Tests for penile cancer
You usually have several tests to check for penile cancer. This might include all or some of the following:
- blood tests
- an examination of your penis and groin
- MRI or CT scans
- an ultrasound scan
biopsies 
Some of these tests might make you feel uncomfortable and embarrassed. Your GP or specialist will try to make you as comfortable as possible.
You can ask for someone else to be in the room with you if you want, to act as a chaperone. A chaperone can be a friend or relative, or a trained health professional such as a practice nurse or a specialist nurse. They can be with you during the test or examination.
Before any examination, your GP or specialist explain what they are going to do. Ask them if you are not clear about anything.
Tests your GP might do
Most people start by seeing their GP if they have symptoms. They can do some tests to help them decide whether you need a referral to a specialist. Your GP might do the following:
Examination of your penis
Your GP will examine your penis. Let them know if there are any sore areas. They may take a swab (sample) from any sore areas. They might feel the at the top of your legs to see if they feel swollen or harder than usual.
Blood tests
A blood test can check your general health, including how well your liver and kidneys are working. Your GP will also check the number of blood cells.
Tests your specialist might do
Depending on the results of your examinations, your GP may refer you to a specialist at the hospital. This is usually a . They will arrange further tests for you. These may include:
- a biopsy of the affected area
- MRI scan
- CT scan
- PET-CT scan
- ultrasound scan and fine needle aspiration of the lymph nodes
- sentinel lymph node biopsy
Biopsy
A biopsy means removing a sample of tissue from the affected area of the penis. You might have one of the following types of biopsy:
- an incisional biopsy, where the doctor uses a surgical knife (scalpel) to remove a small piece of the abnormal area
- a punch biopsy, where the doctor uses a small cutting device to remove a small piece of the abnormal area
- an excisional biopsy, where your doctor removes the whole of the abnormal area
You usually have your biopsy as a day patient. You don’t need any special preparation beforehand. Let the team know if you are taking any medicines.
Your doctor will talk you through what happens and ask you to sign a consent form. This is a good time to ask any questions or talk through any worries you might have.
You have a local anaesthetic injection into part of the penis, which numbs the area. Your specialist will make sure the area is numb before they start the biopsy.
Because of their symptoms, some people might find it too uncomfortable to have a biopsy with a local anaesthetic. In this situation you have a general anaesthetic . You might still be able to go home the same day, although some people might stay overnight.
After the biopsy, you have stitches in the area where the skin has been cut. The stitches usually dissolve on their own.
Your doctor sends the sample to a laboratory, where a looks at it under a microscope to see if the sample contains cancer cells.
MRI scan
An MRI is a scan that creates pictures using magnetism and radio waves. MRI scans produce pictures from angles all around the body and clearly show soft tissues. MRI stands for magnetic resonance imaging.
An MRI scan can show your doctor where the cancer is, how big it is and whether it has spread to the lymph nodes .
CT scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
You might have a CT to find out whether the cancer has spread.
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan. PET stands for positron emission tomography. The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal.
You might have a PET-CT scan to see where cancer is in the penis.
Ultrasound scan and fine needle aspiration of the lymph nodes (FNA)
An ultrasound scan is a procedure that uses high frequency sound waves to create a picture of a part of the inside of your body. A fine needle aspiration (FNA) is when your doctor uses a thin needle to take a sample of cells from a lymph node.
Your doctor examines your groin for swollen (enlarged) lymph nodes. You might then have an ultrasound scan to check the nodes in your groin.
If any of the lymph nodes look abnormal you have a FNA. Your doctor sends the sample of cells to the laboratory to check for cancer cells.
Dynamic sentinel lymph node biopsy
A dynamic sentinel lymph node biopsy is a test to find the first lymph node or nodes that penile cancer may spread to. The doctor then checks to see if this lymph node contains cancer cells. If there are no cancer cells in the sentinel node, it is unlikely that the cancer has spread to any other lymph nodes or elsewhere in the body.
It means that your doctor can avoid removing all the lymph nodes in the groin if this is not necessary.
You might have this test if there is no obvious sign that cancer cells have spread to the lymph nodes after:
- you have been examined by your specialist
- you have had an ultrasound scan
Not everyone with penile cancer needs a sentinel lymph node biopsy.
Treatment
The tests you have help your doctor find out if you have penile cancer and how far it has grown. This is the stage of the cancer.
This is important because doctors recommend your treatment according to the stage of the cancer.
Coping with penile cancer
Coping with a diagnosis of penile cancer can be difficult. There is help and support available to you and your family.
