Penile Cancer Surgery

Penile cancer forms in the tissues of the penis, the male external reproductive organ that delivers sperm during sexual intercourse and serves as the passageway for urine to exit the body. Most penile tumors begin in the flat skin cells (squamous cells) on the foreskin or head (glans). The exact cause of penile squamous cell carcinoma is not fully understood. Known risk factors include human papillomavirus (HPV), smoking, poor hygiene and tight foreskin (phimosis).

Penile cancer is relatively uncommon and predominantly affects older men. Symptoms can include growths or sores on the penis, foul-smelling discharge, changes in skin color and swelling. Surgery is often the primary treatment approach, which may be accompanied by radiation therapy or chemotherapy.

Surgical treatment options for penile cancer can include:

Laser surgery for penile cancer

Laser surgery uses focused, high-energy light beams to precisely remove cancerous tissue from the surface of the penis. This minimally invasive procedure may be considered for early-stage or superficial penile tumors, allowing the surgeon to target and destroy cancer cells while sparing surrounding healthy tissues. Laser surgery can minimize bleeding and often has a faster recovery time compared to more invasive procedures, making it an effective option for treating small, localized penile tumors.

How to prepare for laser surgery for penile cancer

To prepare for laser surgery, the patient should follow their physician’s instructions, which may include fasting for several hours beforehand and stopping certain medications that could increase bleeding risks. They should also arrange transportation home afterward because sedation or anesthesia may be used during the procedure.

What to expect after laser surgery for penile cancer

After laser surgery, the patient may experience some mild discomfort, swelling and/or sensitivity at the surgical site, which should subside within a few days. Their physician will provide specific after-care instructions on how to keep the treated area clean and when to schedule any recommended follow-up visits to monitor healing and check for signs of recurrence.

What are the risks and potential complications of laser surgery for penile cancer?

Compared to traditional surgery, laser surgery carries a higher risk of cancer recurrence, particularly for large and invasive tumors. Potential complications include infection, bleeding, scarring and/or changes in sensation, which can be minimized with proper post-surgical care.

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Cryotherapy for penile cancer

Cryotherapy uses extreme cold, such as liquid nitrogen, to freeze and destroy cancerous cells on the surface of the penis. Often considered for small, early-stage tumors, this minimally invasive procedure helps to preserve surrounding healthy tissues. While cryotherapy may cause some temporary discomfort at the treatment site, it generally has a shorter recovery period and fewer side effects compared to more invasive surgical options.

How to prepare for cryotherapy for penile cancer

To prepare for cryotherapy, the patient should follow their physician’s instructions, which may include avoiding certain medications that increase bleeding risk and arranging for someone to drive them home afterward if sedation will be used. The patient should also ask about post-treatment care to help ensure proper healing.

What to expect after cryotherapy for penile cancer

After cryotherapy, the patient may experience some mild discomfort, swelling, blistering and/or scabbing in the treated area, which should improve within a few days. As part of the healing process, a small amount of pale scar tissue may develop. In addition to following their physician’s specific after-care instructions to keep the surgical site clean and prevent infection, they will need to schedule follow-up visits to monitor healing and check for signs of recurrence.

What are the risks and potential complications of cryotherapy for penile cancer?

Risks associated with cryotherapy include incomplete cancer removal, especially if the tumor is large or deep, which can increase the chance of recurrence. Possible complications include infection, scarring, changes in skin color or texture and, in rare cases, nerve damage leading to altered sensation in the treated area.

Mohs micrographic surgery for penile cancer

Mohs micrographic surgery is a highly precise, tissue-sparing technique in which thin layers of skin are removed and examined under a microscope. The process is repeated until only cancer-free tissue remains. This surgical approach minimizes the removal of healthy tissue, making it especially useful for preserving function and appearance when treating small, localized penile tumors. Mohs surgery has a high cure rate and can reduce the risk of recurrence by ensuring all cancerous cells are removed.

How to prepare for Mohs micrographic surgery for penile cancer

To prepare for Mohs surgery, the patient should follow their surgeon’s preoperative instructions, which may include avoiding certain medications, such as blood thinners, to reduce the risk of bleeding. They should also arrange for transportation home after the procedure, as local anesthesia or sedation may be used.

What to expect after Mohs micrographic surgery for penile cancer

After Mohs surgery, the patient may experience some swelling, discomfort and/or bruising at the surgical site, which can usually be managed with prescribed pain-relieving medications. Follow-up appointments will be necessary to monitor healing and assess the surgical site for signs of complications or cancer recurrence.

What are the risks and potential complications of Mohs micrographic surgery for penile cancer?

Risks associated with Mohs surgery can vary depending on the size and location of the tumor, which can affect the complexity of the procedure and the healing process. Potential complications include infection, excessive bleeding, scarring and changes in penile appearance or function, though these risks are generally low with proper surgical technique and aftercare.

Circumcision for penile cancer

A surgical procedure that involves removing the foreskin, circumcision may be considered for treating penile cancer that affects the foreskin or glans. The goal is to eliminate the cancerous tissue and reduce the risk of recurrence.

How to prepare for circumcision for penile cancer

The patient should prepare for circumcision by discussing their current medications with their physician, as they may need to avoid taking blood thinners and certain supplements before the surgery. They will also need to arrange for transportation home afterward because anesthesia will be used.

What to expect after circumcision for penile cancer

After circumcision, the patient can expect some pain and swelling in the surgical area, which can typically be managed with prescribed pain relievers. The healing process usually takes a few weeks, and the patient will need to follow specific aftercare instructions to promote proper recovery and minimize the risk of infection.

What are the risks and potential complications of circumcision for penile cancer?

Risks associated with circumcision include excessive bleeding, infection and adverse reaction to anesthesia. Possible complications involve scarring, changes in penile sensitivity and, in rare cases, healing issues that may require additional medical attention.

Wide local excision for penile cancer

A traditional surgical procedure, wide local excision involves removing a cancerous tumor along with a slim margin of surrounding healthy tissue. The removed tissue will then be sent to a lab for microscopic analysis by a pathologist, who can confirm that no visible cancerous cells remain (a clear margin). If the margin is clear, further treatment may be unnecessary. This surgical technique helps to minimize the risk of cancer recurrence while preserving as much healthy penile tissue as possible.

How to prepare for wide local excision for penile cancer

Preparation for wide local excision begins with a discussion between the patient and their physician regarding medical history and medications, which may need to be paused before surgery. Because anesthesia will be used during the procedure, the patient will need to arrange for someone to drive them home afterward.

What to expect after wide local excision for penile cancer

After wide local excision, the patient may experience some pain and swelling at the surgical site, which can typically be managed with prescribed pain relievers. The patient should follow their physician’s specific aftercare instructions to promote healing and monitor for signs of infection.

What are the risks and potential complications of wide local excision for penile cancer?

Risks of wide local excision can vary based on the location and extent of the tumor, which can affect the surgical outcome and recovery process. Potential complications include infection, excessive bleeding, scarring and changes in penile sensitivity or function. Serious complications are relatively uncommon when the procedure is performed by an experienced surgeon.

Glansectomy for penile cancer

Glansectomy is a surgical procedure that involves removing the glans, often along with a portion of the shaft of the penis, to excise a cancerous tumor while preserving as much healthy tissue as possible. Urination and sexual function are usually retained after the procedure, although the surgeon may place a skin graft to reconstruct the penis.

How to prepare for glansectomy for penile cancer

The patient should prepare for glansectomy by discussing their medical history and medication use with their physician. Certain medications, such as blood thinners, may need to be temporarily discontinued. They will also need to arrange for transportation home after the procedure because anesthesia will be used.

What to expect after glansectomy for penile cancer

After glansectomy, the patient can expect some discomfort at the surgical site, which can usually be managed with prescribed pain relievers and proper wound care. Recovery time can vary, and follow-up visits will be scheduled to monitor healing and assess for any complications.

What are the risks and potential complications of glansectomy for penile cancer?

Risks associated with glansectomy can vary based on the extent of the tumor and the patient’s overall health, which can affect the surgical outcome and healing timeline. Potential complications involve infection, excessive bleeding, scarring, changes in penile function or sensitivity and, in some cases, issues related to sexual function. These risks can be minimized with careful surgical techniques and proper aftercare.

Penectomy for penile cancer

A surgical procedure that involves partial or complete removal of the penis, penectomy may be considered for treating a tumor that has invaded deep penile tissues. This procedure aims to eliminate the cancerous tissues and may be followed by reconstructive surgery to assist with urinary function.

How to prepare for penectomy for penile cancer

The patient should prepare for penectomy by undergoing a thorough medical evaluation, which will include a medication review. Certain medications, particularly blood thinners, may need to be paused before surgery. The patient should also arrange transportation home because anesthesia will be used during the procedure.

What to expect after penectomy for penile cancer

After penectomy, the patient can expect some pain and swelling at the surgical site. During the healing process, the patient may need to adjust to changes in their urinary function. Follow-up care will be necessary to monitor recovery, manage pain and address any complications.

What are the risks and potential complications of penectomy for penile cancer?

Risks associated with penectomy include infection, excessive bleeding and complications related to anesthesia, along with potential psychological impacts due to changes in body image. Complications can involve urinary issues, such as difficulty urinating or incontinence, and sexual dysfunction, although these risks can often be managed with appropriate aftercare and support.

Lymphadenectomy for penile cancer

Often performed along with other types of penile cancer surgery, lymphadenectomy involves removing lymph nodes in the groin or pelvis to check for cancer spread and help prevent further metastasis. This procedure may be considered if the cancer has (or is believed to have) grown beyond the primary tumor site.

How to prepare for lymphadenectomy for penile cancer

The patient should prepare for lymphadenectomy by discussing their medical history and medications with their physician. In particular, anticoagulant use may need to be adjusted before surgery. Because anesthesia will be used, the patient should also arrange for transportation home.

What to expect after lymphadenectomy for penile cancer

After lymphadenectomy, the patient may experience some discomfort in the groin area, which can usually be managed with pain medications and proper aftercare. During recovery, follow-up visits will be necessary to assess healing and check for signs of recurrence.

What are the risks and potential complications of lymphadenectomy for penile cancer?

Lymphadenectomy carries general surgical risks, such as infection, excessive bleeding and complications from anesthesia. Additionally, the procedure involves specific risks, such as swelling due to fluid buildup (lymphedema) and nerve damage that can lead to changes in sensation or movement in the legs. Though uncommon, these surgical complications can have a significant impact on the patient’s recovery and quality of life.

Benefit from world-class care at Moffitt Cancer Center

Patients who entrust their penile cancer treatment to Moffitt are in good hands. The surgeons in our Urologic Oncology Program have extensive experience in performing all types of penile cancer surgery, including the latest techniques in Mohs micrographic surgery and other complex procedures. In addition, the surgeons in our Reconstructive Oncology Program offer the latest options in penile reconstruction. 

If you would like to learn more about penile cancer surgery, you can request an appointment with a specialist in the Urologic Oncology Program at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.