Penis (penile) cancer may be rare, but so is our deep experience treating it. At Penn Medicine, you benefit from expertise that comes from treating a large number of cases. Your treatment plan includes the latest advances and reflects our intense desire to return you to your preferred lifestyle.
Types of penile cancer treatment
Penile cancer surgery is one of the most common treatments for cancer of the penis. The type of surgery you need depends on the type and size of the cancer and if it has spread.
Some males may also receive chemotherapy or radiation therapy (adjuvant therapy) after surgery to kill any remaining cancer cells.
Our experienced surgeons offer all surgical options for penile cancer, including:
Mohs surgery
Mohs surgery may be a good option for earlier stage cancer that hasn't grown deep into the penis tissue.
During Mohs surgery (Mohs micrographic surgery), your surgeons remove the penis tumor from the skin in layers. They examine each layer under a microscope. The procedure is over when they can't see any more cancer.
Mohs surgery allows your doctors to save a larger amount of healthy tissue around the penis tumor. This approach can help maintain your penis' appearance and function.
Circumcision
During a circumcision, doctors remove all or part of the penis foreskin. This procedure can cure cancer that is only on the foreskin.
Wide local excision
Wide local excision surgery removes cancer and some normal tissue around it (wide margins). Doctors remove the normal tissue to make sure they get all the cancer.
Penectomy (penis removal surgery)
For cancers that have grown deep in the penis tissue, a penectomy procedure can be an effective treatment. A total penectomy removes all of the penis and the penis' roots that go into the pelvis. A partial penectomy removes part of the penis.
Our surgeons put a focus on your quality of life after surgery. For this reason, they save as much of the penis as possible while removing cancer.
Perineal urethrostomy
If you have a total penectomy procedure, you will need a new way to urinate. Your surgeon will perform a perineal urethrostomy to create a new hole that allows urine to drain.
The new opening is located between the scrotum (the sack of skin that holds the testicles) and anus. It connects to the urethra, which drains urine from the bladder.
After a perineal urethrostomy, you still have control over when you urinate. You keep this ability because the urethra's sphincter muscle—its on-off switch—remains intact. But you will sit, not stand, during urination.
Lymph node surgery
You may need surgery to remove one or more lymph nodes if cancer could have spread beyond the penis. Our pathologists examine the tissue under a microscope to check for cancer (biopsy).
If any lymph nodes have cancer, your surgeon may perform an inguinal lymph node dissection (lymphadenectomy). When possible, our surgeons use minimally invasive robotic techniques for this procedure. These advanced methods help you experience:
- Less blood loss, complications and pain
- Shorter hospital stay
- Faster recovery
Chemotherapy uses drugs to slow or stop cancer's growth. We can treat some early-stage penile cancers with special chemotherapy creams you apply to the skin.
Other chemotherapy drugs work by attacking cancer cells throughout the body. Doctors call these drugs systemic chemotherapy. You may receive systemic chemo:
- Orally: You take pills or capsules by mouth.
- Intravenously (IV): We inject the medication into a vein.
- Intramuscularly (IM): We inject the medication into a muscle.
- Subcutaneously: We inject the medication under your skin.
Our medical oncologists personalize these medications to your health, the cancer and other factors. Their experience and expertise—along with input from the rest of our penile cancer team—helps them choose which drug or combination of drugs are best for you.
Doctors use radiation therapy alone or with other treatments to kill penile cancers. Radiation damages the DNA of cancer cells, causing them to die.
During a process called radiation simulation, we use advanced technology to model how your body will respond to different types of radiation. Then we can choose the treatment that will work best for you.
Our wide range of radiation therapy tools gives you access to the safest, most effective therapies available, including:
- Cyberknife®: Cyberknife is a type of high-dose radiation. Doctors use a robot that moves around you to precisely direct the treatment at the penis tumor. Cyberknife is not painful and does not require anesthesia or a hospital stay. Read more about Cyberknife.
- Image-guided radiation therapy (IGRT): IGRT uses real-time images during treatment to target tumors precisely and accurately. This process helps us spare healthy tissue. Learn about image-guided radiation therapy.
- Intensity-modulated radiation therapy (IMRT): IMRT uses computer technology and 3-D imaging scans to tailor the radiation dose to the size and shape of the tumor. This technology delivers higher radiation doses with less risk to surrounding healthy tissues. Find out more about intensity-modulated radiation therapy.
- Proton therapy: Proton therapy is a great option for tumors near organs and tissues sensitive to radiation. It also has high cure rates. Our radiation oncologists are among the world's experts in this special technology. Learn about proton therapy.
Some immunotherapies can treat penile cancers. Immunotherapy (also called biologic therapy) often has fewer side effects than conventional cancer treatments because it uses the body's own immune system to:
- Target specific cancer cells, which help prevent damage to normal cells
- Make cancer cells easier for the immune system to recognize and destroy
- Prevent or slow tumor growth and spread of cancer cells
Imiquimod is one immunotherapy drug that doctors use to treat penile cancer. Imiquimod comes in cream form, which you put on the affected skin over many weeks.
We can kill penile cancer cells using energy sources from light or extreme cold. Laser therapy destroys cancer cells with a laser beam. Cryosurgery (cryoablation and cryotherapy) freezes cancer cells to kill them.
These procedures are less invasive alternatives to traditional surgery. They are bloodless and cause less damage to the penis than other treatments.
Ablation therapy may be right for you if you have an earlier stage penile cancer that hasn't spread. Learn more about tumor ablation.