Types of treatment for cancer of the penis
Find out how doctors plan treatment for penile cancer (cancer of the penis) and read about the main treatments. You can find out about
Treating cancer of the penis
The National Institute for Health and Care Excellence (NICE) recommends that anyone with penile cancer sees a specialist team. Because it is a rare cancer, the specialist might not be at your nearest hospital. When planning your treatment your specialist will take into account the type and size of the cancer, your general health, your age, and the stage and grade of your cancer.
Treating carcinoma in situ (CIS)
This is the earliest stage of penile cancer. The cancer cells are only in the top layers of skin of the penis, and haven't spread anywhere else. Some doctors call them pre cancerous cell changes. Treatments for CIS aim to keep the penis looking and working normally. You might have creams or other treatments such as laser therapy or cryotherapy.
Treatments for penile cancer
For penile cancer that is not in the very earliest stage, you might have surgery, radiotherapy or chemotherapy. You may need just one or a combination of treatments. Surgery is usually the main treatment.
You can view and print the quick guides for all the pages in the treating penile cancer section.
This is the earliest stage of penile cancer. The cancer cells are only in the top layers of skin of the penis and haven't spread anywhere else. These are really pre cancerous cell changes. Doctors might also call it penile intraepithelial neoplasia (PIN).
There are various treatments to treat penile CIS. These aim to keep the penis looking and working normally.
The treatment you have will depend on
- what you prefer
- what your doctor thinks is best for your type of cancer
- which treatments are available at your hospital.
You might have creams or other treatments.
Your doctor might suggest a cream to treat the affected area. This may be chemotherapy cream, such as fluorouracil (5FU). Or it could be a cream called imiquimod. Imiquimod uses the immune system to fight cancer.
You might have laser therapy to the affected area. Some doctors use cryotherapy. Or you might have an operation to remove the top layers of tissue from the glans or tip of the penis. The area is then covered with a skin graft. This is called glans resurfacing.
Find out more about these surgical treatments for penile cancer.
The treatment you need depends on the stage and grade of the cancer. Surgery is the most common treatment. You might have surgery alone or a combination of other treatments.
These cancers have grown below the skin of the penis but not into deeper layers.
If the cancer is only in the foreskin you might have removal of the foreskin (circumcision). Treatment options for cancers elsewhere on the penis include the following
- removal of the cancer and a surrounding area of tissue (wide excision)
- removal of part of the penis (partial penectomy)
- radiotherapy to the penis
- laser treatment
These cancers have grown deep into the tissues of the penis or the tube that takes urine through the penis (the urethra). They have not spread to nearby lymph nodes.
You usually have removal of part of the penis or removal of the whole penis. You might also have radiotherapy.
Some men have radiotherapy first and then surgery if some cancer cells remain afterwards.
Your doctor might check the lymph nodes in your groin with a test called sentinel lymph node biopsy) to see if cancer cells have spread there.
Find out about sentinel lymph node biopsy.
Or your surgeon might remove the lymph glands.
Find out about removing the lymph glands.
Stage 3 penile cancers have spread to nearby lymph nodes in the groin. The main cancer might have grown into the deeper tissues of the penis (the corpus spongiosum or corpus cavernosum) or the urethra. But it has not grown into nearby structures such as the bladder or prostate gland.
You usually have removal of part of the penis or removal of the whole penis. Some men have chemotherapy or chemotherapy with radiotherapy before surgery. These treatments shrink the cancer so the surgeon can remove it more easily.
You also have treatment for the lymph glands in the groin. You might have the glands removed with surgery (lymphadenectomy). Or you may have radiotherapy to the groin nodes. If you have surgery you might have radiotherapy afterwards.
If the lymph nodes are very large you might have chemotherapy (with or without radiotherapy).
Stage 4 cancers have spread into nearby organs, beyond nearby lymph glands, or into organs or lymph glands further away from the penis.
For cancers that have spread into nearby tissues, such as the prostate, bladder, scrotum, or abdominal wall, you usually have surgery. You might need to have removal of the whole penis and removal of other affected areas. The surgeon makes a new opening in the abdomen or the perineum (space between the scrotum and anus) so that urine can drain. Some men have chemotherapy (sometimes with radiotherapy) before surgery to try to shrink the tumour and make it easier to remove.
Your surgeon will remove the lymph nodes in your groin (inguinal nodes) on both sides. Afterwards you might also have radiotherapy to that area, unless you had it before surgery.
For cancers that have spread beyond the nearby lymph nodes or to lymph nodes in the pelvis, you usually have surgery. The surgeon removes the whole penis and the lymph nodes in the groin on both sides. They remove the lymph nodes inside the pelvis if they are enlarged or feel hard. You might have radiotherapy to the lymph node areas to try to kill any cancer cells that might be left behind. Some men also have chemotherapy.
For cancers that have spread to distant organs and tissues, surgery or radiotherapy can't get rid of the cancer completely. Treatment aims to keep the cancer under control and prevent or relieve symptoms. You might have surgery to remove as much of the cancer in the penis as possible. Or you might have radiotherapy to shrink the cancer.
You might have surgery or radiotherapy (sometimes with chemotherapy) to treat lymph nodes close to the penis. Radiotherapy may also help to treat areas of cancer in other parts of the body, such as the bones, brain or spinal cord. Chemotherapy can help to treat cancer that has spread to the lungs or liver.
Find out more about these treatments
Treatment depends on where the cancer comes back and which treatment you had before.
For cancers that come back in the penis, you might need further surgery to remove the cancer cells. The surgery might be followed by radiotherapy.
For cancers that come back in the lymph nodes, you might have surgery to remove the nodes, Radiotherapy or chemotherapy may also be options for some men.
For cancers that come back in other parts of the body, you might have chemotherapy or radiotherapy.
The National Institute for Health and Care Excellence (NICE) recommends that anyone with penile cancer sees a specialist team. Because it is a rare cancer, the specialist might not be at your nearest hospital. You may have to travel to see them.
There are a number of factors that help your specialists plan your treatment, including
- the type and size of the cancer
- whether the cancer has spread (the stage)
- what the cancer cells look like under the microscope (the grade)
- your general health
- your age
You might find that other men you meet with penile cancer are having different treatment to you. This may be because some of the factors above are different.
Ask your doctor or nurse any questions you have about your treatment. It helps to make a list of questions you want to ask. Take a close friend or relative with you when you go to the doctor. They can help you to remember the information.
Check our list of questions you can ask your doctor about treatment.
Some people want to get an opinion from another doctor before they decide about their treatment. If you would like a second opinion, you can ask your specialist or your GP. It can be better to arrange this through your specialist because all your notes and test results can go to the appointment with you.
Note that a second opinion doesn't always mean that the second doctor will take over your care. Your original specialist may still manage your treatment.
Question about cancer? Contact our information nurse team