Understanding Penile Cancer
Penile cancer is a rare but serious cancer that starts in the skin or deeper tissues of the penis. It most often affects men in their 50s, 60s or older, but can occasionally occur earlier as well. In many cases, it begins as small, subtle changes on the surface of the penis – a patch, sore, growth, or persistent redness – which may not hurt and are easy to ignore or mislabel as “infection” or “allergy.”
Because the penis is such a private and sensitive part of the body, many men feel shy, embarrassed or afraid to show a doctor early on. As a result, diagnosis is often delayed. The reality is that earlier detection usually means simpler treatment, better chances of cure, and more options for preserving function and appearance.
Penile cancer is most commonly a type of skin cancer called squamous cell carcinoma. It can grow locally and may spread to nearby lymph nodes in the groin, and in advanced stages to other organs. The good news: when recognised and treated early at a specialised centre, many cases can be managed effectively with organ-sparing options.
What is Penile Cancer?
In simple terms, penile cancer is an abnormal, uncontrolled growth of cells in the tissues of the penis. Most often, it starts in the thin layer of skin covering the head (glans), foreskin, or shaft. Over 90–95% of cases are squamous cell carcinomas, meaning they arise from the flat cells that line the surface of the penis.
Penile cancer can begin as:
- A superficial lesion limited to the top skin layers (carcinoma in situ / PeIN)
- A small, warty or ulcer-like growth
- A patch of red, white, or velvety skin that doesn’t heal
If not treated, these abnormal cells can grow deeper into the tissues, involve the erectile bodies, and spread to lymph nodes or distant organs. Understanding the basics of penile cancer helps men recognise that any persistent change on the penis deserves medical attention – it is always better to be told “this is harmless” than to find out late that it was not.
Recognizing Penile Cancer Symptoms
Being aware of penile cancer symptoms can make a big difference in catching it early. Not every change means cancer, but persistent or progressive symptoms should never be ignored. Common signs of penile cancer may include:
- A sore or ulcer that doesn’t heal
- May be on the glans, foreskin or shaft
- Can be painless or mildly painful
- May bleed, ooze or crust over
- A lump, growth, or thickened area of skin
- Can look warty, cauliflower-like, or flat
- Sometimes mistaken for an STI or “wart” that keeps recurring
- Red, velvety, or discoloured patches
- Persistent reddish, whitish or brown patches that don’t go away with creams or basic treatment
- Foul-smelling discharge under the foreskin
- Especially in uncircumcised men
- May be associated with itching, irritation or swelling
- Tight foreskin (phimosis) that becomes worse
- Inability to retract the foreskin, especially if new or associated with lesions underneath
- Pain, tenderness or swelling of the penis
- Swollen lymph nodes in the groin
- Firm, painless lumps in the groin region may indicate spread to regional lymph nodes
Remember: infections and other benign conditions can cause similar symptoms. However, if any of these signs of penile cancer persist for more than 2–3 weeks, or keep coming back, it is strongly advisable to see a urologist or oncologist.
Early Warning Signs to Watch For
Early penile cancer can be subtle. Key red flags include:
- A small, persistent spot or patch
- Red, white or slightly raised, which doesn’t respond to usual creams
- Mild itching, burning or irritation on the glans or foreskin
- Especially if local treatment doesn’t fully clear it
- Tiny warty or crusted lesions
- That recur or slowly increase in size
- Unusual odour or discharge under the foreskin
- Even without obvious pain
- New difficulty retracting the foreskin
- Particularly if shrinking or scarring of the opening is seen
These early penile cancer symptoms are often painless, which is why they are easy to dismiss. Any persistent change that feels “not normal” for you is worth a professional opinion.
Exploring the Causes of Penile Cancer
There is no single cause of penile cancer, but research has identified key penile cancer causes and patterns. The disease is more common in regions with lower hygiene standards and limited access to healthcare, and tends to affect uncircumcised men more frequently.
One of the strongest modern risk factors is chronic infection with high-risk human papillomavirus (HPV), especially types 16 and 18 – the same viruses linked to cervical and some throat cancers. Another major factor is phimosis, where the foreskin cannot be fully retracted, leading to chronic irritation and infections.
Other contributors include poor genital hygiene, long-standing inflammation (balanitis, lichen sclerosus), smoking, multiple sexual partners, and low socio-economic status.
Importantly, having one or more risk factors does not mean you will definitely develop penile cancer. But understanding risk factors for penile cancer allows men to make informed choices: practicing safer sex, quitting tobacco, maintaining good genital hygiene, and seeking early care for persistent foreskin or skin issues.
Key Risk Factors
Some of the more important causes of penile cancer and high-risk features are:
- Persistent high-risk HPV infection
- Especially HPV 16 and 18
- Linked to a significant proportion of penile cancers
- Phimosis (tight foreskin)
- Strongly associated with invasive penile cancer
- Leads to trapped secretions and chronic inflammation
- Poor genital hygiene
- Irregular cleaning under the foreskin can allow smegma, infections, and irritation to persist
- Smoking and tobacco use
- Tobacco carcinogens and HPV together increase risk significantly
- Chronic inflammatory conditions
- Such as balanitis xerotica obliterans (lichen sclerosus) and recurrent infections
- Multiple sexual partners / unprotected sex
- Increases chance of HPV and other sexually transmitted infections>
- Low socio-economic status and late healthcare access
- Awareness and prevention strategies around these factors can meaningfully reduce risk at a population level.
Types of Penile Cancer
When we talk about types of penile cancer, we are mostly talking about different forms of squamous cell carcinoma, plus a few rarer tumours. More than 95% of penile cancers worldwide are squamous cell carcinomas (SCC). These can be further subtyped based on how the cells look under the microscope: usual type, warty, basaloid, verrucous, papillary, etc. Some of these are linked more strongly to HPV, while others are more related to chronic inflammation and phimosis.
In addition to invasive cancers, there are pre-cancerous conditions like penile intraepithelial neoplasia (PeIN) or carcinoma in situ (CIS), where abnormal cells are limited to the top layer of the skin. Detecting and treating these early changes can prevent progression to deeper, invasive cancer.
Rarely, other tumour types can arise in the penis, such as melanoma, sarcoma, basal cell carcinoma, or metastases from cancers elsewhere in the body. Each behaves differently and needs a tailored approach. Overall, accurate classification by an experienced pathologist is crucial because it guides prognosis and treatment choices.
Squamous Cell Carcinoma
Squamous cell penile cancer is the most common form, arising from the squamous (flat) cells on the surface of the glans, foreskin, or shaft. It can start as a persistent ulcer, warty growth, plaque, or red area. Some subtypes – such as warty and basaloid carcinomas – have a stronger association with HPV infection, whereas others are more linked with chronic foreskin problems and inflammation.
If caught early, SCC may be managed with local treatments, laser, or limited surgery. However, if it grows deeper into the erectile tissues or spreads to lymph nodes, more extensive surgery (including partial or total penectomy) and lymph node treatment may be needed.
Because SCC is so dominant among types of penile tumours, most guidelines, staging systems, and treatments are designed around it.
Other Rare Types
Rare penile cancers include:
- Melanoma of the penis – arising from pigment-producing cells; can be aggressive and requires melanoma-specific management.
- Sarcomas – such as leiomyosarcoma or other soft tissue sarcomas of the penis; these arise from connective tissues and are treated more like sarcomas elsewhere.
- Basal cell carcinoma – a usually slow-growing skin cancer that rarely spreads but can cause local damage if neglected.
These uncommon tumours require evaluation at a centre with experience in melanoma and sarcoma of the penis, often with a multidisciplinary team.
Understanding Penile Cancer Stages
Staging describes how far penile cancer has spread. The most commonly used system is based on TNM (Tumour, Nodes, Metastasis). Here is a simplified overview, combining stage groupings often used in practice:
Stage |
Typical TNM Pattern* |
What it Usually Means |
|
Stage 0 (Carcinoma in situ / PeIN) |
Tis or Ta, N0, M0 |
Abnormal cells are limited to the top layer of skin; no spread to lymph nodes or distant organs. |
|
Stage I |
T1a, N0, M0 |
Tumour has grown just below the surface into subepithelial tissue, but without high-risk features (no lymph/vascular invasion, not high grade). No node or distant spread. |
|
Stage II |
T1b or T2–T3, N0, M0 |
Tumour has grown into deeper tissues like the corpus spongiosum or corpus cavernosum, and/or has high-risk features, but lymph nodes and distant organs are still clear. |
|
Stage IIIA |
T1–T3, N1, M0 |
Tumour may be superficial or deep, and cancer has spread to 1–2 lymph nodes in the groin on one side, but not beyond. |
|
Stage IIIB |
T1–T3, N2, M0 |
Similar primary tumour, but spread to multiple or bilateral groin lymph nodes (3 or more, or both sides). No distant spread. |
|
Stage IV |
T4, any N, M0 / any T, N3, M0 / any T, any N, M1 |
Tumour invades nearby structures (scrotum, prostate, pubic bone), and/or has spread extensively to pelvic nodes, and/or has distant metastasis (lungs, liver, etc.). |
*Actual TNM details are more complex; your doctor will explain your exact stage.
TNM Staging System Explained
The TNM staging for penile cancer breaks things down into three main components: oncolink.org+1
- T (Tumour) – How deep and far the primary tumour has grown in the penis
- Tis/Ta: confined to surface layers
- T1: into subepithelial tissue
- T2: into corpus spongiosum
- T3: into corpus cavernosum
- T4: into nearby organs (scrotum, prostate, pubic bone)
- N (Nodes) – Whether nearby lymph nodes (especially in the groin) are involved, and how many
- M (Metastasis) – Whether cancer has spread to distant organs (lungs, liver, etc.)
The combination of T, N, and M helps doctors plan treatment: from local therapies at early stages to more extensive surgery and systemic treatment in advanced stages.
Diagnosis at Onco Life Cancer Centre
At Onco Life Cancer Centre, penile cancer diagnosis is approached with medical thoroughness and emotional sensitivity. We understand that this is an intimate, anxiety-provoking issue, and we prioritise privacy and respectful communication.
Diagnosis typically includes:
- Detailed history and examination
- Discussing symptoms, duration, sexual history, infections, smoking, HPV vaccination status, etc.
- Gentle local examination of the penis and groin lymph nodes.
- Imaging tests
- Ultrasound and/or MRI of the penis to assess depth of invasion.
- Ultrasound/CT of groin and pelvis to assess lymph nodes and possible spread.
- Biopsy of the lesion
- A small tissue sample taken under local or regional anaesthesia to confirm the type of penile cancer and grade.
- Additional tests
- Blood tests, sometimes chest imaging or PET-CT in Satara, depending on stage and planned treatment.
All findings are then discussed in a multidisciplinary setting so that how penile cancer is diagnosed directly and efficiently leads into a clear, personalised treatment plan.
Treatment Approaches for Penile Cancer
Penile cancer treatment has two main goals: control the cancer and preserve as much function and appearance as safely possible. The exact plan depends on stage, tumour location, grade, and the patient’s overall health. At Onco Life Cancer Centre, we use a “leaflet-style” approach to explain options:
1. Organ-Sparing Treatments (Early Disease)
- Topical therapies or laser for some carcinoma in situ / PeIN cases
- Limited local excision, glansectomy, or reconstructive procedures for small, well-localised tumours
- Careful margin assessment to balance cancer control and tissue preservation
2. Surgical Management (Invasive Disease)
- Partial penectomy – removal of the involved part of the penis while keeping a functional stump when safe
- Total penectomy – reserved for more advanced disease when organ-sparing is not oncologically safe
- Lymph node surgery – sentinel node biopsy or inguinal lymph node dissection when nodes are involved or at high risk
3. Radiotherapy
- External beam radiation or brachytherapy in selected early-stage cases
- Used as an alternative to surgery in some patients or as adjuvant (post-surgery) therapy in node-positive disease
4. Systemic Therapies
- Chemotherapy – for advanced or metastatic penile cancer, often combined with surgery/radiation in multimodal treatment
- Targeted and immunotherapy – evolving options in clinical trials and selected patients
5. Supportive and Psychosexual Care
- Wound care, pain management, and rehabilitation
- Psychological counselling, sexual counselling, and partner support to address emotional and relationship impacts
The best penile cancer treatment is the one that gives the highest chance of cure while respecting the patient’s dignity, sexual health, and quality of life.
Why Choose Onco Life Cancer Centre for Penile Cancer Treatment?
Onco Life Cancer Centre offers a focused, team-based approach to managing penile cancer, combining urologic oncology, radiation oncology and medical oncology expertise under one roof. Our clinicians are familiar with both common and rare presentations of penile cancer and follow evidence-based international guidelines tailored to Indian realities.
Key strengths include:
- Multidisciplinary tumour board discussions for all complex cases
- Access to advanced imaging, pathology and reconstructive surgical techniques
- Meticulous lymph node evaluation and management, which is crucial for outcomes
- Emphasis on organ preservation whenever oncologically safe
- Strong focus on privacy, counselling, and long-term follow-up
- Being a dedicated cancer centre, we also integrate palliative care, psychological support and survivorship planning. For men and families facing penile cancer, this means care that is technically sound, emotionally sensitive and respectfully communicated.
To make it easier for patients to connect with our experts, please see the details of our key specialists below:
Specialists & Consultation |
Frequently Asked Questions (FAQ)
Blog-Penile Cancer: Types, Stages & Expert Care in India
Is Penile Cancer Common In Younger Men?
Penile cancer is generally uncommon and usually affects older men, typically above 50–60 years. However, it can occasionally occur in younger men, especially if strong risk factors like high-risk HPV infection, phimosis or chronic inflammation are present. Any persistent lesion on the penis at any age should be checked.
Can Hpv Cause Penile Cancer?
Yes. Persistent infection with high-risk HPV types (especially 16 and 18) is one of the most important risk factors for penile cancer. HPV vaccination, safer sex practices and regular care of foreskin problems can help reduce this risk.
What Is The Survival Rate For Penile Cancer?
Survival depends heavily on the stage at diagnosis, lymph node involvement, and tumour grade. Early-stage cancers limited to the penis, with no lymph node spread, often have good long-term outcomes when treated appropriately. Advanced disease with nodal or distant spread has a more guarded prognosis. Your oncologist can give stage-specific figures based on your individual case.
How Can I Prevent Penile Cancer?
While not all cases are preventable, you can lower your risk by:
- Practising good genital hygiene
- Getting treatment for phimosis and chronic foreskin problems
- Avoiding tobacco
- Practising safer sex and considering HPV vaccination (where eligible)
- Regular self-checks and early consultation for any persistent change are equally important.
What Are The Psychological Impacts Of Penile Cancer?
Penile cancer can affect body image, masculinity, sexual function and relationships. Feelings of fear, shame, anger or depression are common and completely understandable. Psychological support, sexual counselling and open communication with partners can be extremely helpful. At a centre like Onco Life, these aspects are considered an essential part of care, not an afterthought.
Are There Any Clinical Trials For Penile Cancer In India?
Because penile cancer is rare, clinical trials are fewer than for more common cancers. However, some centres and collaborative groups do run studies on new chemotherapy, targeted therapies or combined treatments. Your oncologist at Onco Life can check current options and, if appropriate, help you explore trial participation at our centre or through referral networks.
Note: This information is meant for education and awareness. It does not replace a consultation with a qualified doctor. If you notice any persistent changes in the penis, please seek medical advice promptly.
