Treatment for penile cancer often depends on how advanced the cancer has become. Typical treatments include surgery, radiation, and chemotherapy. Sometimes a combination of treatments is used.
Surgery is the most common treatment for penile cancer.
• Mohs surgery involves cutting the tumor, one thin layer at a time. Each layer is examined with a microscope to see whether any cancer cells remain. If cancer cells are present, another layer is cut. This process repeats until no more cancer cells are visible.
• Circumcision is a procedure that removes the foreskin. This may be done if the cancer cells are concentrated in the foreskin or to facilitate radiation therapy later on.
• Excision involves cutting out the tumor along with some healthy tissue that surrounds it. Taking this extra tissue makes it harder for any remaining cancer cells to spread.
• Laser surgery uses a laser beam to cut tissue or vaporize cancer cells.
• Cryosurgery destroys cancer cells by freezing them.
• Penectomy (amputation) may be required in more advanced cases. Depending on the situation, part or all of the penis may need to be removed. In a partial penectomy, the surgeon usually removes the tip of the penis. When a total penectomy is done, the entire penis is removed. An opening is made between the scrotum and anus so that the patient can still urinate.
If cancer cells have spread, lymph nodes may need to be removed. Sometimes, one lymph node is removed and examined first to determine the extent of the cancer spread. At that point, doctors can decide whether more lymph nodes need to be removed.
Radiation therapy uses high energy x-rays to kill cancer cells. This treatment may be used alone or in conjunction with surgery.
With external beam radiation therapy, radiation is aimed at the tumor using a machine outside of the body.
Brachytherapy, or internal radiation therapy, involves putting the radiation source either in the tumor or very close to it. The radiation may be delivered through needles, tiny pellets, or catheters.
Chemotherapy uses drugs to destroy cancer cells or keep them from spreading. This treatment may be given topically, regionally, or systemically.
Topical chemotherapy drugs come in a cream form and are applied directly to the skin of the penis. This approach is usually more appropriate for very early stages of penile cancer.
Regional chemotherapy drugs are administered to a particular region of the body, such as the abdomen.
Systemic chemotherapy drugs are either taken as a pill or injected into a vein. They enter the bloodstream (the body’s “system”) and can attack cancer cells in many parts of the body. This is especially helpful if the cancer has spread.