Treatments for localised penile cancer

The following treatments are used to treat pre-cancerous conditions of the penis as well as some early, localised penile cancers.

Topical Agents (local treatments)

Chemotherapy 5-fluorouracil

This is a type of chemotherapy cream which is applied to the affected area of the penis for around 4 – 6 weeks. Chemotherapy works by destroying cancer cells. Chemotherapy will also affect some healthy cells on the penis and therefore the area treated may become inflamed, encrusted and sore. If this happens men may be advised to use a steroid cream to help reduce some of these symptoms. Soreness can sometimes last for a few months; however, it is important to continue treatment if possible for the full duration of the recommended period.

Men will need to make sure that they wash their hands thoroughly if they do not use gloves to apply the cream.

This type of chemotherapy will not cause hair loss.

 

Imiquimod cream

This is a type of immunotherapy treatment. Unlike chemotherapy, immunotherapy stimulates the body’s immune system to fight and regress cancerous cells. It can be used as a treatment on its own or if chemotherapy cream has not worked fully.

Treatment is usually applied for 4 – 6 weeks.

For both of the above treatments it may be necessary to use a barrier cream to protect areas around the treatment site and treatment may not be suitable for patients with a weakened immune system.       

Surgery (localised)

Circumcision

This is the removal of the foreskin and may be appropriate if only the foreskin appears to have been affected by a precancerous condition or cancer itself. Sometimes it will be the only treatment that a man may need.

For more detailed information on circumcision from the British Association of Urological Surgeons (BAUS) please click here.

Wide local excision

Possible cancerous tissue will be removed from the affected area of the penis and a few millimetres of healthy tissue will be removed from around the site to reduce the possibility of any potentially cancerous cells from being left behind.

In general the following guidelines may be useful to follow after any minor penile surgery:

  • There will be a surgical dressing on the penis. This can usually be removed about 24 hours after the procedure. Stitches (sutures) will be dissolvable but can take up to 2 weeks or more to fully dissolve.
  • Men can shower, normally after 24 hours, but it is important not to rub soap on the wound area. The wound area should be dried by gently patting it with a clean towel/gauze pad. Men can have a bath after 1 week.
  • The penis may be bruised and swollen after the operation. Prescribed painkillers should be taken on a regular basis, (not just when men get pain) for the first 48 hours or until they feel comfortable.
  • Although these are minor procedures, it is important to take things easy for the first week. Most men should be able to return to work within a few days.
  • Men may begin normal sexual activity again six weeks after their operation, as long as they feel comfortable.
  • Men should be given a follow up appointment within a few weeks of their operation for the results. At this time any further treatment which may be reccommended will be discussed.

Cryotherapy

This technique uses liquid nitrogen at a temperature of between -20° C and -50° C to freeze and kill cancerous cells. The skin on the penis will later blister and peel and the procedure can leave a small scar.

Laser ablation

Laser therapy is the use of a very powerful beam of light to kill cancer cells. Laser surgery can be used along with a minor surgical procedure to destroy cancerous cells. This can cause some minor pain and bleeding but is usually well tolerated. It may take 2 – 3 months after treatment for the penis to recover fully.

Photodynamic therapy

This is a newer treatment that is still being fully assessed. Light sensitive chemicals are applied to the penis and left for a few hours. A special type of light is then shone at the treated area which can cause the cancer cells to die.

Glansectomy

Another type of localised surgery is called glansectomy. For more information on this treatment please see side panel.

 

 

To read personal stories of men who have been affected and treated for penile cancer please click here

 

Reviewed March 2021. Next review 2022.

References available on request.

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