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Penile Cancer: Surgery

Surgical tools in an operating room

Surgery is the most common treatment for penile cancer. Early stages of penile cancer can usually be cured by surgery alone. (An early stage cancer is small and has not spread.) The kind of surgery you will have depends on these things:

  • What type of penile cancer you have

  • How big the tumor is

  • Where the tumor is

  • Whether the cancer has spread to nearby tissue or further into other parts of the body

Types of surgery for penile cancer

These are some of the kinds of surgery used to treat 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, circumcision may be able to remove all the cancer. Circumcision is surgery to remove the foreskin.

  • Simple excision.  The surgeon cuts the tumor out and also takes 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 cuts out the tumor and healthy tissue on all sides (more than with a simple excision). This ensures that all the cancer is taken out. A skin graft may be needed to cover the area.

  • Cryosurgery. Liquid nitrogen can be used to freeze and kill cancer cells. The skin blisters and peels. This treatment is mostly used for small cancers on the glans. It may be repeated until all the cancer cells are gone.

  • Mohs micrographic surgery.  This type may be an option for small, shallow tumors. The surgeon takes off a layer of the tumor and the skin around it. The sample is checked under a microscope to see if there are cancer cells in it. This is repeated until there are no more cancer cells in the layer of skin. Mohs surgery is a slow process. But it can save normal tissue around 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 used only for small tumors that are on the surface of the skin. It might also be used for men who don't want to have surgery.

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

  • Inguinal lymphadenectomy (groin lymph node dissection). This surgery is done on the nearby lymph nodes, not the penis itself. If any of the groin lymph nodes that drain lymph from the penis contain cancer cells, the surgeon removes them. These nodes can be found using a procedure called a sentinel lymph node biopsy. It allows the surgeon to find the first (sentinel) nodes that drain the tumor. These few can be removed and checked for cancer cells. If there's no cancer in them, no more nodes need to be taken out. If cancer cells are found, more nodes are removed. Many men with penile cancer have swollen groin lymph nodes. 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 this surgery might be done to remove the lymph nodes and check them for cancer. 

Medical Reviewers:

  • Kimberly Stump-Sutliff RN MSN AOCNS
  • Louise Cunningham RN BSN
  • Richard LoCicero MD