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Penile and Urethral Cancer

  • Two rare cancer types that affect the penis and urethra
  • Symptoms may include changes in color of the penis and growths on the urethra
  • Treatment usually includes surgery, radiation, and chemotherapy
  • Involves Urologic Oncology Program and Prostate & Urologic Cancers Program

Overview

You'll be relieved to learn that penile cancers and urethral cancers (which can affect women, too) are rare. Sexually transmitted diseases are one risk factor that can put people at higher risk of developing these types of cancers. 

"Yale Medicine Urology offers a comprehensive, multidisciplinary approach to cancers of the penis and urethra," says Patrick Kenney, MD, a Yale Medicine urologist. "Our approach includes expert diagnosis with the aid of dedicated genitourinary pathologists. In appropriate patients, we are able to employ multimodal treatment approaches including chemotherapy, radiation and surgery."

Thanks to advanced surgical techniques, Yale Medicine’s urologists specialize in surgical techniques that help patients who are diagnosed with penile or urethral cancers have the best possible outcomes. "Whenever possible, we aim to treat the cancer while preserving organs and organ function,” says Dr. Kenney.

What are penile and urethral cancers?

These rare cancers develop when tumors form inside the penis and/or urethra.

Penile cancer refers to the growth of cancer cells inside the penis, while urethral cancer is a specific type of cancer that develops inside the long tube that carries urine outside the body. In men, the urethra is about eight inches long and carries semen as well as urine.

How common are cancers of the penis?

Penile cancer accounts for less than 1% of cancers in men in North America. Urethral cancer, which can occur in both men and women, is also very rare and represents less than 1 percent of cancers overall. In addition, the number of people with urethral cancer has been declining over the last 30 years.

What are the risk factors for penile and urethral cancers?

In general, men who have human papillomavirus (HPV) or other sexually transmitted diseases are at higher risk for both penile and urethral cancers. Men who have never been circumcised carry higher risk of penile cancer.

Men with a history of bladder cancer carry higher risk of urethral cancer.

Having a greater risk does not mean you will develop cancer. At the same time, some patients develop cancer even if they don’t have any of the risk factors.

How are penile or urethral cancer diagnosed?

These cancers are so rare that screening is not formally recommended. Yet, these cancers can be caught early with regular checkups and by understanding the risk factors.

Penile cancer could start to cause lumps or redness on the penis. Men with urethral cancer might notice urinary incontinence, difficulties with urination, unusual discharge or blood from the urethra or a lump in the penis/groin area.

Men who experience these visible symptoms might be suffering from penile or urethral cancer and should visit their doctor.

How are penile and urethral cancer treated

Surgery is almost always required to remove the cancerous tissue. Depending on how far the tumor has spread, treatment will include surgery alone or surgery plus radiation and/or chemotherapy.

Our surgeons are well-versed in penis-preserving techniques - removing the tumor entirely while sparing as much normal tissue as possible.

If the tumor is extensive, and the penis needs to be partially or fully removed, reconstructive plastic surgery might be an option.

What surgical techniques are used to preserve the penis?

We treat patient at all stages of disease, from early-stage cancer to late-stage, in which the cancer has spread elsewhere in the body. Smaller tumors can often be removed using lasers, an electrical cauterization tool or with a surgical instrument inserted inside the urethra.

In addition, a technique called Mohs surgery, in which layers of tissue are removed, is also an effective way to remove cancerous tissue. Often, chemotherapy is used to shrink larger tumors inside the penis before removal is attempted.

The urologists at Yale Medicine are trained in the latest penile-preserving techniques. When possible, this will include a complex technique called glans resurfacing, which is only offered at specialist care centers. Surgeons will also attempt to reconstruct the urethra whenever possible.

Recognizing the importance of detecting cancer that may have spread to surrounding tissue, our urological oncologists are also trained in dissection of nearby lymph nodes, which are oval-shaped organs in the groin.

Are experimental treatments an option?

One experimental treatment for penile cancer is a new type of surgery which involves removing a patient’s first lymph node. This node is more likely to contain cancer cells because it often collects lymphatic drainage from the tumor. After removing lymph nodes with any cancer cells in them, the tumor will also be removed.

Other experimental treatments include drugs called radiosensitizers, which make the tumor more susceptible to radiation. Another experimental treatment is biologic therapy, also called immunotherapy, which uses a patient’s own immune system to fight off cancer.

Why turn to Yale Medicine?

Our urologists are trained in advanced surgical techniques that help patients who are diagnosed with penile or urethral cancers. We are one of the largest urology departments in the Northeast and New York, offering a full range of urologic care in a compassionate, supportive setting provided by top surgeons in the field.