Penile cancer

Content written by John P. Mulhall, MD

Penile cancer is a rare condition in the United States. It is far more common in more underdeveloped areas of the world such a certain parts of Africa and India. It is almost universally seen in uncircumcised men. As with many cancers there are a variety of forms, however, the most common form is called squamous cell carcinoma. Its treatment and prognosis are directly related to the stage of the condition, which relates to the depth of invasion of the cancer into the penis. Superficial cancers can be treated with local radiation or superficial resection of the lesion (Moh’s resection). Cancers that affect the foreskin only may be treated with circumcision. However invasive cancer is routinely treated with penectomy either partial or total. Superficial tissue resection generally leads to very little impact on sexual function outside of the psychological disturbance associated with the presence of cancer on the penis. It is easy to appreciate that penectomy results in a profound impact on a man’s sexual function. Total penectomy renders men completely incapable of having sexual intercourse or any penis based sexual activity. Partial penectomy, depending on the location of the cancer, may leave the patient with sufficient penile length to participate in some form of sexual activity however it is routinely difficult for men in this situation to have sexual intercourse. Men with this form of cancer generally require significant psychological support to help them overcome the depression associated with loss of penile form and function.