Possible symptoms of penile cancer may include:

Penis

• Rash
• Growth/lesion/lump
• Swelling
• Bleeding
• Ulcer
• Discharge
• Change in colour of foreskin.

Groin

• Lumps felt under the skin in the groin area.

Any abnormal rash, lesion, ulcer, or discharge, on or from the penis should be checked by a doctor as soon as possible. If it is not possible to identify an obvious cause, men should be referred to a hospital specialist called a urologist for urgent assessment.

Risk Factors 

The causes and the way that penile cancer develops is not fully understood but there are some factors which increase the risk of developing the disease.

Human Papilloma Virus (HPV)

There are many different types of HPV virus. Common types can cause warts and verruca’s and are spread by skin-to-skin contact. Some types of HPV are transmitted via sexual intercourse, and several are considered high risk viruses. These can infect the anus, penis, throat, and cervix in women, and are linked with the development of cancer. The body’s immune system is usually able to kill the virus, but sometimes it can persist for many years without causing any symptoms then develop into cancer or a pre-cancerous condition. Around 50% of men diagnosed with the most common type of penile cancer have been infected with one of these types of HPV.

It has been estimated that over 80% of the world’s population are exposed to some type of HPV during their lifetime, and getting penile cancer does not mean that an individual’s lifestyle is to blame. Practicing safe sex using a condom can help reduce the risk of HPV as well as Sexually Transmitted Infections (STIs).

The Presence of the Foreskin

Penile cancer is rare in men who have been circumcised (surgical removal of the foreskin) as a baby. Circumcision in later life does not reduce the risk of penile cancer and the risk of for these men is greater in the presence of phimosis (below).

Phimosis

This is the inability to pull back or retract the foreskin fully. It can be a result of skin irritation or inflammation or affect some men from birth. It will reduce the ability of a man to clean the penis thoroughly or notice any abnormal changes. It may also increase the risk of HPV infection. Research suggests that men with phimosis are around 10 times more at risk of developing penile cancer.

Smoking

Some research has suggested that smoking may increase the chance of developing penile cancer. This may be due to harmful chemicals found in cigarettes which are passed out in urine and may react with substances that can build up under the foreskin causing abnormal changes in the penis.

Psoralen-UV-A Photochemotherapy (PUVA)

Psoralen-UV-A Photochemotherapy (PUVA) is used to treat some forms of skin disease such as psoriasis, as well as some types of cancer. High doses of PUVA can increase the risk of penile cancer.

Pre-cancerous conditions

The names or terms used to describe pre-cancerous lesions can be confusing. The correct medical term is PeIN (Penile Intraepithelial Neoplasia) but there may be other names for these conditions that the medical team may use.

Bowenoid papulosis

This is an HPV related lesion, typically a small plaque which may form on the penile shaft.

It rarely progresses to penile cancer and can usually be treated by simple surgical removal or other minor surgical techniques.

Bowens disease/ Erythroplasia of Queryat

Bowens disease is found on the shaft skin of the penis and is not associated with the HPV virus. Erythroplasia of Queryat is found on the glans or foreskin of the penis and is more likely to progress to penile cancer.

Some pre-cancerous conditions may be treated in a similar way to how early penile cancer is treated.

Information on non-cancerous conditions of the penis can be found here

Reviewed November 2023