Surgery

Surgery is the primary treatment for all stages of penile cancer. The doctor may recommend any of the following procedures, depending on the stage of the disease. Lymph nodes may also be removed during surgery.

• Circumcision: A circumcision is surgery to remove the foreskin. A circumcision can often cure penile cancer that is only in the foreskin. This procedure may also be recommended before radiation therapy, as radiation may cause the foreskin to become inflamed and constricted.
• Mohs Surgery: The doctor removes the tumor by removing very thin layers of skin and examining them under a microscope for cancer cells. The doctor will keep removing thin layers until no more cancer cells are present. This procedure allows the doctor to remove as little healthy skin as possible to minimize discomfort and scarring.
• Simple Excision: The surgeon uses a surgical knife to remove the tumor and a margin of healthy skin around it. The margin of healthy tissue depends on the size of the tumor.
• Cryosurgery: The doctor uses an instrument to spray the tumor with liquid nitrogen in order to freeze and destroy it. The doctor may repeat this process multiple times or combine it with other treatments to destroy all the cancer. This procedure is minimally invasive and allows the doctor to treat the cancer with little damage to healthy tissue.
• Laser Surgery: The doctor uses a narrow, intense beam of light to remove and/or destroy the tumor. The doctor may remove the tumor layer-by-layer, depending on its depth. This is a very precise procedure that is easy to control without much damage to healthy tissue.
• Partial or Total Penectomy: A penectomy is surgery to remove all or part of the penis. This procedure may be recommended for tumors that have grown deeply into the penis. If a total penectomy is necessary, the doctor will create a new opening for urine to pass out of the body, in the area between the anus and the scrotum. For very advanced cases, the doctor may need to remove the scrotum and testicles as well.

Radiation Therapy

Radiation therapy uses waves of high-energy rays to target and kill cancer cells. In external beam radiation, a large machine delivers radiation to your tumor from outside the body. In internal radiation therapy, your doctor places radioactive pellets inside the body near the tumor.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. The doctor may recommend either systemic chemotherapy or topical chemotherapy to treat penile cancer. Systemic chemotherapy is injected into a vein or administered by mouth, and travels through the bloodstream to target cancer cells throughout the body. Topical chemotherapy is a cream or lotion that is applied to the skin and is used to treat superficial tumors that have not grown very deeply into the skin.

Topical Biologic Therapy

Biologic therapy stimulates the body’s immune system and helps it fight cancer cells. It stimulates the body’s natural defense system. The doctor may recommend a topical form of biologic therapy to treat carcinoma in situ of the penis.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.