Radiotherapy for localised penile cancer

Radiation therapy is the use of high-energy x-rays to kill cancer cells. It can be directed at cancer from outside of the body (external beam radiotherapy) or from within the body (brachytherapy). Both types of radiotherapy can be used to treat penile cancer which is confined to the penis as an alternative to surgery.

External beam radiotherapy

Once the exact area to be treated has been identified it will be marked with ink. You will need to be circumcised (surgical removal of the foreskin) before radiotherapy to reduce the chance of skin swelling and irritation. Treatment may to be given over a six-week period in short doses (10-15 minutes). Beams of radiation are directed at the cancer and controlled by a computer.

Brachytherapy

This can be used to treat penile cancer which is not greater than 4cm in size. Under general anaesthetic radioactive needles are positioned in the penis and small radioactive pellets inserted near to the cancerous areas. The needles will need to stay in place for up to 7 days and you will have to stay in hospital during this time. Your movement will be limited (bed rest) during this time. Children and pregnant women will not be allowed to visit you. To protect the urethra or water pipe and allow urinary drainage a urinary catheter will be inserted into your bladder. The needles and the catheter will be removed under a general anaesthetic once all the treatment has been given.

Plesiobrachytherapy

This is a type of brachytherapy which uses a special plastic mould to cover the penis. Small radioactive wires are attached to the cancerous area of the penis. Radiation can then be given through the wires. This type of treatment is performed on a daily basis for several days.

Side Effects

Skin reactionsRadiotherapy can irritate the skin These symptoms may occur 2-3 weeks after treatment. Vitamin E supplements and topical creams can help the healing process, and these may be prescribed by the healthcare team. It is also advisable to keep areas that have been exposed to radiotherapy covered and protected from direct sunlight. Treated areas may turn a slightly darker colour temporarily.  
Fatigue  This may be caused by a combination of treatment and travel. Getting small restful naps or taking a mild sedative medication may help.  
Feeling sick (nausea)  Anti-sickness medication can be prescribed to help stop nausea.
Diarrhoea  Reducing your intake of high fibre food may help (fruit, vegetables, wholewheat products). Drinking plenty of fluids will help reduce the risk of dehydration.
LymphoedemaLymphoedema occurs when lymph fluid accumulates in the groin area and prevents
adequate drainage to the lower body (usually the legs and scrotum). This can cause swelling. Lymphoedema is treated by a specialist team of healthcare professionals. For more information on lymphoedema please click here

Following radiotherapy, the medical team will review you in hospital on a regular basis and you may have further scans such as an MRI or CT scan to see how effective treatment has been.

    We hope you found this information useful. If you would like to submit your own advice based on your experience to help other men, please comment below. Comments will be kept anonymous, but where possible and we would like to share them with other orginisations who are trying to improve the care and support for anyone affected by penile cancer.

    Reviewed November 2023