Further tests for penile cancer
Find out about the further tests you might need if you are diagnosed with cancer of the penis. There is information about
Further tests for penile cancer
When you are diagnosed with penile cancer, you need more tests to find the stage of the cancer. The stage means the size of the cancer and whether it has spread. Your specialist needs to know this before they can decide on the best treatment for you.
Scans and X-rays
You might have a CT scan of your chest and tummy (abdomen). This checks if the cancer has spread to other areas. An MRI scan can give a detailed picture of your penis and groin. Your doctor might use this to plan surgery. A PET-CT scan can show if cancer has spread to the lymph nodes close to the penis or elsewhere in the body.
Fine needle aspiration and sentinel lymph node biopsy
Your doctor might use an ultrasound scan to check for abnormal lymph nodes in the groin. To take a sample for testing, they put a needle into the lymph node and draw out some fluid and cells. They send it to the lab. Your doctor might use ultrasound to help guide the needle into the lymph node.
Sentinel nodes are the lymph nodes nearest to a cancer. If there are no cancer cells in the sentinel node, it is unlikely that the cancer has spread to any other lymph nodes. It is also unlikely that it has spread elsewhere in the body. Men who don’t have any obvious signs of cancer in the lymph nodes might have a sentinel lymph node biopsy. This avoids unnecessarily removing lymph nodes in the groin.
Waiting for results
It is normal to feel anxious while waiting for your test results. Talking to a friend or relative can help. Sometimes talking to someone outside your own friends and family can also help. We have information about counselling.
You can view and print the quick guides for all the pages in the diagnosing penile cancer section.
You might have a CT scan of your tummy (abdomen) and chest. This type of scan takes a series of X-rays from different angles. A computer uses the pictures to form a detailed picture of the inside of your body. This helps your doctor to see whether the cancer has spread elsewhere in the body, including the lymph nodes.
Find out more about having a CT scan.
You might have an MRI scan of your penis and groin. MRI scans use radio waves and strong magnets to give a detailed picture of the inside of your body. An MRI shows the body's soft tissues better than a CT scan. This can help your doctor plan surgery. MRI scans also check for signs of cancer in the lymph nodes close to the penis or elsewhere in your body.
Read about having an MRI scan.
Your doctor will examine your groin for swollen (enlarged) lymph nodes. They might also use an ultrasound scan to check the nodes. If any lymph nodes look or feel abnormal, your doctor will take a sample (biopsy) to check for cancer cells. This is called a fine needle aspiration (FNA).
Your doctor puts a needle into the lymph node and sucks out a sample of fluid and cells. They might use ultrasound to help guide the needle into the lymph node. Your doctor sends the sample to the lab. A pathologist looks at it under a microscope. If they find cancer cells, you will need to have your lymph nodes removed in an operation called a lymph node dissection. You usually have this at the same time as surgery to your penis.
Sentinel node biopsy is another type of test to find out if lymph nodes have any cancer cells inside them. You might have this test if there is no obvious sign that cancer cells have spread to the lymph nodes. This is to try and avoid removing lymph nodes in the groin unnecessarily.
Sentinel nodes are lymph nodes nearest to a cancer – the first place that cancer cells will reach if they spread. There might be one or more than one. If there are no cancer cells in the sentinel node, it is unlikely that the cancer has spread to any other lymph nodes. It is also unlikely that it has spread elsewhere in the body.
By testing the sentinel node, surgeons might be able to avoid removing all of the lymph nodes (lymph node dissection). They only need to remove all the lymph nodes if the sentinel node contains cancer cells. So testing the sentinel node can save on unnecessary surgery.
Your surgeon puts local anaesthetic cream on your penis. They then inject a small amount of radioactive fluid into the area around your cancer. The radioactive fluid drains away together with lymph (the fluid that circulates round body tissues) to the lymph glands. You then have a scan using a gamma camera to show up the radioactive material. This shows the lymphatic system and the sentinel nodes. The doctor marks these on your skin.
You then have an operation to remove the sentinel nodes. The surgeon injects blue dye around the tumour during the operation to show the drainage channels to the sentinel nodes. You have a 3 or 4cm wound in your groin where the surgeon removes the sentinel nodes.
If the doctor finds cancer cells in the sentinel node, they remove the rest of the lymph nodes in your groin. If they don't find cancer cells, you won’t need any more lymph nodes removed.
It is important that surgeons have special training before they can do sentinel node biopsies. So this test isn't available everywhere.
A PET-CT scan is a combination of a PET scan and a CT scan. A PET-CT scan takes CT pictures of the inside of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines this information. Your doctor can see any changes in the activity of cells and know exactly where the changes are happening.
You might have a PET-CT scan to check for any cancer cells in the lymph nodes close to the penis or elsewhere in your body. PET-CT scans are not available in every hospital so you may need to travel to have one.
Your doctor will ask you to go back to the hospital for your test results. This might take a week or so. It is normal to feel anxious during this time.
While you are waiting for results, it can help to talk to a close friend or relative about your feelings. Sometimes talking to someone outside your own friends and family also helps.
Find out about organisations that support men with penile cancer.
Many men find that counselling helps them to cope with cancer. Find out about about counselling.
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