Penile Cancer: A Plain-Language Overview

This page is for men facing penile cancer and the people close to them. It covers how rare it is, the signs, the pathology report, staging, and treatment.

The American Cancer Society projects 2,260 new cases in the United States in 2026, and 450 deaths. The ACS also notes that this is under 1 in 100,000 men a year. NCI's PDQ summary lists the earlier 2025 estimate of 2,190 new cases and 510 deaths. NCI puts the rate in rich countries at fewer than 1 case per 100,000 men a year.

Because penile cancer is rare, it can help to ask whether a second opinion makes sense for your plan.

NCI states that "signs of penile cancer include sores, discharge, and bleeding." It says to check with a doctor about "redness, irritation, or a sore on the penis" or "a lump on the penis." NCI adds that "these and other signs may be caused by penile cancer or by other conditions."

NCI says anyone with these changes should see a health care provider. Embarrassment can lead men to wait. Do not wait. A sore, bleeding or a lump that does not go away needs a prompt visit, because only an exam and tests can tell what is causing it.

Nearly all penile cancers start in squamous cells. Those are the flat cells that make up skin. The report will usually name a subtype. NCI lists verrucous carcinoma, warty carcinoma, and basaloid carcinoma. Neuroendocrine carcinomas happen but are much less common.

Subtype hints at cause. NCI writes that "warty carcinoma and basaloid carcinoma appear to be more highly associated with human papillomaviruses (HPV), particularly HPV 16, than typical squamous cell carcinoma or verrucous carcinoma of the penis."

The Centers for Disease Control and Prevention (CDC) puts numbers on the HPV share. CDC counts an average of 1,429 penile cancers a year. It estimates that about 900 of them are caused by HPV. That is 63%. The 2,260 figure is a one-year forecast. The two counts use different methods, so they will not match.

NCI also cites data on circumcision. Studies link newborn male circumcision to lower risk. The odds ratio is 0.37, which means a clearly lower risk. The number needed to treat is about 909. That means about 909 circumcisions for each cancer prevented. That last figure is the honest part. The disease is so rare that hundreds of procedures match one cancer prevented.

NCI groups stage using the TNM system. T describes the tumor, N the lymph nodes, and M spread to distant parts of the body (metastasis). Higher numbers mean more disease.

• Stage 0. Carcinoma in situ (Tis) or noninvasive disease (Ta), N0, M0.
• Stage I. T1a, N0, M0.
• Stage II. T1b through T3, N0, M0.
• Stage III. T1 through T3 with N1 or N2 nodes, M0.
• Stage IV. T4 with any N. Or any T with N3. Or any T with M1.

NCI states the outlook plainly. "When diagnosed early (stage 0, stage I, and stage II), penile cancer is highly curable. Curability decreases sharply for stage III and stage IV disease."

Penile cancer drains first to the inguinal nodes, meaning the lymph nodes in the groin. Whether cancer has reached them drives both stage and survival. It is also hard to answer.

The trap is that swollen groin nodes are often just infected. NCI notes that groin swelling is common at diagnosis. It may reflect infection, not cancer. So the stated approach is to remove the primary tumor first, give antibiotics, and wait. If nodes stay enlarged, NCI states that "bilateral inguinal lymph node dissection should be performed." That surgery comes three or more weeks after the primary tumor is removed.

The gentler option is dynamic sentinel node biopsy. It maps and removes only the first node the tumor drains into. NCI cites one study with an 11% false-negative rate. Those were men with T2 to T3 tumors and normal-feeling nodes. So about one map in nine missed disease that was there.

That number explains the tension. NCI describes the cost of full node dissection directly: "infection, skin necrosis, wound breakdown, chronic edema, and even a low, but finite, mortality rate." Chronic edema means lasting leg swelling. The choice is a firm answer with real harm, or a softer test that sometimes misses.

Stage 0. NCI lists:

• Surgical excision, which cuts out the tumor.
• Fluorouracil cream applied to the skin (topical).
• Imiquimod 5% cream, which NCI calls "a topical immune response modifier that has been effective."
• Laser therapy.
• Cryosurgery, which freezes the tumor.

Stage I. Options include:

• Wide local excision, which removes the tumor with a margin of healthy tissue.
• Penile amputation.
• External-beam radiation.
• Microscopically controlled surgery, which removes the tumor in thin layers.
• Nd:YAG laser.

Stage II. NCI lists partial, total, or radical penile amputation. It lists external-beam radiation and brachytherapy, which places radiation right against the tumor. Nd:YAG laser is an option for some small lesions.

Stage III. Bilateral ilioinguinal lymph node dissection is central. Radiation is an option when surgery is not. On drugs, NCI notes that a "combination of vincristine, bleomycin, and methotrexate has been effective as both neoadjuvant and adjuvant therapy." NCI also lists cisplatin with continuous-infusion fluorouracil.

Stage IV. NCI lists surgery and radiation for symptom relief. NCI says drugs with some effect include vincristine, cisplatin, methotrexate, and bleomycin.

Fluorouracil and capecitabine belong to a drug family called fluoropyrimidines. NCI notes that an estimated 1% to 2% of people carry a harmful variant in the DPYD gene. Ask your care team whether DPYD testing applies to you before these drugs, and whether the result is back.

• Which squamous subtype is on my report?
• Was HPV testing done?
• What is my T stage? Does the tumor invade the erectile bodies?
• Are my groin nodes involved, and is that infection or cancer?
• Am I a candidate for sentinel node biopsy instead of full dissection? What false-negative rate do you use?
• Can any organ-sparing option work here, such as glans surgery, laser, or brachytherapy?
• Has DPYD testing been ordered?
• Would a second opinion help with my plan?

See also Cancer Staging, Pathology Reports, and Getting a Second Opinion.

• https://www.cancer.gov/types/penile/hp/penile-treatment-pdq
• https://www.cancer.gov/types/penile/symptoms
• https://www.cdc.gov/cancer/hpv/cases.html
• https://www.cancer.org/cancer/types/penile-cancer/about/key-statistics.html