Penile Cancer
Penile cancer is a rare but serious condition that requires the expertise of a specialized oncology team. At Charleston Oncology, we understand that a penile cancer diagnosis brings not only medical challenges but deeply personal concerns as well. Our oncologists approach each patient with discretion, respect, and an unwavering commitment to the most effective, evidence-based treatment available. While penile cancer accounts for less than 1% of all cancers in men in the United States — with roughly 2,000 new cases diagnosed annually — those affected deserve access to highly experienced specialists and the full range of modern treatment options. Charleston Oncology is that resource for patients throughout the South Carolina Lowcountry.RSFH Penile
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What to expect from Medical Oncology at Charleston Oncology
What Is Penile Cancer?
Penile cancer develops when abnormal cells grow uncontrollably in the tissues of the penis. It most commonly originates on the skin of the penis or beneath the foreskin, and the majority of cases — approximately 95% — are squamous cell carcinomas.
Other, less common types include:
- Carcinoma in situ (Bowen’s disease / Erythroplasia of Queyrat) — early, noninvasive forms
- Adenocarcinoma — arising from sweat glands of the penile skin
- Melanoma — rare, but occurring in the genital region
- Basal cell carcinoma — uncommon in this location
- Sarcoma — arising from connective tissue
Risk Factors
Several factors are associated with an increased risk of developing penile cancer. Awareness of these factors supports early detection:
- Human papillomavirus (HPV) infection — particularly HPV types 16 and 18
- Phimosis — a condition in which the foreskin cannot be fully retracted
- Lack of circumcision
- Smoking — which introduces carcinogens to the genital tissue
- Chronic inflammation or poor hygiene
- HIV infection and a weakened immune system
- Age — more commonly diagnosed in men over 60
- History of lichen sclerosus or other chronic inflammatory skin conditions
Signs and Symptoms
Penile cancer often begins as a subtle skin change that can be mistaken for a benign condition. Men should consult a physician promptly if they notice:
- A growth, sore, or ulcer on the penis that does not heal
- A change in skin color, texture, or thickness on the penis or foreskin
- Redness, irritation, or rash that persists
- A foul-smelling discharge beneath the foreskin
- Bleeding not associated with injury
- Swollen lymph nodes in the groin
Many of these symptoms are caused by conditions other than cancer, but any persistent change should be evaluated promptly. Early-stage penile cancer has significantly better outcomes than advanced disease.
How Penile Cancer Is Diagnosed
Accurate diagnosis is the foundation of effective treatment. At Charleston Oncology, our evaluation may include:
- Physical examination — detailed assessment of the lesion and groin lymph nodes
- Biopsy — sampling of abnormal tissue to confirm malignancy and identify cancer type
- Imaging — ultrasound, MRI, CT scan, or PET/CT scan to assess depth of invasion and potential nodal or distant spread
- Cystoscopy or urethroscopy — if urethral involvement is suspected
Staging is critical to treatment planning and helps determine whether the cancer is localized or has spread to nearby lymph nodes or distant organs.
Treatment Options
Treatment for penile cancer is tailored to the stage, location, and extent of the disease, as well as the patient’s overall health and personal goals. A multidisciplinary team approach — coordinating medical oncology, urology, radiation oncology, and pathology — provides the most comprehensive care.
Chemotherapy
Chemotherapy plays an important role in the treatment of advanced, node-positive, or metastatic penile cancer. It may be used as a primary systemic therapy, in combination with radiation (chemoradiation), or as neoadjuvant therapy before surgery to shrink the tumor and improve surgical outcomes. Common regimens include cisplatin-based combinations.
Immunotherapy
For advanced or recurrent penile cancer — particularly tumors with high HPV association or specific biomarker profiles — immune checkpoint inhibitor therapy is an emerging and increasingly important treatment option. Your oncologist will evaluate biomarker testing results to determine immunotherapy candidacy.
Targeted Therapy
Molecular profiling of penile cancer tumors can identify actionable mutations or overexpressed targets. In select cases, targeted agents may be incorporated into the treatment plan, particularly in the metastatic setting.
Radiation Therapy
Radiation — either external beam or brachytherapy — may be used as primary treatment for smaller tumors, or as adjuvant therapy following surgery to reduce the risk of recurrence. Radiation is sometimes preferred as an organ-sparing approach for appropriate candidates.
Surgery
Surgical options range from conservative, organ-preserving procedures for early-stage disease to more extensive surgery for advanced cases. Surgical coordination with urology and reconstructive specialists is arranged as part of the multidisciplinary care plan at Charleston Oncology.
Clinical Trials
Charleston Oncology participates in clinical research through the Bon Secours St. Francis Cancer Care network. Clinical trials may offer access to novel therapies for eligible patients. Speak with your oncologist to learn more.
Your Care Team
A penile cancer diagnosis is best managed by a coordinated team of specialists. At Charleston Oncology, your care team may include:
- Medical oncologists — leading systemic treatment strategy
- Urologic oncologists — managing surgical evaluation and intervention
- Radiation oncologists — delivering localized radiation therapy
- Reconstructive surgeons — supporting functional and cosmetic outcomes
- Oncology social workers — providing emotional support, counseling referrals, and practical resource navigation
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Common Questions
How is penile cancer diagnosed?
Penile cancer is typically diagnosed after a physical examination reveals a suspicious lesion, sore, or skin change. A biopsy — in which a small tissue sample is removed and examined — is required to confirm the diagnosis and identify the cell type. If cancer is confirmed, imaging studies such as MRI, CT scan, or PET/CT are used to determine staging. Inguinal (groin) lymph node assessment is a critical component of staging, as lymph node involvement significantly affects treatment planning and prognosis.
Is penile cancer related to HPV?
Yes — human papillomavirus (HPV), particularly high-risk strains HPV 16 and 18, is present in a significant proportion of penile cancers. HPV vaccination, ideally before sexual exposure begins, is one of the most effective preventive measures against HPV-related penile cancer, as well as cervical, anal, oropharyngeal, and other HPV-associated cancers. Men who have not been vaccinated and are within the recommended age range should discuss HPV vaccination with their healthcare provider.
Will I lose the entire penis with treatment?
Preservation of the penis is a primary goal of modern penile cancer management, and organ-sparing approaches are used whenever oncologically appropriate. For early-stage or superficial tumors, conservative treatments — including wide local excision, laser therapy, or radiation — can effectively treat the cancer while preserving structure and function. Total penectomy is reserved for cases where less extensive surgery cannot achieve adequate margins or where disease is too advanced for organ preservation. Your care team will discuss all available options and expected functional outcomes.
What is the importance of lymph node management in penile cancer?
The status of the inguinal (groin) lymph nodes is one of the most important prognostic factors in penile cancer. If cancer has spread to these lymph nodes, it significantly changes the treatment plan — typically requiring lymph node dissection and potentially systemic chemotherapy. For patients with intermediate- or high-risk tumors who do not have clinically palpable nodes, sentinel lymph node biopsy may be performed to accurately assess nodal status. Your multidisciplinary team will determine the appropriate approach to lymph node evaluation.
Schedule a Consultation
At Charleston Oncology, we provide expert, respectful, and compassionate care for men diagnosed with penile cancer. If you have received a diagnosis or are seeking a second opinion, our team is available to help.
Call us at 843-577-6957 or schedule a consultation. We serve patients from Charleston, North Charleston, West Ashley, Mount Pleasant, Summerville, and Walterboro, SC.
