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Penile Cancer Symptoms and Signs

by Dr. Joe Morales

What is penile cancer?

Penile cancer is a malignant growth found on the skin or in the tissues of the penis. Around 95% of penile cancers are squamous cell carcinomas. Penile cancer is a rare form of cancer that occurs mostly in uncircumcised men, meaning they still have a piece of skin called the foreskin. Circumcision may reduce the risk of penile cancer.

Other types of penile cancers such as Merkel cell carcinoma, small cell carcinoma, melanoma and other are generally rare. Penile cancer develops on the penis. A cancerous (malignant) tumor starts from one abnormal cell. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiplies ‘out of control’.

Penile cancer causes

  • Human papillomavirus (HPV) infection. …
  • Smoking
  • Age
  • Smegma
  • Phimosis
  • HIV/AIDs
  • Psoriasis treatment.

Early signs of penile cancer

The following are the earliest signs of penile cancer to look after.

  1. Change in the skin of the penis
  2. Sores
  3. Redness
  4. Irritation
  5. Discharge
  6. Bleeding
  7. A lump on the penis.
  8. Unexplained pain in the shaft or tip of the penis
  1. Reddish, velvety rash beneath the foreskin
  2. Small, crusty bumps beneath the foreskin
  3. Swollen lymph nodes in the groin

Symptoms of penile cancer

The signs and symptoms below don’t always mean a man has penile cancer. In fact, many of them are more likely to be caused by other conditions. Still, if you have any of these signs or symptoms, see your doctor right away so the cause can be found and treated, if needed. The sooner a diagnosis is made, the sooner you can start treatment and the more effective it is likely to be.

1.    Skin changes

The first symptom of penile cancer changes in the color of the skin of the affected part of the glans or foreskin of the penis. The affected skin can also be thickened or appear like a small red rash. The affected area of the skin the gradually develop in a small flat growth (often bluish-brown in color) or a growth or sore which may bleed. It does not usually cause pain. In some cases, the early cancer develops a small crusty bump.

If left untreated, cancer typically grows to involve the entire surface of the glans or foreskin. It eventually grows further to deeper parts of the penis and other parts of the body to cause various other symptoms.

Change in the color of the penis does not always mean that one has penile cancer. Penile could also be caused by:

  • Post Inflammatory Hyperpigmentation.

Not common for men, especially those with darker skin, to have some variations in coloration; it’s normal for the penis to be slightly different color than the skin on the rest of the body.

  • Bruising

Bruising of the penis following an injury can cause the skin in the affected area to change

  • Hematoma

A red, blotchy appearance or visible blood vessels under the skin’s surface may also result from penile injury.

  • Penile vitiligo

In some individuals, areas of skin on the body, including the penis, may fade in color over time until they become almost white.

2.    Swelling

Swelling at the end of the penis, especially when the foreskin is constricted, is another possible sign of penile cancer. This swelling causes formation of very painful sores on the penis.

The sensation of swelling in, on or around your penis may cause it to feel red, inflamed and tender.

Penis swelling can be accompanied by bloody or redness or discomfort. Penis swelling can be extremely uncomfortable and create difficulty with daily living, sexual relations, and urination.

Certain sexually transmitted diseases can cause penile swelling. This includes:

  • Genital warts
  • Herpes
  • Syphilis
  • Chlamydia
  • Balanitis

3.    Lumps under the skin in the groin area

Penile cancer spreads from the penis, travels to the lymph nodes in the groin. This can make those lymph nodes to swell. Lymph nodes are a collection of immune system cells. Normally, they are bean-sized and can barely be felt at all. If they are swollen, lymph nodes may be felt as lumps under the skin.

But swollen lymph nodes don’t always mean that cancer has spread there. More commonly, lymph nodes swell in response to an infection. The skin in and around penile cancer often become infected, which might cause the nearby lymph nodes to swell, even if cancer has not reached them.

Common causes of a lump or lumps in the groin area in include:

  • A cyst. Harmless fluid-filled lump.
  • Swollen glands. Usually, a sign of infection, such as cold or glandular fever, the gland tends to go down when you recover.
  • A hernia-internal part of the body, such as part of the bowel, pushes through a weakness in the muscles or surrounding tissue wall.
  • An enlarged vein-caused by a faulty valve inside the vein, the lump often disappears when you lie down.
  • Genital warts-small fleshy growth caused by sexually transmitted infection

4.    Sores

A sore on your penis that does not heal within four weeks. It can look like a wart, ulcer or blister and might not be painful. It is important to know what is normal for you.

A sore is a discontinuity of skin or mucous membrane. The skin mucous membrane is lost, thereby exposing the tissues underneath it. Sores or lumps from penile cancer are not usually painful, but they can be in some cases. You should see a doctor if you find any kind of new growth or other abnormality on your penis, even if it is not painful.


Not all male genital sores originate as a result of infection from penile cancer. Penile sores in males are most commonly caused by sexually transmitted diseases that include the following:

  • Herpes simplex virus infection (HSV2) is the leading cause of genital ulcers
  • Syphilis caused by the bacterium Treponema pallidum
  • Chancroid caused by the microorganism Haemophilus ducreyi.
  • Lymphogranuloma venereum caused by Chlamydia trachomatis (bacterium)
  • Granuloma inguinale caused by Klebsiella granulomatis.
  • Genital warts caused by human papillomavirus (HPV)

Usually, men who have genital ulcer sores may have one or more sexually transmitted infection.

Genital Ulcer Sores in Males may be also caused by non-infectious factors that include:

  • Intercourse-related trauma to the genital region
  • Psoriasis: The exact cause and mechanism of the condition are unknown. Researchers propose that the following factors may play a role:
    • Overactive immune mechanisms (especially T cell, white blood cell)
    • Family history is positive in up to a third of the affected individuals
    • Unknown environmental triggers
  • Behcet disease: The exact cause and mechanism are not known. Researchers propose genetic and unknown environmental factors may play a role
  • Fixed drug eruptions as a side effect to medications, particularly antibiotics

5.    Redness

The skin color of the penis changes from the normal and turns reddish.

6.    Irritation

Formation of sores on the penis causes a very severe pain.

7.    A Foul Smelling Discharge

A foul smell discharge can occur due to an infection or something irritating the skin of the penis. It can also be due to washing often or thoroughly enough. Cancer of the penis is a less common

8.    Bleeding From Your Penis

Bleeding can be a sign of cancer, including from under your foreskin

Penile cancer is accompanied by blood coming out on the penis. This is because the skin mucous membrane is lost, thereby exposing the tissues underneath.

9. A lump on the penis.

Penile cancer commonly presents as a lump, mass or ulcer on the penis. Lesions can be raised and wart-like or flat. The penile lesions can be sore or inflamed, and there may be itching and burning in the region as well.

Generally, penile cancer affects the head or the foreskin of the penis rather than the shaft of the penis. The presentation for penile cancers can vary significantly from a small bump to very large, infected, and aggressive lesions. The cause for such a wide range of presentations can be explained in in the delay in diagnosis.

10. A rash on your penis

You may notice that a rash develops on your penis or foreskin. It is important to be aware of what is normal for you and report any changes to the doctor.

11. Difficulty in drawing back your foreskin (phimosis)

Is a condition whereby the foreskin becomes too tight to be pulled back over the head of the penis (glans).You may notice it becomes more difficult to draw back your foreskin. Phimosis is normal in babies and toddlers, but in older children, it is may be the result of a skin condition that has caused a scarring. It is not usually a problem unless it causes symptoms. Immediate treatment is needed in cases where phimosis causes problems such as difficulty in urinating.

In adults, phimosis can occasionally be associated with sexually or different skin conditions including:

  • Eczema-is a long-term condition that causes the skin to itchy, red, dry and cracked.
  • Psoriasis- a skin condition that causes red, flaky, crusty patches of the skin covered with silvery scales.
  • Lichen planus- is a non-infectious itchy rush that can affect many areas of the body.
  • Lichen sclerosis- a scarring condition of the foreskin (and sometimes glans) that is probably caused by urinary irritation in susceptible men and boys.

Symptoms of advanced penile cancer

Male often feel embarrassed or frightened by such symptoms. They may put off going to their doctor until their cancer is more advanced. So it is important to report any symptoms to your doctor straight away. This means that if you have cancer, you can get it diagnosed and treated early.

Symptoms of advanced penile cancer (stage 3 or 4) may include:

  • A lump (swollen lymph node) in the groin
  • Feeling tired
  • Abdominal (tummy) pain
  • Pain in the bones
  • Loss of weight

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1 comment

Chuck Oct 4, 2019 - 8:42 pm

I had a fixed drug eruption from antibiotic in June. A blister formed on right side of penis glans, went over corona and down shaft to just above circumcision scar. I also had swelling in mucous membrane of mouth and red itchy hand palms. Went to a Dermatologist. He put me on oral steroid and steroid cream for penis and had me wrapping my penis with medicated gauze. The glans healed nicely in about a month. The shaft has healed to a point. i have redundant skin that folds over the bottom of my glans, I need a circumcision revision. Because the skin golds over the bottom of the head the wound is very slow healing, it appears the skin is macerated because it’s white. There is one red spot in the middle of this white moist skin. Went back to dermatologist, he said to keep the doing dry! And was concerned about herpes! Which I new there was no way. But we go down that road anyway, put me on Valacyclavoir. I knew that’ was virtuously impossible. The med had zero effect. And didn’t have herpes! He put me on doxycycline and the red spot has shrunk but the white moist skin has thickened. I’m at a loss as to what to do. When this is resolved I’m certainly going to get a circumcision revision to get rid if this skin that seems to be keeping everything moist and macerated. Any suggestion to hurry this healing process?