Penile cancer: squamous cell carcinoma of the glans

Penile cancer is relatively rare, with only 670 cases a year in the UK, but doctors still need to recognise it. The usual type is squamous cell carcinoma, a cancer of the flat, skin-like surface cells. It accounts for about 95% of cases and primarily affects the glans, the rounded head of the penis. The foreskin (the skin that usually covers the glans) can also be involved, but the glans is the commonest site.

Other cell types are much less likely. Transitional cell carcinoma, also called urothelial carcinoma (from the lining of the urinary tract), is the usual type of bladder cancer. Basal cell carcinoma (a skin cancer) and melanoma (a cancer of pigment-producing cells) are both uncommon on the penis.

Risk factors include phimosis, a foreskin that cannot be pulled back, and infection with human papillomavirus (HPV, a common virus) types 16 and 18. Phimosis also makes the area under the foreskin hard to keep clean and inspect.

The red flags, meaning warning signs that need prompt referral, include a growth or sore that has lasted more than 4 weeks, bleeding, phimosis and any other change in appearance. A biopsy (a small sample of tissue examined under the microscope) confirms the type. When the lymph nodes in the groin are clinically suspicious, a CT scan of the abdomen and pelvis can look for metastases (deposits of cancer that have spread) in lymph nodes or other organs.