Penile cancer

**Penile cancer** is cancer of the penis.

## Signs and symptoms
Penile cancer usually causes changes in the skin of the penis. A part of the penile skin may become thicker, or it may change in color. Penis cancer can also cause a wound that bleeds and doesn't heal like a normal wound. Penis cancer can also cause a bump or wart-like lump on the penis. Penis cancer usually happens on the head of the penis, but it can also happen on the shaft.

Cancer cells can spread from the penis to the lymph nodes in the groin (the inguinal lymph nodes). This causes lymphadenopathy (swelling of the lymph nodes).

Cancer cells can also spread to other body parts via the blood stream. This is called metastasis. Penile cancer can metastasise to the bones. This causes bone pain.

## Treatment
The treatment of penile cancer depends on many things: the kind of cancer, how large the cancer is, if it has spread to other body parts, and how healthy the patient is.
*Surgery on the penis: a surgeon can cut away the cancer. Usually, the surgeon cuts away the cancer and some of the healthy tissue around the cancer. This is to make sure that all of the cancer is removed. If the cancer is very large, the surgeon may have to remove the entire penis. This is called a penectomy.
*Surgery on the lymph nodes: if there is a high chance of cancer cells being in the lymph nodes, the doctors will also cut away the lymph nodes in the groin.
*Chemotherapy: chemotherapeutic drugs are medications that kill cancer cells. However, chemotherapeutic drugs also kill some of the patient's healthy cells. Because of this, chemotherapy usually makes the patient very sick.
*Radiation therapy: radioactivity can be used to kill cancer cells.

## Risk factors
There are many risk factors for penile cancer:
*Human papillomavirus (HPV) infection: HPV is a virus that infects the skin. There are many kinds of HPV. Some kinds cause papillomas (warts). Other kinds cause cancer of the penis, vulva (area outside the vagina), anus, throat, and cervix. The kinds of HPV that can cause cancer are called "high-risk HPV" (hr-HPV). hr-HPV causes about 60% of penile cancer.
*Not being circumcised: circumcision removes all or part of the foreskin. Men who were circumcised as a child have a lower chance of getting penile cancer. Men who are circumcised as an adult don't have a lower chance. Scientists think circumcision lowers the risk of penile cancer because it lowers the chance of getting other risk factors, like phimosis and smegma.
*Phimosis: phimosis means the foreskin can't be pulled back over the head of the penis. Men with phimosis have a high risk of getting penile cancer.
*Smegma: the head of the penis produces a white material called smegma. Smegma keeps the head of the penis moist (wet). Smegma gathers under the foreskin. If it is not cleaned often, smegma can irritate the head of the penis. This irritation increases the chance of developing penile cancer.
*Age: older men have penile cancer more often than younger men.
*AIDS: men with AIDS have a higher chance of getting penile cancer. If someone has AIDS, his immune system is weak and can't kill cancer cells.
*Tobacco: smoking or chewing tobacco increases the risk of many kinds of cancer, including penile cancer.

## Epidemiology
Cancer of the penis is rare in developed countries. It is much more common in developing countries.

## References