Staging penile cancer | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter
 

A quick guide to what's on this page

Staging penile cancer

The staging of a cancer means how far it has grown or spread. Staging helps your doctor to decide on the best treatment for you.

The TNM and number staging systems

There are different ways of staging cancers. The two main ones are the TNM system and the number system.

TNM stands for Tumour, Node, Metastasis. The T gives information about the size of the tumour. The N tells you if there are any cancer cells in the lymph nodes. The M tells you if the cancer has spread to other parts of body away from the penis. The doctor gives each a number. So a small cancer that hasn’t spread is T1, N0, M0.  A cancer that is larger and has spread is T3, N1, M1.

The number staging system has four stages. Stage 1 is an early cancer that hasn’t spread elsewhere. Stage 2 means that the cancer is larger but hasn’t spread. Stage 3 is when there are cancer cells in the lymph nodes. Stage 4 means that there are cancer cells in the lymph nodes and the cancer might have spread to other parts of the body.

What is grade?

The grade of a cancer means how similar cancer cells are to normal cells when looked at under a microscope. In general, the more they look like normal cells, the lower the grade. A low grade cancer usually grows slowly. A high grade cancer might grow more quickly and is more likely to spread.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating penile cancer section.


 

 

What staging is

You have tests and scans to diagnose your cancer. Further tests tell doctors about the stage of your cancer. The stage means how far a cancer has grown or spread. Staging helps your doctor to decide on the best treatment for you.

 

What penile cancer grade means

The grade of a cancer means how similar cancer cells are to normal cells when looked at under a microscope. The general rule is the more a cancer cell looks like a normal cell, the lower the grade. The less it is like a normal cell, the higher the grade.

Knowing the grade of your cancer gives your doctor an idea of how it is likely to behave. Low grade cancers usually grow very slowly. High grade cancers tend to grow more quickly. 

  • Gx means the grade can't be assessed
  • G1 means the cells look very like normal cells – they are called well differentiated or low grade
  • G2 means the cells look unlike normal cells – they are called moderately differentiated
  • G3–4 means the cells look very abnormal – they are called poorly differentiated/undifferentiated or high grade
 

The different staging systems

There are different ways of staging cancers. The two main ones are the TNM system and the number system.

Cancer staging can be hard to understand. Ask your doctor if you have questions about the stage of your cancer.

Check our list of questions for your doctor.

 

TNM staging of cancer of the penis

TNM stands for Tumour, Node, and Metastasis. It gives information on

  • The size of the primary tumour (T)
  • Whether there are lymph nodes containing cancer cells (N)
  • Whether the cancer has spread to a different part of the body (M)

The size of the primary tumour (T)

The different T stages are

  • TX – the tumour can't be assessed
  • T0 – no evidence of a tumour
  • Tis or carcinoma in situ – this is the earliest stage of penile cancer and the cancer cells are only in the top layers of the skin
  • Ta – the cancer is wart-like or verrucous in the top layers of the skin
  • T1a – the tumour has grown into the tissue below the top layers of skin but has not grown into the blood or lymph vessels and is not Grade 3 or 4
  • T1b – the tumour has grown into the tissue below the top layers of skin, as well as the blood and lymph vessels OR is Grade 3 or 4
  • T2 – the tumour has grown into the spongy erectile tissue of the penis
  • T3 – the tumour has grown into the urethra
  • T4 – the tumour has grown into the nearby body parts such as the prostate gland

Whether lymph nodes contain cancer cells (N)

The N stage refers to whether any lymph nodes (glands) contain cancer cells.

  • NX – nearby lymph nodes can't be assessed
  • N0 – cancer cells have not spread to nearby lymph nodes
  • N1 – cancer cells have spread to one lymph node in the groin (inguinal)
  • N2 – cancer cells have spread to several groin lymph nodes OR to lymph nodes in both groins
  • N3 – cancer cells have spread to lymph node(s) in one or both sides of the pelvis OR the cancer cells in a nearby lymph node have grown into surrounding tissues

Whether the cancer has spread to a different part of the body (M)

The M stage refers to any spread of the cancer (secondary cancers or metastases) to other organs in the body.

  • M0 – cancer cells have not spread to tissues or organs in other parts of the body
  • M1 – cancer cells have spread to tissues and organs in other parts of the body, such as the liver, lungs or bones or to lymph nodes outside the pelvis
 

The number staging system

Occasionally doctors use a number system to stage your cancer. These usually have a scale of 1 to 4.

Stage 1

The cancer has grown into the tissue below the top layers of the skin of the penis. It hasn’t grown into the blood or lymph vessels. The cancer is not high grade.

Stage 2

The cancer has grown into the tissue below the top layers of the skin, as well as the blood and lymph vessels. It might have grown into the spongy erectile tissue or the urethra or both. The cancer might also be high grade.

Stage 3 has two stages

  • Stage 3a means the cancer involves the penis and one lymph node in the groin (inguinal). The cancer cells haven't spread to tissues or organs in other parts of the body.
  • Stage 3b means the cancer involves the penis and has spread to several groin lymph nodes. It might also have spread to lymph nodes in both groins. It has not spread to tissues or organs in other parts of the body.

Stage 4 can be any of the following

  • The cancer has grown into a body part near the penis such as the prostate gland. It might not have spread to any lymph nodes OR might have spread to lymph nodes in the pelvis OR has spread to one nearby lymph node and has grown through the outer layer of the lymph node into the surrounding tissue. It hasn't spread to tissues or organs in other parts of the body.
  • The cancer has spread to one or more lymph nodes in one or both sides of the pelvis OR has grown through the outer layer of a nearby lymph node into the surrounding tissue. It has not spread to tissues or organs in other parts of the body.
  • The cancer might have spread into lymph nodes and it has spread to tissues and organs in other parts of the body, such as the liver, lungs or bones.
Rate this page:
Submit rating

 

Rated 5 out of 5 based on 10 votes
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 4 April 2016