Penile cancer is cancer of the male reproductive organ, the penis. It is a rare cancer, affecting only about one in 100,000 men in the United States, according to the American Cancer Society. Once penile cancer is diagnosed and staged, treatment can begin. Treatment typically depends on how far the cancer has spread and the individual's overall health, and can include multiple treatment modalities.
Surgery
Surgery is the most common treatment for all stages of cancer of the penis, according to the National Cancer Institute. If the cancer is only on the foreskin of the penis, it can also be treated by circumcision, which removes the foreskin and some skin nearby. Another procedure is called simple excision, whereby the tumor is surgically removed, along with a margin of normal skin around the tumor. If a large amount of surrounding skin is removed, the procedure is called a wide local excision. Mohs microsurgery is an operation in which a tumor is removed layer by layer, with each layer microscopically viewed for cancer cells until no cancer is seen. In some cases of penile cancer, a partial or total penectomy is done; this is removal of part or all of the penis. In more invasive and deeper spreading penile cancers, lymph nodes are typically removed for evaluation to see if the cancer has spread to the nodes, according to the American Cancer Society.
Radiation Therapy
The American Cancer Society describes radiation therapy as using high-energy rays to kill cancer cells. This mode of treatment may be done instead of surgery for very early-stage penile cancer, or it may be used after surgery to kill any remaining cancer cells and reduce the possibility of the cancer recurring. In advanced penile cancers, it may be used to slow the growth of the cancer, or to relieve any symptoms caused by the disease. External beam radiation therapy uses a machine outside the body to aim radiation toward the cancerous area. Internal radiation, or brachytherapy, is when radioactive needles or pellets are placed directly into or near the cancerous area for a period of time, then removed.
Chemotherapy
Chemotherapy is the use of medications to kill or slow down the growth of cancer cells. Penile cancer is typically treated with topical chemotherapy, which is placed on the skin, and systemic chemotherapy with intravenous drugs, according to the American Cancer Society. 5-fluorouracil, or 5-FU, is a commonly used topical chemotherapy medication for penile cancer. This medication is used as a cream and is directly rubbed into the skin of the penis daily for a prescribed amount of weeks. Used this way, the medication cannot reach deep into the tissues, and cannot kill cancer cells in other parts of the body, so this is generally only used in noninvasive penile cancers. Systemic chemotherapy travels through the bloodstream and is able to kill cancer cells throughout the body. Drugs in this category for penile cancer include cisplatin, 5-FU, vincristine, methotrexate and bleomycin.
Biologic Therapy
The National Cancer Institute defines biological therapy as a treatment that helps an individual's immune system attack the cancer. Biotherapy and immunotherapy are other names for this kind of treatment. For noninvasive cancer of the penis, or carcinoma in situ, a topical biotherapy medication called imiquimod may be used to treat the disease.
