Penile cancer: symptoms, causes, tests and treatment

The NHS lists the most common symptoms below. It adds that other symptoms may include a lump in your groin, feeling tired, tummy pain and losing weight without trying. Some of these symptoms are very common and can be caused by other conditions, so having them does not definitely mean you have penile cancer.

• A growth, lump or sore that does not heal within 4 weeks.

• A rash.

• Bleeding from your penis or under your foreskin.

• A smelly discharge.

• Difficulty pulling back your foreskin (phimosis).

• A change in the colour of the skin of your penis or foreskin.

The NHS advises seeing a GP if you have any changes to how your penis looks, discharge or bleeding from your penis, any of the other symptoms listed, or symptoms that are not going away. It encourages people to try not to be embarrassed, as the doctor or nurse will be used to talking about these symptoms. Finding cancer early may make it easier to treat.

At the appointment the GP may check your penis and ask you to have a blood test. They will usually ask about your general health, your symptoms, when they started and whether anything you have used has made them better or worse. If the GP thinks the symptoms could be cancer you may get an urgent referral for more tests or to see a specialist in hospital. The NHS stresses that this does not definitely mean you have cancer.

The NHS says penile cancer may be more treatable if it is found early. Treatment depends on the size and type of the cancer, where it is, whether it has spread, and your age and general health.

Roughly half of all penile cancers are caused by certain types of HPV, according to the NHS. HPV is passed on by skin-to-skin contact of the genital area, vaginal, anal or oral sex, and sharing sex toys. Most people affected by HPV will not get penile cancer.

The NHS says you might also be more likely to get penile cancer if you smoke, have problems pulling back your foreskin to keep your penis clean (phimosis), have or had treatment for psoriasis with psoralens and an ultraviolet (UVA) light source (PUVA treatment), or have a weakened immune system because of a condition such as HIV.

You cannot always prevent penile cancer, but the NHS suggests ways to lower the chance: getting the HPV vaccination if you can, using condoms, stopping smoking, and having a circumcision if you have phimosis and this is recommended as treatment.

Cancer Research UK explains that penile cancer happens when abnormal cells in the penis start to divide and grow in an uncontrolled way. It can develop anywhere on the penis but is most common under the foreskin in men who have not been circumcised, or on the head of the penis (the glans). The NHS says most penile cancers affect the skin covering the penis (the foreskin) or the head.

It is uncommon: the NHS calls it very rare and Cancer Research UK says cancer of the penis is very rare. It can affect anyone with a penis, although it is most common in men over 50. Because so many other, much more common, conditions affect the foreskin and glans, many people with symptoms will not have cancer, but the NHS is clear that symptoms should be checked.

If a GP refers you to a specialist, you may need more tests. The NHS says a biopsy is the main test: a specialist takes a small piece of tissue from the affected area under local anaesthetic, and you should be able to go home on the same day. You should get the results within a few weeks, and you can call the hospital or GP if you are worried.

If cancer is found, further tests find out its size and how far it has spread, which is called the stage. The NHS lists scans such as MRI, CT or PET, and a test to see whether the lymph glands in the groin have been affected, called a lymph node biopsy. You may not have all of these tests, or any of them. You will be supported by a specialist team that includes a clinical nurse specialist who is your main point of contact.

The NHS recognises that surgery may affect how the penis looks, such as its size or shape, and that this may affect how you feel about your body. It says the specialist team can answer questions about how you will pee or have sex and can explain what surgery means for you. Reconstructive surgery may be possible if the penis needs to be removed, using skin and muscle from other parts of the body.

If the cancer is advanced and cannot be cured, the NHS says treatment aims to slow growth and spread, help with symptoms and help you live longer, and you will be referred to a symptom control or palliative care team. Being told you have cancer can feel overwhelming, and the NHS points people to Macmillan Cancer Support for a free helpline.

The NHS says that if a GP thinks your symptoms could be cancer you may get an urgent referral for more tests or to see a specialist in hospital, which does not definitely mean you have cancer. You will be supported by a team of specialists that includes a clinical nurse specialist, who is your main point of contact during and after treatment.

Some people choose to see a private urologist for a second opinion. The NHS and Cancer Research UK both signpost support: Macmillan Cancer Support has a free helpline, and Cancer Research UK has a nurse helpline.