Diagnosis
If you have any symptoms of penile cancer, your doctor will conduct a physical examination and ask you questions about your general health, lifestyle, and family history. Your doctor will also thoroughly examine the penis and genital area. If your doctor suspects penile cancer, he or she may recommend any of the following diagnostic procedures:
Biopsy
A biopsy is the only way to know for sure if a tumor is malignant. The doctor will remove a tissue sample from the tumor and have it examined under a microscope for cancer cells. The doctor may request any of the following biopsy procedures, based on the size and location of the tumor:
Fine needle aspiration (FNA) biopsy
The doctor uses a very thin needle connected to a syringe to extract cells from the tumor. The doctor sends this sample to a laboratory to be examined under a microscope to detect the presence of cancer cells.
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Incisional biopsy
The doctor will use a scalpel to remove part of the tumor for examination. This procedure may be recommended for larger, deeper, or ulcerated lesions.
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Excisional biopsy
The doctor will use a scalpel to remove the entire tumor for examination. This procedure may be recommended for smaller lesions. If the entire lesion is on the foreskin, the doctor may also recommend circumcision to obtain a tissue sample for biopsy.
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Lymph node biopsy
In this procedure, the doctor will either use a very thin needle to extract cells from an enlarged lymph node, or a surgical scalpel to remove one or more lymph nodes for examination. This procedure may be recommended for patients with deeper tumors, and can help determine the stage of the disease.
Imaging Tests
Imaging tests create pictures of the body and help the doctor determine the location and extent of the cancer. The doctor may request any of the following imaging tests before or after a biopsy:
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Computed tomography (CT) scan
For a CT scan, you lie flat on a table while a machine rotates around the body and takes pictures. A special dye may be injected into your veins and you may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan reveals the presence of tumors and whether or not the cancer has spread to other parts of the body.
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Magnetic resonance imaging (MRI) scan
Magnetic resonance imaging (MRI) uses a powerful magnet to produce detailed images of body parts. Magnetic waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show “slices” of the body. MRI scans produce detailed images of the soft-tissues of the penis, and can help spot areas of cancer spread.
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Positron emission tomography (PET) scan
For a PET scan, the doctor injects a radioactive substance into the patient’s bloodstream. This substance collects in malignant (cancerous) cells in the patient’s body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of the cancer in the patient’s body. PET scans are often combined with CT scans, and help identify areas of cancer spread. Doctors usually use PET scans when they think the cancer might have spread but do not know where.
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Ultrasound
Ultrasounds bounce sound waves off of internal organs in order to create echoes that form a picture. Ultrasounds may be able to help doctors determine how deeply the tumor has grown into the penis, and if the cancer has spread to any lymph nodes in the groin.
