What is penile carcinoma?

Penile carcinoma is a cancer of the penis that is rather rare nowadays. It usually affects men over the age of 60. If the cancer is detected and treated early, the chances of recovery are high and the risk that the cancer has spread is rather low.

Have you noticed painless hardening on your penis lately? Do you suffer from chronic inflammation underneath the foreskin? Are there whitish changes on the mucous membrane of your penis?

Table of contents

1.1 How does penile carcinoma develop?
1.2 What are the symptoms?
1.3 How is penile carcinoma diagnosed?
1.4 How is penile carcinoma treated?

1.1 How does penile carcinoma develop?

The question of how penile cancer develops has not yet been fully answered, but it is now suspected that there are certain risk factors. These include, for example, an older age; because most of those affected are over 60 years old. Chronic inflammation under the foreskin and glans also seems to increase the risk of penile cancer. The risk of inflammation at and below the foreskin is increased by so-called phimosis, a narrowing of the foreskin. Since the foreskin can no longer be fully retracted due to the narrowing, residues of foreskin sebum (smegma) are more likely to remain and inflammation is more likely to occur. These can then occur on the glans and the foreskin.

It is also suspected that a certain subtype of HPV infection, which also causes genital warts, is associated with the development of penile carcinoma. In addition, smoking could favour the development of this carcinoma.

1.2 What are the symptoms?

The earlier penile carcinoma is detected, the higher the chances of cure. Therefore, it is recommended that you make an appointment with your urologist for a check-up if you have the following symptoms.

Painless hardening in the glans area is considered a warning sign and should be checked urgently by a urologist.

It is suspected that whitish changes in the mucous membrane, called leukoplakia, are a precursor to penile carcinoma. Therefore, these should also be checked. Surface changes on the penis that tend to bleed quickly due to light contact are considered another symptom. Nodules and small ulcers on the glans as well as a swollen glans are also considered signs. It should be noted that penile carcinoma tends to be painless at first. If a patient experiences pain and severe discomfort, the cancer is usually already advanced. Therefore, do not wait for pain at the first signs and rather make an appointment for a check-up with your trusted urologist.

1.3 How is penile carcinoma diagnosed?

If a patient suspects that he or she has penile carcinoma or if the urologist notices changes in the penis during a preventive medical check-up, the first step is a physical examination in which the doctor feels the affected part of the body. The groin may also be palpated to check for swollen lymph nodes.

In order to be able to make a reliable diagnosis, the urologist will take a small tissue sample if penile carcinoma is suspected. This is called a biopsy. The tissue taken is then examined microscopically by a pathologist. If the pathologist finds that it is a tumour, it is a penile carcinoma.

1.4 How is penile carcinoma treated?

After the biopsy, the pathologist examines whether the entire tumour has been removed. For this to be the case, there must be healthy tissue at the edge of the tumour and it must therefore have been removed with a safety margin. If this is the case, it must be ruled out that the cancer has spread to other organs or to the lymphatic system. Therefore, further examinations by means of ultrasound, MRT or CT can follow. If the carcinoma is already advanced and has spread, treatment of these metastases (daughter tumours) would be necessary in this rare case.

If the biopsy did not remove the entire tumour, another procedure called resection is performed. The aim of this is to remove the remaining remnants of the cancer in order to prevent further growth of the tumour.