Sexual Health

Penile cancer

Penile cancer is a rare malignancy, usually squamous cell carcinoma, presenting as a persistent penile lesion or unexplained foreskin or glans symptoms; suspected cases need prompt cancer-pathway referral and confirmed disease is managed through a specialist supra-urology MDT.

Definition

Penile cancer is a malignant tumour of the penis, most commonly squamous cell carcinoma arising from the glans, foreskin or adjacent penile skin. Penile intraepithelial neoplasia is a precursor and may be HPV-associated or HPV-independent; other malignancies are much less common.

First principles

Persistent penile lesions need a cancer pathway

NICE recommends a suspected-cancer pathway referral for a penile mass or ulcerated lesion after a sexually transmitted infection has been excluded, or for a lesion that persists after STI treatment. Unexplained or persistent symptoms affecting the foreskin or glans also warrant consideration of this pathway. Do not repeatedly label a persistent lesion as balanitis without reassessment.

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