Although penile cancer remains rare, experts are sounding the alarm over a worrying increase in cases.
Researchers say global cases of penile cancer could increase by up to 77% by 2050.
Although developing countries are most affected by this worrying trend, they have observed a significant increase in “most European countries”.
According to the NHS, there are around 760 cases of penile cancer in the UK each year.
Still, this figure represents a 28% increase on cases in the 1990s, and Cancer Research UK predicts that this figure will reach 1,100 per year by 2040.
According to Dr Colin Michie, deputy head of the University of Central Lancashire’s medical school, an ageing population is one of the main causes of cases.
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“Other risk factors include a narrowed foreskin, poor genital hygiene and smoking,” he added in The Conversation.
Penile cancer can often be mistaken for an STI in its early stages and usually presents as a sore on the penis that does not heal or a strong-smelling discharge.
But because of the intimate nature of the condition, many men may delay treatment out of shame.
Dr Michie said: “Diagnosis of penile cancer is often delayed because patients feel guilty or embarrassed.
“Many men report self-medicating with antimicrobial creams or steroids while delaying a doctor’s appointment.
“Doctors also often contribute to delays, as injuries are sometimes misclassified as benign.
If the malignant cells have spread to the lymph nodes in the groin, the chances of recovery are much lower, which is why prompt diagnosis and treatment are important.
From sores to bleeding and rashes, here are the warning signs of penile cancer to know as cases rise.
1. Growths and sores
Cancer can develop anywhere on the penis, but it most often develops under the foreskin in men who have not been circumcised or on the head or tip of the penis – this is called the glans.
One of the first signs of the disease is a growth or sore that has not healed after four weeks.
According to CRUK, it may look like a wart, ulcer or blister and may not be painful.
In these cases, it is important to know what is normal for you so you can report any changes to your doctor.
2. Bleeding
Another warning sign of penile cancer is bleeding from the penis.
This includes bleeding under the foreskin.
3. Smelly discharge
A foul-smelling discharge can be a sign of penile cancer, but the discharge is more likely to be caused by other factors.
This can happen because of an infection or because something irritates the skin on the penis.
It could also be because you’re not washing your private parts often enough or thoroughly enough. A cheese-like substance called smegma can build up if you don’t wash your penis every day.
But this is different from a constant discharge, so it’s important to report this to a doctor if you notice it.
4. Skin rashes
A rash on your penis is another possible sign of cancer.
Be aware of what is normal for you and try not to be embarrassed to talk to a GP about it.
5. Foreskin problem
You may notice that it becomes more difficult to retract your foreskin.
This is called phimosis.
Dr Michie noted: “Penile cancer is rare in people circumcised at birth.”
6. Color changes
Finally, changes in the color of your penis or foreskin should be discussed with a general practitioner.
There are other, rarer symptoms of penile cancer that could be a sign of the disease if it is more advanced:
- A lump in the groin
- Feeling tired
- Abdominal pain
- Pain in the bones
- Weightloss
CAUSES OF PENILE CANCER
“Squamous cells in the skin of the penis are responsible for more than 90% of penile cancers,” Dr Michie said.
Squamous cell carcinoma is a type of skin cancer.
“Other malignant tumors, such as melanoma, basal cell carcinoma or sarcoma, are less common.
“Human papillomavirus (HPV) infection has been identified in approximately half of all cases of squamous cell carcinoma.”
HPV is the name for a very common group of viruses – “probably the most commonly transmitted sexually transmitted infection in humans,” according to Dr Michie – that cause no problems in most people.
The viruses are spread through skin-to-skin contact during sexual intercourse and more than 70% of sexually active adults contract HPV infections, the expert added.
But some high-risk types can lead to genital warts or cancer.
HPV infections can linger just below the surface of the skin.
In the case of penile cancer, this can cause changes in the texture and color of the skin, such as a painless ulcer or wart.
“HPV 16, the most common high-risk HPV type, can cause malignant changes in tissues of the penis or cervix, mouth, throat, vulva, vagina and anus,” Dr. Michie continued.
“This is probably the most cancer-causing HPV. Fortunately, HPV vaccines have already done a great job reducing cervical cancer rates.
“The effects of these vaccines on penile cancer will likely take longer to appear, because there is typically a long period of time between HPV infection and the onset of cancer.”
TREATMENT
Treatment may involve surgery to remove the tumor, use of strong creams, laser treatment, freezing, radiation therapy, or chemotherapy.
Operations to remove part or all of the penis are usually a last resort treatment for advanced cases.
A recent BBC report revealed that Brazil has one of the highest rates of penile amputation, with almost two carried out every day.
Meanwhile, Shaun Evans has bravely shared with Sun Health how his penis was amputated after being struck down by cancer, in a bid to help other men avoid suffering his fate.
Dr Michie said there was “hope on the horizon” regarding new treatments for penile cancer.
“New approaches, such as using engineered T cells (a type of immune cell) that attack HPV-infected cells, or immunotherapies such as tislelizumab that enhance immune responses to squamous cell tumors, have been shown to be effective in a few cases,” he explained.
I spotted a cold sore-like spot on my penis – months later it was amputated
SHAUN Evans, 55, noticed persistent pain in his pelvic area in June 2022.
As his discomfort worsened, he noticed he was bleeding from his foreskin in the shower and discovered a sore at the base of his penis.
Alarmed, Shaun sought help at an STI clinic and was referred to a urologist.
In the months that followed, the 55-year-old found himself in agony.
“I used to walk three miles a night, but I dragged my feet and couldn’t find comfort unless I was lying down.
“I started feeling a burning sensation when I urinated and the whole area became inflamed.”
In September 2022, a few months after his first symptoms, the former West Midlands police officer was diagnosed with penile cancer.
What follows is enough to make any man shudder.
Shaun bravely shared his experience with Sun Health, hoping to spare other men his fate.
Read his story here.