context: Penile cancer starts on the skin cells of the penis and can work its way inside. It's rare. But it can be treated, especially if it's found early on. In the U. S., doctors find it in about 2,100 men each year. If you or someone you love has it, you'll want to know what your options are. Experts don't know exactly what causes this disease. Not being circumcised may make it more likely. If bodily fluids get trapped in the foreskin and aren't washed away, they may contribute to the growth of cancer cells. Some research suggests that men who are exposed to certain strains of HPV (human papillomavirus) may also be more likely to get penile cancer. This type of cancer is more common in men over age 60, in smokers, and in those who have a weakened immune system. Changes in the penis skin are the most common symptom of penile cancer. They can show up on the foreskin of uncircumcised men, or on the penis tip (the glans) or shaft. Warning signs of the disease can include: Changes in thickness or color of skin on the penis A lump on it A rash or small âcrustyâ bumps on it; it can look like an unhealed scab. Growths on the penis that look bluish-brown Smelly discharge underneath the foreskin A sore on the penis, which may be bleeding Swelling at the end of the penis Lumps under the skin in the groin area Most men with these symptoms don't have penile cancer. Instead, it's an infection or an allergic reaction. Even so, it's important to get any unusual symptoms on or near your penis checked out right away. Early treatment is best. Your doctor will give you a physical exam, talk with you about your symptoms, and may recommend other tests, such as: A biopsy. The doctor will take a small sample of tissue from a skin lesion on the penis. Lab tests will check it for cancer cells. Imaging tests, like X-rays, CT scans, ultrasounds, and magnetic resonance imaging ( MRI). These look inside your body for tumors or other signs that cancer has spread. If your cancer is in the early stages, your treatment may include: A medicine that goes on your skin as a cream Cryotherapy, a procedure that uses an extremely cold liquid or a device to freeze and destroy tissue that contains cancer Mohs surgery, in which doctors remove affected skin, one layer at a time, until they reach normal, healthy tissue Lasers to cut and destroy areas that contain cancer Circumcision, which is surgery to remove the foreskin. You would have this procedure if you only had cancer in your foreskin. If your cancer is advanced or has a high risk of spreading, treatment may involve any of the above, and/or: Surgery to remove some or all o your inguinal lymph nodes if your cancer has spread to them Radiation and/or chemotherapy to rid your body of cancer cells A penectomy, which is surgery to remove some or all of your penis Most treatments for early-stage penile cancer don't affect your ability to have sex, but chemotherapy and radiation may. Talk to your doctor about possible side effects. Scientists are looking for new ways to treat early and advanced penile cancer in these studies, which test new drugs to see if they're safe and if they work. Clinical trials often are a way for people to try new medicine that isn't available to everyone. Your doctor can tell you if one of these studies might be a good fit for you. Before you sign up, ask for information on what's involved, and what the risks and benefits would be. You can learn more about different trials throughout the U. S. at the National Cancer Institute's web site, http://www.cancer.gov/about-cancer/treatment/clinical-trials. Ask your doctor about support groups at your hospital or in your community. You can also find support groups for men with penile cancer online. As you go through your treatment, it can also help to talk with a therapist or social worker who works with people who have cancer.