Penile cancer is an uncommon cancer that nearly always starts in the skin of the foreskin or the head of the penis. Almost all cases are squamous cell carcinomas. It mostly affects men over 50, though younger men can develop it.
Embarrassment causes many men to wait months before seeking help, and delay is the main reason treatment becomes more extensive. When found early, the cancer can usually be treated while preserving the appearance and function of the penis. Whether the groin lymph nodes are involved is the most important factor in planning treatment.
Symptome
- A sore, ulcer or lump on the penis that has not healed within 4 weeks
- A red, velvety or scaly patch on the glans or under the foreskin
- Thickening or a change in colour of the skin
- Bleeding or foul-smelling discharge from under the foreskin
- A foreskin that has become tight and cannot be pulled back, hiding the area
- A lump in the groin
Ursachen und Risikofaktoren
Around half of cases are linked to high-risk HPV infection. Other risk factors are a tight foreskin (phimosis) with chronic inflammation, poor hygiene under the foreskin, smoking, lichen sclerosus, a weakened immune system including HIV, and past PUVA light treatment for psoriasis. Circumcision in infancy is strongly protective, mainly by preventing phimosis. HPV vaccination is expected to lower the number of cases over time. Precancerous changes, called penile intraepithelial neoplasia, can be treated before invasive cancer develops.
Wie es diagnostiziert wird
- Examination and biopsy: A specialist examines the penis and groins, and a small sample taken under local anaesthetic confirms the diagnosis and grade.
- MRI or ultrasound of the penis: Shows how deeply the tumour extends when organ-sparing surgery is being planned.
- Assessment of groin nodes: Ultrasound with needle sampling of any enlarged nodes. When the nodes feel normal but the tumour carries risk, dynamic sentinel node biopsy identifies hidden spread with less morbidity than full dissection.
- CT or PET-CT: Used when groin nodes are involved, to check the pelvis and beyond.
Behandlungsmöglichkeiten
- Topical treatment and laser: Fluorouracil or imiquimod cream, or laser ablation, for precancerous and very superficial lesions, with close follow-up.
- Circumcision and wide local excision: Sufficient for tumours confined to the foreskin or small lesions of the glans.
- Glans resurfacing or glansectomy with reconstruction: Removes the diseased surface or the head of the penis and rebuilds it with a skin graft, preserving length and the ability to stand to urinate.
- Partial or total penectomy: Required for larger, deeply invasive tumours. After total penectomy the urethra is rerouted behind the scrotum.
- Lymph node surgery: Removal of groin, and sometimes pelvic, lymph nodes when spread is proven. It is a key part of curative treatment.
- Chemotherapy and radiotherapy: Used for bulky or advanced nodal disease, before or after surgery.
Wenn es dringend ist
Penile cancer seldom presents as an emergency. Seek urgent local care if you cannot pass urine, have heavy bleeding, or develop spreading redness, fever and pain in the penis or groin. After groin node surgery, a hot swollen leg, wound breakdown or fever needs prompt review. Any penile sore lasting more than 4 weeks should be seen by a doctor without further delay.
Reisen nach Türkiye zur Behandlung
Because this cancer is rare, surgeons experienced in organ-preserving techniques and sentinel node biopsy are concentrated in a few centres, so travelling for treatment can be justified. A planned glansectomy or partial penectomy with node staging generally fits a stay of 10 to 14 days. Follow-up examinations every 3 months for the first 2 years, lymphoedema care after node dissection and any chemotherapy should be organised near home. Private, discreet consultation is normal; do not let embarrassment hold you back.
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Häufig gestellte Fragen
Will I lose my penis?
In most early cases, no. Organ-sparing operations remove the cancer while keeping as much length and function as possible. Extensive tumours may need partial or total removal.
Can I still have sex after treatment?
Many men can after organ-sparing surgery, although sensation may change. Counselling and, where needed, reconstructive options are part of care.
Why are the groin nodes so important?
The cancer spreads to the groin nodes first, and removing involved nodes early can be curative. Missing them is the main avoidable cause of poor outcomes.
Does circumcision as an adult prevent it?
It removes a tight foreskin and makes inspection and hygiene easier, which helps, but the protective effect is strongest when done in childhood.