Local Treatments (Other than Surgery) for Penile Cancer
Some very early penile cancers, especially carcinoma in situ (CIS, where the cancer is only in the top layers of the skin) can be treated with techniques other than surgery. Examples include radiation therapy (described in Radiation Therapy for Penile Cancer), laser ablation, cryotherapy, and applying drugs directly to the skin of penis (called topical therapy).
In this approach, the doctor uses a beam of laser light to destroy (ablate) cancer cells. This can be useful for squamous cell carcinoma in situ (CIS) and for very thin or shallow basal cell carcinomas.
For this approach, the doctor uses liquid nitrogen to freeze and kill the cancer cells. This is useful for some verrucous penile cancers and carcinoma in situ (CIS) of the glans.
This is often repeated a couple of times in the same office visit. After the dead area of skin thaws, it will swell, blister and crust over. The wound may have fluid draining from it for a while and take a month or two to heal. It can leave a scar.
Topical chemotherapy means that an anti-cancer medicine is put directly onto the skin instead of being taken as a pill or injected into a vein. The drug used most often to treat penile cancer topically is 5-fluorouracil (5-FU), which is applied daily as a cream for several weeks.
When put directly on the skin, 5-FU reaches cancer cells in the top layers of skin, but it cannot reach cancer cells that have grown deeply into the skin or spread to other organs. For this reason, treatment with 5-FU generally is used only for pre-cancerous conditions or carcinoma in situ (CIS).
Because the drug does not spread throughout the body, the side effects that often occur with systemic chemotherapy do not occur with topical chemotherapy. Treatment with 5-FU cream makes the treated skin red and very sensitive for a few weeks. Using other topical medicines or creams can help relieve this.
Imiquimod is a drug that is sometimes used as a cream to treat CIS of the penis. It causes the immune system to react to the skin lesion and destroy it. It is typically applied at least a few times a week for several weeks, although schedules can vary. It can irritate the skin, which can severe in some people. It can also cause flu-like symptoms, although this is not common.
Last Medical Review: March 30, 2015 Last Revised: February 9, 2016