Radiation Therapy for Penile Cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used in the treatment of penile cancer.

When might radiation therapy be used?

Radiation therapy can be used to treat penile cancer in different situations:

• It might be an option to treat some smaller (early-stage) penile cancers instead of surgery.
• It can be used when surgery isn't an option.
• It can be given along with chemo before surgery to help shrink the tumor and make it easier to remove with less damage to the penis.
• If the cancer has spread to the lymph nodes, radiation may be given either after surgery is done to remove the nodes or by itself.
• It can be used for advanced cancer, to try to slow the growth of the cancer or to relieve symptoms it causes.

For uncircumcised men who are going to get radiation to the penis, the foreskin is typically removed first with a circumcision. This is because radiation can cause swelling and tightening of the foreskin, which could lead to other problems.

How is radiation therapy given?

There are 2 main ways to get radiation therapy for penile cancer:

Possible side effects of radiation therapy

The main drawback of radiation therapy is that it can destroy or damage healthy tissue nearby the cancer cells.

Possible side effects of radiation to the penis

• The skin in the treated area often becomes red and sensitive. There may be patches of skin that are oozing and tender. For some, the skin may even peel.
• For a while, you may feel a burning sensation when you urinate.
• The area may also swell for a time.
• Over time, you may notice the skin of the penis has become darker or less elastic. You may be able to see tiny web-like blood vessels (called telangiectasia).

Good hygiene and skin care are key to keeping the area from getting infected. Side effects tend to slowly start during treatment and then get better over time after radiation is stopped. Most go away over a couple of months.

Less common side effects

Some less common but more serious side effects can include:

• Some of the skin or tissue at the end of the penis might die (called necrosis).
• The urethra (the tiny tube that carries urine out of the penis) might become narrow from scar tissue (called stenosis), leading to problems urinating.
• An abnormal opening (fistula) might form between the urethra and skin, which could result in urine leaking out through the opening.
• Radiation to the shaft of the penis might affect the ability to have erections. But in cases where the tumor has not grown beyond the glans, radiation is directed only at the tip of the penis, so erections should not be affected.

In many cases, the function and appearance of the penis slowly go back to normal in the months and years after radiation therapy.

Possible side effects of radiation to the lymph nodes

Possible short-term side effects of radiation to the pelvic area and groin lymph nodes include:

• Skin changes such as redness and irritation in the areas being treated
• Feeling tired
• Abdominal (belly) cramps
• Diarrhea
• Problems with urination

Long-term problems can include:

• Changes in bowel movements, such as chronic diarrhea
• Changes in urination, such as having to go more often
• Changes in the ability to have an erection
• An increased risk of lymphedema (fluid buildup in the legs or groin area)