Types and grades of penile cancer

The type of penile cancer you have depends on the type of cell that the cancer started in. Knowing this helps your doctor decide which treatment you need.

Your doctor takes a tissue sample (biopsy) and sends it to a laboratory where a pathologist Open a glossary item examines it closely. The cells of each type of penile cancer look different under a microscope.

Squamous cell cancer

More than 95 out of 100 penile cancers (more than 95%) are squamous cell cancer. So it is the most common type. These cancers develop from squamous cells which are flat, skin like cells that cover the surface of the penis. They can develop anywhere but the most common sites are the head of the penis (glans) or the foreskin (in uncircumcised men).

This type generally grows slowly over many years, but occasionally it can grow more quickly. The cells might go through pre cancer changes before squamous cell cancer develops.

Squamous cell cancers that are found early are usually curable. 

Verrucous carcinoma is a rare type of squamous cell penile cancer. It looks like a large wart and is a slow growing tumour that rarely spreads to other parts of the body. Verrucous carcinoma is usually curable with surgery.

Other types

The remaining 10 out of 100 (10%) penile cancers are made up of the following types:

Sarcoma

Sarcomas are cancers that develop in the body’s connective tissues that form the structure of the body, such as bone, muscle, fat and cartilage. Sarcomas of the penis are extremely rare but they tend to grow more quickly than other types of penile cancer.

Basal cell cancer

Basal cell cancers develop from basal cells found in the deepest layer of the skin. They develop mostly in areas exposed to the sun but can develop in other places. This type of cancer is very slow growing and very rarely spreads to other parts of the body. 

Melanoma

Melanomas develop from the cells in the skin that give the skin its colour. Although melanomas usually develop in areas that are exposed to the sun, a few develop in places that are not generally directly in the sun. 

Adenocarcinoma

Adenocarcinomas are cancers that develop in gland cells that produce sweat in the skin of the penis. These are very rare.

Grades of penile cancer

The grade of a cancer tells you how much the cancer cells look like normal cells.

The grade gives your doctor an idea of how the cancer might behave and what treatment you need. Squamous cell cancers are graded by the World Health Organisation (WHO) classification system. Here we describe the grading of squamous cell cancers.

Low grade cancers usually grow very slowly. High grade cancers tend to grow more quickly.

  • Grade X means the grade can't be assessed
  • Grade 1 (low grade) cancer cells look very like normal cells
  • Grade 2 cancer cells look a bit like normal cells
  • Grade 3 (high grade) cancer cells look very abnormal and not like normal cells

Some cancers look extremely abnormal. Doctors might call them undifferentiated Open a glossary item. They are sometimes described as grade 4.

  • Cancer: Principles and Practice of Oncology (12th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Wolters Kluwer, 2023

  • EAU-ASCO Collaborative Guidelines on penile cancer 
    O R Brouwer and others 
    European Association of Urology, 2023 and American Society of Clinical Oncology 

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • Textbook of Penile Cancer
    A Muneer and S Horenblas (editors)
    Springer-Verlag, 2016

Last reviewed: 
23 Jan 2024
Next review due: 
23 Jan 2027

Related links