Dr Brendan Dias

Key Points

Penile cancer is a rare cancer that usually starts on the foreskin or head of the penis. Early signs include a persistent lump, ulcer, rash or bleeding under the foreskin. Most cases are squamous cell carcinoma, and early treatment — often organ-preserving surgery — is highly effective.

Penile cancer is rare, accounting for less than 1% of cancers in men in Australia, and most commonly affects men over 60.
The most important early sign is any persistent change on the penis: a lump, ulcer, wart-like growth, redness, discharge or bleeding — particularly under a tight foreskin.
Major risk factors include phimosis (tight foreskin), HPV infection, smoking, and chronic inflammation; circumcision in childhood is strongly protective.
Diagnosis requires a biopsy — a small sample of the abnormal area, usually done under local anaesthetic.
Early-stage disease is often treated with organ-preserving surgery such as circumcision, wide local excision or laser therapy; more advanced disease may require partial penectomy.
Most men treated early are cured. Any persistent penile lesion should be examined without delay — embarrassment should not prevent assessment.

Written and clinically reviewed by Dr Brendan Dias

Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)

Last clinically reviewed: 20 August 2026

What is penile cancer?

Penile cancer is a rare malignancy that develops in the skin or tissues of the penis, most often on the foreskin or the glans (head). Around 95% of cases are squamous cell carcinoma. Although uncommon in Australia, it is an important diagnosis not to miss: caught early, it is highly curable, but delayed diagnosis allows it to spread to the groin lymph nodes and beyond.

Early signs and symptoms

See a doctor promptly if you notice any of the following, especially if it persists beyond a few weeks:

A lump, growth or wart-like lesion on the penis
An ulcer or sore that does not heal
Persistent redness, rash or velvety patches on the glans or foreskin
Bleeding from the penis or from under the foreskin
Foul-smelling discharge beneath the foreskin
A change in skin colour, or thickening of the penile skin
A new lump in the groin (which may indicate spread to lymph nodes)

These symptoms are far more often caused by benign conditions — infections, lichen planus, or inflammation — but only examination, and sometimes biopsy, can tell the difference.

Risk factors

Phimosis — a tight foreskin that cannot be retracted is the strongest risk factor, because it promotes chronic inflammation and poor hygiene.
HPV infection — human papillomavirus (particularly types 16 and 18) is found in around half of penile cancers.
Smoking — a significant independent risk factor.
Not being circumcised — circumcision in childhood is strongly protective; adult circumcision may be recommended for men with phimosis.
Chronic inflammatory skin conditions — such as lichen sclerosus.
Age — most cases occur in men over 60.

Diagnosis and staging

Diagnosis begins with examination and a biopsy of any suspicious area — a minor procedure usually performed under local anaesthetic. If cancer is confirmed, staging investigations may include MRI of the penis, ultrasound or CT scanning, and assessment of the groin lymph nodes. The stage and grade of the tumour guide treatment.

Treatment options

Organ-preserving treatment (early-stage disease)

Circumcision — often sufficient for tumours confined to the foreskin. See circumcision.
Wide local excision — removal of the tumour with a margin of healthy tissue.
Laser or Mohs-type surgery — for carefully selected superficial lesions.
Topical or radiotherapy — for some pre-cancerous or very early lesions.

Partial or total penectomy (advanced disease)

For larger or more invasive tumours, removal of part of the penis — partial penectomy — is required. Modern surgical techniques aim to preserve as much length and function as oncologically safe; most men can still urinate standing after partial penectomy, and many retain sexual function.

Lymph node management

If cancer has spread — or is at high risk of spreading — to the groin lymph nodes, these may be removed (inguinal lymph node dissection) or sampled. Chemotherapy or radiotherapy may be added for advanced disease.

Prognosis

When treated early, penile cancer is cured in the great majority of men. Outcomes are strongly linked to stage at diagnosis — one more reason to have any persistent penile change examined promptly rather than waiting.

Frequently asked questions

Is penile cancer contagious?

No. Cancer itself cannot be passed to a partner. However, HPV — a risk factor for some penile cancers — is sexually transmitted, and vaccination reduces HPV-related disease.

Will I lose my penis?

Most men diagnosed early are treated with organ-preserving surgery such as circumcision or local excision. Penectomy is reserved for more advanced tumours.

I'm too embarrassed to see a doctor — what should I do?

Urologists examine penile problems every day; it is routine clinical work. Delay is the enemy of a good outcome — please make an appointment rather than waiting.

Assessment in Melbourne

Dr Brendan Dias assesses and treats penile lesions, phimosis and penile cancer. Learn more about penile cancer treatment, call +61 (03) 9110 3828, or use the contact form.

Penile Cancer — Signs, Diagnosis and Treatment Options