epidemiology, pathogenesis and prevention". World Journal of Urology. 27 (2): 141–150. doi:10.1007/s00345-008-0302-z. PMID 18607597.
  2. 1 2 3 4 "Stage Information for Penile Cancer". National Cancer Institute. Retrieved 3 November 2013.
  3. 1 2 3 4 5 PubMed Health PubMed, Last Reviewed: September 16, 2011
  4. 1 2 3 4 5 6 7 Cancer Research UK: Penile Cancer: Symptoms of penile cancer Cancer Research UK
  5. 1 2 3 4 5 6 7 8 9 The American Cancer Society: Penile Cancer: "What are the risk factors for penile cancer?" The American Cancer Society
  6. Bleeker, M. C. G.; Heideman, D. L. A. M.; Snijders, P. J. F.; Horenblas, S.; Meijer, C. J. L. M. (2011). "Epidemiology and Etiology of Penile Cancer". Textbook of Penile Cancer. p. 1. doi:10.1007/978-1-84882-879-7_1. ISBN 978-1-84882-878-0.
  7. 1 2 3 4 5 6 7 Pow-Sang, M. R.; Ferreira, U.; Pow-Sang, J. M.; Nardi, A. C.; Destefano, V. (2010). "Epidemiology and Natural History of Penile Cancer". Urology. 76 (2): S2–S6. doi:10.1016/j.urology.2010.03.003. PMID 20691882.
  8. National Cancer Institute: Penile Cancer National Institutes of Health
  9. HPV-Associated Penile Cancer Rates by Race and Ethnicity] Center for Disease Control and Prevention
  10. Brandel France de Bravo; Maushami DeSoto; Krystle Seu (April 2009). "HPV: Q&A". Cancer Prevention and Treatment Fund. Retrieved August 13, 2013.
  11. 1 2 Cancer Research UK: Penile Cancer: Risks and causes of penile cancer Cancer Research UK
  12. 1 2 3 4 5 6 7 Minhas, S.; Manseck, A.; Watya, S.; Hegarty, P. K. (2010). "Penile Cancer—Prevention and Premalignant Conditions". Urology. 76 (2): S24–S35. doi:10.1016/j.urology.2010.04.007. PMID 20691883.
  13. Reis AA, Paula LB, Paula AA, Saddi VA, Cruz AD (June 2010). "[Clinico-epidemiological aspects associated with penile cancer]". Cien Saude Colet (in Portuguese). 15 Suppl 1: 1105–11. PMID 20640268.
  14. Morris BJ, Gray RH, Castellsague X, et al. (2011). "The Strong Protective Effect of Circumcision against Cancer of the Penis". Adv Urol. 2011: 812368. doi:10.1155/2011/812368. PMC 3113366Freely accessible. PMID 21687572.
  15. 1 2 Larke NL, Thomas SL, dos Santos Silva I, Weiss HA (August 2011). "Male circumcision and penile cancer: a systematic review and meta-analysis". Cancer Causes Control. 22 (8): 1097–110. doi:10.1007/s10552-011-9785-9. PMC 3139859Freely accessible. PMID 21695385.
  16. Micali, G.; Nasca, M. R.; Innocenzi, D.; Schwartz, R. A. (2006). "Penile cancer". Journal of the American Academy of Dermatology. 54 (3): 369–391; quiz 391–4. doi:10.1016/j.jaad.2005.05.007. PMID 16488287.
  17. de Souza KW, dos Reis PE, Gomes IP, de Carvalho EC (March 2011). "[Prevention strategies for testicular and penile cancer: an integrative review]". Rev Esc Enferm USP (in Portuguese). 45 (1): 277–82. PMID 21445520.
  18. The American Cancer Society: Penile Cancer: What is penile cancer? American Cancer Society, Last revised: January 8, 2012
  19. The Official Website of the Royal Australasian College of Physicians, Published September 2010
  20. Frisch M, Friis S, Kjær SK, Melbye M. Falling Incidence Of Penis Cancer In An Uncircumcised Population (Denmark 1943-90). BMJ: British Medical Journal. 1995;311(7018):1471.
  21. The American Cancer Society: Penile Cancer: What are the key statistics about penile cancer American Cancer Society, Last revised: January 18, 2012
  22. Cold CJ, Storms MR, Van Howe RS (April 1997). "Carcinoma in situ of the penis in a 76-year-old circumcised man". J Fam Pract. 44 (4): 407–10. PMID 9108839.
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