HEALTH INSIGHTS

Penile Cancer: Surgery

March 16, 2019

Penile Cancer: Surgery

Surgery

Surgery is the most common treatment for penile cancer. Early stages of penile cancer can usually be cured by surgery alone. The kind of surgery you will have depends on these things:

  • Your type of penile cancer

  • The size and location of the tumor

  • Whether the cancer has spread to the surrounding area or further into the body

Types of surgery for penile cancer

These are some of the kinds of surgery for penile cancer. Your surgeon will try to find a treatment that will give you the best chance for a cure. He or she will also try to preserve as much of your penis as possible.

  • Circumcision. If the cancer is only on the foreskin of the penis, sometimes circumcision will remove all of the cancer. This is a procedure to remove the foreskin.

  • Simple excision. The surgeon cuts the tumor out and may also take some of the nearby skin. He or she stitches the remaining skin back together. This is the same as an excisional biopsy.

  • Wide local excision. The surgeon takes out the cancerous tissue. He or she also removes some healthy tissue on both sides (more than with a simple excision) to be sure that all of the cancer is taken out.

  • Cryosurgery. For this surgery, the surgeon uses liquid nitrogen to freeze and kill cancer cells. This is only used for precancerous lesions on the penis. Or it is for small cancers that haven't invaded deeply into the penis.

  • Mohs micrographic surgery. For this, the surgeon takes off a sample of the layer of skin that the tumor may have invaded. He or she checks it under a microscope to see if it is cancerous. If it is, the surgeon continues to remove layers and look at the samples. The surgeon does this until he or she finds no more cancer. Mohs surgery is a slow process. But it can save normal tissue near the tumor. It also may not change the look or function of the penis as much as some other surgeries.

  • Laser surgery. The surgeon uses a laser beam to kill cancer cells. Laser surgery is usually only used for cancers that are on the outer layer of skin or for some kinds of skin cancer.

  • Amputation (penectomy). Amputating or removing part or all of the penis is often the best way to treat penile cancers that have spread deep into the penis. Amputation may be partial, total or radical. This depends on how far the cancer has spread.

  • Inguinal lymphadenectomy (groin lymph node dissection). If any of the groin lymph nodes that drain the penis contain cancer cells, the surgeon may remove them. This can be determined by a procedure called a sentinel lymph node biopsy. Lymph nodes in the groin area may be swollen. This swelling is often from an infection rather than cancer, so antibiotics are given. If the swelling doesn't go away in a few weeks, then a second operation, called an inguinal lymphadenectomy, is done to remove the lymph nodes. 

Updated:  

March 16, 2019

Sources:  

Carcinoma of the Penis: Surgical and Medical Treatment. UpToDate.

Reviewed By:  

Alteri, Rick, MD,Levy, Adam S, MD