Penile Cancer

Call for an Appointment 866-385-3123

Duke Health urologists, dermatologists, medical oncologists, and radiation oncologists use the latest medical and surgical techniques to diagnose and treat penile cancer, a rare form of cancer that usually starts on the skin of the penis. If left untreated, the cancer can work its way inside the penis and spread to nearby lymph nodes and/or other organs. Therefore, early detection is important. Our goal is to use the least-invasive treatments and preserve as much of your penis’ appearance and function as possible.

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Penile Cancer Symptoms and Risk Factors

Common symptoms of penile cancer include:

A sore, lump, or growth on the skin
Thickened skin or a change in skin color
A rash
Discharge or bleeding
Swollen lymph nodes around the groin

You may be at higher risk of penile cancer if you:

Are over 55
Are uncircumcised
Smoke or use tobacco
Have HPV (human papillomavirus) or HIV (human immunodeficiency virus)
Have phimosis (trouble pulling back your foreskin)
Don’t wash your penis frequently or thoroughly enough

Call for an Appointment

866-385-3123

Diagnosing Penile Cancer

Physical Exam
Your doctor will examine your penis and check for unusual skin changes. They may also feel around your groin area for swollen lymph nodes.

Skin Biopsy
A biopsy is used to determine if a skin abnormality on your penis is cancerous. During a biopsy, your doctor will remove a piece of the abnormal skin to examine under a microscope. If the lesion is large, your doctor may only remove a small part. If the lesion is small, your doctor may remove all of it.

Imaging
A CT scan, PET scan, or MRI of your pelvis can help identify if you have a tumor and if the tumor has spread to your lymph nodes or surrounding organs.

Lymph Node Biopsy
A lymph node biopsy helps your doctor determine the extent or stage of the cancer. A lymph node biopsy can be performed through a fine needle aspiration or a small surgical incision. During a fine needle aspiration, your doctor inserts a hollow needle into your lymph node to remove cells. In other cases, a surgical incision is made in the groin area to access the lymph nodes.

Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy may be recommended when lymph nodes appear normal and seem unlikely to contain cancer cells. Your surgeon injects a radioactive tracer and/or dye to identify the first lymph node -- known as the sentinel lymph node -- that drains the cancer. The lymph node is removed and tested for cancer. This procedure removes fewer lymph nodes and dramatically reduces your chances of developing lymphedema.

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Penile Cancer Treatment

The type of treatment your doctor recommends will depend on the location and extent of your penile cancer.

Surgical Approaches

Mohs Micrographic Surgery

Mohs surgery removes the skin cancer on your penis layer by layer. Your surgeon will carefully remove a layer of skin, then examine it under a microscope for cancer. They will continue to remove a layer of skin and examine it until no cancer cells are found. This method helps preserve as much of your penis as possible and is less invasive than a total or partial penectomy.

Inguinal Lymphadenectomy

If the sentinel lymph node biopsy indicates cancer is present, or the lymph nodes around your groin are very swollen, your surgeon will make an incision along your groin to remove more lymph nodes, known as the inguinal lymph nodes. This procedure takes place in the hospital under general anesthesia, so you will not be awake.

Pelvic Lymphadenectomy

If lymph nodes surrounding your groin are swollen or if the inguinal lymph nodes contain cancer, additional lymph nodes from the pelvic area may be surgically removed.

Partial or Total Penectomy

A penectomy is the most common treatment for penile cancer. Depending on the location and extent of your penile cancer, part (partial penectomy) or all of your penis (total penectomy) may be surgically removed. Your doctor will preserve as much of your penis as possible. During the inpatient surgery, you will be given general anesthesia, so you will not be awake.

During a partial penectomy, a plastic surgeon may also perform a skin graft or tissue flap procedure. A tissue flap is the transfer of skin that includes blood vessels. It enables the surgeon to cover a larger area or tissue compared to a graft.

Urethra Reconstruction

Your surgeon will do their best to preserve your ability to urinate while standing. However, if too much of the penis is removed, urethral reconstruction may be done during your penectomy procedure. Your surgeon will reroute your urethra to the perineum, which is the area between your scrotum and anus.

Non-Surgical Options

Chemotherapy

If the cancer has spread to your lymph nodes, chemotherapy is usually prescribed to kill cancer cells around the time you have surgery. Chemotherapy may also be recommended if you are unable to have surgery due to other complications or if your cancer recurs after surgery.

Topical Chemotherapy Creams

If your cancer is in a very early stage or only on the surface of your penis, a topical chemotherapy cream may be enough to treat it. Creams such as 5-fluorouracil or imiquimod are applied directly to the skin cancer to target and kill the abnormal cells.

Radiation

Radiation therapy uses precision X-rays to destroy cancer cells or shrink tumors. It is often combined with other cancer treatments, such as surgery and chemotherapy.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2025–2026.

Why Choose Duke

The Duke Cancer Institute
The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Specialized Team Approach
We believe that the best results stem from comprehensive cancer care, involving a team of experts from many areas of medicine. Your team might include dermatologists, surgical dermatologists, surgical oncologists, radiation oncologists, medical oncologists, and urologic oncologists.

Minimally Invasive Techniques
We are one of a few facilities in the area to offer sentinel lymph node biopsy, a minimally invasive procedure. It allows fewer lymph nodes to be removed and a faster recovery time.