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CancerMail from the National Cancer Institute
Information from PDQ for Patients
Penile cancer
208/01082
** DESCRIPTION **
-- What is cancer of the penis? --
Cancer of the penis, a rare kind of cancer in the United States, is a disease
in which cancer (malignant) cells are found on the skin and in the tissues of
the penis.
Men who are not circumcised at birth may have a higher risk for getting cancer
of the penis. A circumcision is an operation in which the doctor takes away
part or all of the foreskin from the penis. The foreskin is the skin which
covers the tip of the penis. A circumcision is done on many baby boys before
they go home from the hospital.
A doctor should be seen if there are any of the following problems: growths or
sores on the penis, any unusual liquid coming from the penis (abnormal
discharge), or bleeding.
If there are symptoms of cancer, the doctor will examine the penis and feel for
any lumps. If the penis doesn't look normal or if the doctor feels any lumps,
a small sample of tissue (called a biopsy) will be cut from the penis and
looked at under a microscope to see if there are any cancer cells.
The prognosis (chance of recovery) and choice of treatment depend on the stage
of the cancer (whether it is just in the penis or has spread to other places),
and the patient's general state of health.
** STAGE EXPLANATION **
-- Stages of cancer of the penis --
Once cancer of the penis is found, more tests will be done to find out if the
cancer has spread from the penis to other parts of the body (staging). A
doctor needs to know the stage of the disease to plan treatment. The following
stages are used for cancer of the penis:
-- Stage I --
Cancer cells are found only on the surface of the glans (the head of the penis)
and on the foreskin (the loose skin that covers the head of the penis).
-- Stage II --
Cancer cells are found in the deeper tissues of the glans and have spread to
the shaft of the penis (the long, slender cylinders of tissue inside the penis
that contain spongy tissue and expand to produce erections).
-- Stage III --
Cancer cells are found in the penis and have spread to nearby lymph nodes in
the groin. (Lymph nodes are small bean-shaped structures that are found
throughout the body; they produce and store infection-fighting cells).
-- Stage IV --
Cancer cells are found throughout the penis and the lymph nodes in the groin
and/or have spread to other parts of the body.
-- Recurrent --
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the same area or in another place.
** TREATMENT OPTION OVERVIEW **
-- How cancer of the penis is treated --
There are treatments for all patients with cancer of the penis. Four kinds of
treatment are used:
- surgery (taking out the cancer in an operation)
- radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells and shrink tumors)
- chemotherapy (using drugs to kill the cancer cells)
- biological therapy (using the immune system to fight cancer)
Surgery is the most common treatment of all stages of cancer of the penis. A
doctor may take out the cancer using one of the following operations:
- Wide local excision takes out only the cancer and some normal tissue on
either side.
- Microsurgery is an operation that removes the cancer and as little normal
tissue as possible. During this surgery, the doctor uses a microscope to
look at the cancerous area to make sure all the cancer cells are removed.
- Laser surgery uses a narrow beam of light to remove cancer cells.
- Circumcision is an operation that removes the foreskin.
- Amputation of the penis is an operation that takes out the penis. It is
the most common and most effective treatment of cancer of the penis. In a
partial penectomy, part of the penis is taken out. In a total penectomy,
the whole penis is removed. Lymph nodes in the groin may be taken out
during surgery.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation may come from a machine outside the body
(external radiation) or from putting materials that contain radiation through
thin plastic tubes into the area where the cancer cells are (internal
radiation). Radiation may be used alone or after surgery.
Chemotherapy uses drugs to kill cancer cells. Fluorouracil cream (a
chemotherapy drug put on the skin of the penis) is sometimes used for very
small surface cancers of the penis. Chemotherapy may also be given by pill or
by a needle in a vein. When chemotherapy is given in this way, it is called a
systemic treatment because the drugs enter the bloodstream, travel through the
body, and can kill cancer cells outside the penis.
Biological therapy tries to get the body to fight cancer. It uses materials
made by the body or made in a laboratory to boost, direct, or restore the
body's natural defenses against disease. Biological treatment is sometimes
called biological response modifier (BRM) therapy.
-- Treatment by stage --
Treatment of cancer of the penis depends on the stage of the disease, the type
of disease, and the patient's age and overall condition.
Standard treatment may be considered because of its effectiveness in patients
in past studies, or participation in a clinical trial may be considered. Not
all patients are cured with standard therapy and some standard treatments may
have more side effects than are desired. For these reasons, clinical trials
are designed to find better ways to treat cancer patients and are based on the
most up-to-date information. Clinical trials are ongoing on in many parts of
the country for most stages of cancer of the penis. To learn more about
clinical trials, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237); TTY at 1-800-332-8615.
** STAGE I PENILE CANCER **
If the cancer is limited to the foreskin, treatment will probably be wide local
excision and circumcision.
If the cancer begins in the glans and does not involve other tissues, treatment
may involve:
- Fluorouracil cream
- Microsurgery
If the tumor begins in the glans and involves other tissues, treatment may
involve:
- Amputation of the penis (partial penectomy). Lymph nodes in the groin may
also be removed.
- External radiation therapy
- Microsurgery
Clinical trials of laser therapy for stage I penile cancer are also being
conducted.
** STAGE II PENILE CANCER **
Treatment may be amputation of the penis (partial, total, or radical penectomy)
or radiation therapy followed by amputation of the penis. Clinical trials of
laser therapy for stage II penile cancer are also being conducted.
** STAGE III PENILE CANCER **
Treatment may be amputation of the penis, followed by removal of lymph nodes on
both sides of the groin or amputation of the penis followed by radiation
therapy. Clinical trials of chemotherapy and chemotherapy with radiation
therapy are also being conducted.
** STAGE IV PENILE CANCER **
Treatment will be designed to reduce symptoms and may include wide local
excision, microsurgery, amputation of the penis, or radiation therapy.
Clinical trials of chemotherapy combined with surgery or radiation therapy are
also being conducted.
** RECURRENT PENILE CANCER **
If the cancer has come back (recurred), treatment may include amputation of the
penis or radiation therapy. Clinical trials of chemotherapy or biological
therapy are also being conducted.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a
clinical trial. A clinical trial is a study to answer a scientific question,
such as whether one treatment is better than another. Trials are based on past
studies and what has been learned in the laboratory. Each trial answers
certain scientific questions in order to find new and better ways to help
cancer patients. During treatment clinical trials, information is collected
about new treatments, the risks involved, and how well they do or do not work.
If a clinical trial shows that a new treatment is better than one currently
being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. Many cancer doctors who
take part in clinical trials are also listed in PDQ. For more information,
call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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