Penile cancer: information & penile cancer specialists

Penile cancer mainly occurs in older men from the age of around sixty. According to the German Cancer Society, around 800 men are diagnosed with penile cancer every year. To improve early detection, men over the age of 45 can have an annual cancer screening by a urologist. Regular self-examination of the penis is also recommended.

Here you will find further information and selected penile cancer specialists and centers.

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Brief overview:

What is penile carcinoma? A malignant tumor that usually occurs on the foreskin of the penis or on the glans.
Types: The most common type is squamous cell carcinoma, less frequently basal cell carcinoma or malignant melanoma. Soft tissue tumors are very rare.
Risk factors: sebum under the foreskin, narrowing of the foreskin, changes in the mucous membrane, HPV infections and chronic inflammation. Also smoking and genital warts.
Symptoms: swelling or hardening of the foreskin or glans, slight bleeding or unpleasant smelling discharge. If metastases form in the groin area, lymphoedema can develop.
Diagnosis: A urologist usually recognizes the disease during a physical examination. A tissue sample confirms the suspicion and the spread can be examined more closely using imaging techniques (ultrasound, CT, MRI).
Treatment: The earlier treatment is started, the better the prospects. Complete surgical removal of the tumor is the best way to cure it. If necessary, chemotherapy and/or radiotherapy can be used.
Prevention: Careful hygiene, which prevents the build-up of sebum under the foreskin, is the best way to prevent it.

What is a penile carcinoma?

Penile carcinoma is a malignant tumor that most commonly occurs on the foreskin of the penis and the glans. If it spreads, penile cancer can also affect the erectile tissue and extend to the abdominal wall.

Penile cancer can occur in various forms :

malignant tumor of the skin (squamous cell carcinoma), most common form of penile cancer,
basal cell carcinoma (rare),
malignant melanoma and
soft tissue tumor (very rare).

The prognosis for penile carcinoma is good if it is detected at an early stage. Early treatment is then possible, which improves the chances of recovery.

Are there risk factors that favor the development of penile carcinoma?

The risk factors for the development of penile carcinoma are still largely unknown. However, certain factors are suspected of favoring the development of penile cancer:

Poor hygiene: sebum (smegma) can accumulate under the foreskin, which is carcinogenic in the long term.
Constricted foreskin(fimosis): Complete retraction of the foreskin and therefore adequate hygiene is not possible.
Mucosal changes: Leukoplakia as a precursor to squamous cell carcinoma. They appear as whitish changes and thickening of the mucous membrane.
HPV infections: Human papillomaviruses (HPV) are transmitted through sexual activity. The virus infection can become externally visible through a wart-like change in the genital skin.
Chronic inflammation: Especially chronic inflammation of the foreskin or glans.

The development of penile cancer is also facilitated by regular smoking and condyloma. This is a sexually transmitted disease that is also known as genital warts or genital warts.

Symptoms of penile cancer

There are no symptoms that are characteristic of penile cancer, especially in the early stages.

Instead, skin changes may occur. These are manifested by swelling or indurations that become visible on the foreskin or glans. Sometimes the skin changes also take on a cauliflower-like form.

There may be slight bleeding and sometimes an unpleasant-smelling discharge.

Sometimes penile carcinoma also leads to the formation of metastases in the lymph nodes in the groin area. This often results in lymph congestion in the legs. They swell and lymphoedema can develop.

What methods are used to diagnose penile cancer?

The urologist is responsible for diagnosing penile cancer. Based on his experience, he usually recognizes penile cancer during the physical examination.

The search for a diagnosis begins with a careful anamnesis, i.e. the patient interview. The medical history obtained during the consultation is followed by a physical examination.

The diagnosis is confirmed with the help of a tissue sample, also known as a biopsy, which is examined under a microscope.

If the suspicion of a penile carcinoma is confirmed, further examinations are carried out using imaging techniques, such as

Ultrasound (sonography): Painless and low-risk method in which the desired areas and internal organs are examined using ultrasound waves. Ultrasound is the most cost-effective imaging method and is usually very informative in itself.
Computed tomography (CT): Modern variant of X-ray examination. The patient is placed on an examination table and moved into the tube-shaped device. For the duration of the examination, the computer tomograph rotates around the patient and provides precise images of the desired body regions layer by layer. The images from the CT scanner are immediately visible on a monitor. This examination method is completely painless for patients.
Magnetic resonance imaging (MRI ): radiation-free and painless examination that provides a detailed image of the tissue and internal organs. During the examination, electrical signals from the body are measured and combined into images on the computer.

What treatment options are there?

The earlier the diagnosis is made, the sooner treatment can be started and the greater the chances of a cure.

The first treatment option is always surgery. This is especially true if the penile carcinoma has not yet metastasized. Ideally, the tumor can then be removed.

Only in exceptional cases is a complete penis amputation performed if no other option is available. If metastases are detected in the adjacent lymph nodes, these are also surgically removed.

Chemotherapy before surgery can be useful to shrink the tumor. It can also be used after the operation to remove spread metastases and prevent further spread.

Chemotherapy or radiotherapy are also necessary at an advanced stage of the cancer.

However, organ-preserving surgical therapy has become increasingly popular in recent years. This means that the aim of treatment today is to maintain the patient's quality of life and, above all, sexual satisfaction.

Are preventive measures possible?

It is possible to reduce certain risk factors for the development of penile cancer by adopting certain behaviors. These include, above all, careful hygiene. Men should regularly retract their foreskin and remove sebum from under the foreskin.

This can prove difficult for men who suffer from foreskin constriction. In this case, it makes sense to consult a urologist and have the constricted foreskin removed.