The type of treatment your cancer care team will recommend depends on how far the cancer has spread. This section summarizes the choices available according to the stage of your cancer.

Stage 0

Stage 0 includes 2 types of tumors: carcinoma in situ and verrucous carcinoma. They are treated differently.

Patients with carcinoma in situ that only involves the foreskin can often be treated with circumcision. If the tumor developed in the glans and does not affect other tissues, it may be possible to treat it with topical chemotherapy (such as 5-FU cream) or immunotherapy (imiquimod), or Mohs (microscopically directed) surgery. Laser treatment and radiation therapy may also be options. Penectomy is not often needed.

Verrucous carcinoma can often be treated with laser therapy or Mohs surgery. Only rarely will penectomy be needed. Radiation is not used for this type of tumor, because it can make it more likely to spread.

Stage I

These tumors have grown below the skin of the penis but have not invaded deeper layers. Options for treatment may include circumcision (for tumors confined to the foreskin), surgical removal of part of the penis (partial penectomy), radiation therapy, and Mohs surgery. The use of laser surgery for superficial penile cancer is currently being studied.

Stage II

Stage II penile cancer usually requires a partial or total penectomy, with or without radiation therapy. A less common approach is to use radiation therapy as the first treatment with surgery remaining as an option if the cancer is not completely destroyed by the radiation.

Many doctors recommend checking groin lymph nodes, even if they are not enlarged. This may be done with a sentinel lymph node biopsy or with a more extensive lymph node dissection.

Stage III

Stage III penile cancer is treated with a partial or total penectomy. If the tumor involves the scrotum or parts of the abdominal wall, it may also be necessary to remove the testicles and/or the scrotum. A new opening can be made in the abdomen or the perineum to allow urination. In extreme cases, removal of the bladder and prostate may also be needed. Chemotherapy or chemotherapy plus radiation may be used first to shrink the tumor so that it can be removed with surgery.

These cancers usually require an inguinal lymphadenectomy to remove lymph nodes in the groin, but a sentinel lymph node biopsy may be an option in some cases. Radiation therapy to the groin may be used as well, either after surgery or instead of surgery in selected cases.

These tumors can be hard to treat, so men may want to consider taking part in clinical trials of new treatments.

Stage IV

Stage IV penile cancer is usually not considered curable by current methods. Treatment is designed to try to keep the cancer in check and to prevent or relieve symptoms to the best extent possible. Choices to treat the penile tumor usually include wide local excision, penectomy, or radiation therapy. Surgery or radiation therapy may also be considered to treat nearby lymph nodes.

Chemotherapy may be used to treat cancer that has spread to other areas, such as the lungs or liver. Studies are under way to determine the value of chemotherapy combined with surgery or radiation therapy.

These tumors can be hard to treat, so men may want to think about taking part in clinical trials of new treatments.

Recurrent cancer

The treatment of recurrent cancer depends on where the cancer comes back and what treatments were used before. If penectomy was not done before, a recurrent penile cancer may be treated with surgical removal of the penis. Radiation therapy may also be an option. Surgery and/or radiation may also be options for some cancers that recur in the lymph nodes. Chemotherapy may be helpful in treating more advanced recurrent penile cancers. These tumors can be hard to treat, so men may want to think about taking part in a clinical trial of a newer treatment.

Last Medical Review: 10/07/2009
Last Revised: 10/07/2009