Penile Cancer

Table of Contents

1. Overview
2. Anatomy of the Penis
3. Types of Penile Cancer
4. Epidemiology
5. Risk Factors
6. Staging
7. Diagnosis
8. Treatment
9. Complications
10. Prognosis
11. Prevention
12. References & Research
13. Research Papers
14. Connections
15. Featured Videos

1. Overview

Penile cancer is a malignancy that develops in the tissues of the penis. It is rare in the United States — roughly 2,200 new cases and about 400 deaths each year according to NCI SEER data — but it carries a devastating physical and psychological burden because of where it occurs. Many men delay seeking evaluation out of embarrassment or fear, and that delay is genuinely dangerous. When penile cancer is found early, it is curable. Found late, it is not. That single fact is the most important thing on this page.

If you or someone you love is reading this because of a sore, lump, or change on the penis that has not healed, please do not wait. The skin of the penis does not routinely develop persistent lesions that do not resolve on their own. A doctor needs to look at it. That appointment is not dramatic; it is just necessary.

About 95% of penile cancers are squamous cell carcinomas (SCC) — cancers that arise from the skin-like lining cells that cover the external surface and inner foreskin. There are two distinct biological pathways to penile SCC, one involving the human papillomavirus (HPV) and one involving chronic inflammation from a non-retractable foreskin (phimosis). Understanding which pathway applies matters for prognosis and, increasingly, treatment.

Penile cancer is far more common in parts of Africa, Asia, and South America where neonatal circumcision is uncommon and where it can account for up to 10% of all male cancers. In the United States and Western Europe it is uncommon but not vanishingly rare, and it is not a disease that only strikes older men — though most cases occur in men in their 60s and 70s.

This page uses honest language and real numbers. Some of what follows is difficult to read. We believe that accurate information — even when it is hard — serves patients and families better than false comfort.

2. Anatomy of the Penis

Understanding where penile cancer can arise requires a brief map of the anatomy, because the location of the tumor influences treatment options, surgical planning, and outlook.

The penis has several distinct regions. The glans penis is the rounded distal tip — the most sensitive part, and in uncircumcised men it is covered by the foreskin (prepuce), a retractable fold of skin. Between the glans and the shaft of the penis runs a groove called the coronal sulcus. The shaft makes up the long body of the penis. Inside, two cylindrical structures called the corpora cavernosa (one on each side) fill with blood during erection; below them runs the corpus spongiosum, which surrounds the urethra (the tube carrying urine and semen).

These internal structures matter enormously for staging and surgery. Invasion into the corpus spongiosum indicates a more advanced tumor (T2). Invasion into the corpora cavernosa means the cancer has reached even deeper structures (T3). Invasion into the urethra is also T3. These distinctions determine whether organ-sparing surgery is possible or whether a partial or total penectomy is required.

Where penile cancers arise most often:

• Glans penis — the most common site, roughly 50% of cases
• Foreskin/prepuce — about 20%
• Coronal sulcus — about 15%
• Shaft — about 10%

Lymphatic drainage follows a predictable path: superficial inguinal lymph nodes (in the groin) → deep inguinal nodes → pelvic lymph nodes (external iliac). This chain is critically important because penile cancer spreads primarily through the lymphatic system, and the status of the inguinal lymph nodes is the single most important factor predicting whether a man can be cured. Unlike some other cancers, "skip metastases" — where cancer jumps directly to deep nodes without first passing through superficial ones — are uncommon in penile cancer.

3. Types of Penile Cancer

The vast majority of penile cancers — about 95% — are squamous cell carcinomas (SCC), arising from the flat, skin-like cells on the surface of the penis. Within SCC there are several distinct subtypes that differ in their biology and prognosis:

HPV-related pathway (approximately 40–50% of cases): HPV types 16 and 18 integrate into the DNA of penile epithelial cells and drive uncontrolled growth through a well-understood mechanism — the virus's E6 and E7 proteins deactivate the tumor-suppressor proteins p53 and Rb. The result is a type of pre-cancer called penile intraepithelial neoplasia (PeIN) — sometimes called Bowen's disease when on the shaft, or erythroplasia of Queyrat when on the glans. The HPV-related tumors tend to be warty or basaloid in histological appearance and may arise in somewhat younger men. Some evidence suggests HPV-positive tumors have a marginally better prognosis than HPV-negative ones, but this is not firmly established.

Non-HPV / chronic inflammation pathway (approximately 50–60% of cases): Phimosis — the inability to retract the foreskin — traps smegma (a mix of shed skin cells and secretions) beneath the prepuce. Over years, the resulting chronic inflammation and repeated minor trauma drive keratinocyte DNA damage and eventually keratinizing, differentiated SCC. This pathway is more common in older men and in populations where neonatal circumcision is less practiced. Lichen sclerosus (a chronic scarring condition of the foreskin and glans) is closely linked to this pathway.

Other, rarer types of penile cancer include:

• Verrucous carcinoma — a low-grade, slow-growing, locally invasive SCC variant that rarely metastasizes. Often HPV 6/11-related. Appears as a large, warty, cauliflower-like growth.
• Adenocarcinoma — very rare; arises from sweat glands or the penile urethra.
• Melanoma of the penis — uncommon but reported.
• Sarcoma — extremely rare; arises from connective tissue.
• Basal cell carcinoma — rare on the penis.
• Paget's disease of the penis — an intraepithelial adenocarcinoma that can signal an underlying visceral malignancy.

4. Epidemiology

In the United States, approximately 2,200 men are diagnosed with penile cancer each year, and about 400 die from it (American Cancer Society 2024 estimates). These are small numbers by cancer standards — penile cancer accounts for less than 1% of all male cancers in the US — but "rare" is cold comfort to the man facing it and his family.

The global picture is very different. In parts of Uganda, Brazil, and India, penile cancer accounts for up to 10% of all male cancers. Across sub-Saharan Africa and Southeast Asia, age-standardized incidence rates can be ten times higher than those in the United States. The dominant explanation is the combination of lower circumcision rates, higher HPV prevalence, and limited access to penile hygiene and healthcare.

In the United States, penile cancer is most common in men in their 60s and 70s. It is uncommon before age 40, though it can occur in younger men, particularly in the HPV-driven pathway. Rates are modestly higher in Black and Hispanic men in the US compared to non-Hispanic white men — a difference likely reflecting circumcision patterns and socioeconomic access to healthcare rather than intrinsic biology.

Circumcision and risk: Neonatal circumcision reduces the lifetime risk of penile cancer by roughly three-fold. The protection comes from eliminating phimosis as a possible risk factor and substantially reducing the opportunity for HPV to establish persistent infection under the foreskin. Adult circumcision provides partial but lesser protection. This is not an argument for universal circumcision — that is a personal and cultural decision — but it is a fact that the epidemiology makes impossible to ignore.

HIV and immunosuppression increase the risk of penile cancer, most likely by impairing immune control of HPV infection. Men with HIV have higher rates of penile PeIN and invasive cancer.

5. Risk Factors

Several well-established risk factors increase a man's chance of developing penile cancer. Knowing them does not mean any of this is a man's fault — most men with these exposures never develop the disease. But understanding the risks helps with screening awareness and prevention.

• Phimosis — inability to retract the foreskin — is the greatest single risk factor in the non-HPV pathway. Studies report an odds ratio of approximately 11 compared to men without phimosis. The mechanism is chronic smegma retention and repeated local inflammation.
• HPV infection — particularly types 16 and 18 (high-risk oncogenic strains) and types 6/11 (lower-risk strains associated with condyloma). HPV is the most common sexually transmitted infection and usually clears on its own; persistent infection is the risk.
• Lack of neonatal circumcision — not an absolute risk factor (most uncircumcised men never develop penile cancer) but a recognized contributor via the phimosis and HPV pathways.
• Smoking — an independent risk factor, synergizing with both HPV and chronic inflammation. The carcinogens in tobacco smoke are concentrated in smegma and also impair local immune surveillance of HPV.
• Poor penile hygiene — in uncircumcised men, infrequent cleaning under the foreskin allows smegma to accumulate and the chronic-inflammation pathway to operate.
• Lichen sclerosus (LS) — formerly called balanitis xerotica obliterans (BXO). This chronic scarring condition of the foreskin and glans causes the skin to become pale, thickened, and inelastic. It can cause phimosis and is itself a precancerous condition — men with LS have meaningfully higher rates of penile cancer.
• Prior radiation therapy to the penis or pelvic region — rare, but radiation-induced malignancy is a recognized late complication.
• PUVA phototherapy — psoralen combined with ultraviolet-A radiation, used to treat psoriasis, increases the risk of penile SCC with long-term exposure.
• HIV infection and immunosuppression — as noted above, impaired immune control of HPV drives risk.
• Multiple sexual partners / early sexual debut — increases lifetime HPV exposure.

It is worth stating plainly: most men with penile cancer did not do anything "wrong." Phimosis is not a personal failing. HPV infection is nearly universal among sexually active people. Smoking is an addiction. The risk factors above are tools for prevention and early detection, not a list of things to feel guilty about.

6. Staging

Penile cancer is staged using the AJCC 8th Edition (2017) system, which classifies both the primary tumor (T) and lymph node involvement (N). Stage at diagnosis — particularly whether cancer has spread to the inguinal lymph nodes — is the most important determinant of whether a man can be cured.

Primary Tumor (T)

• Tis — Carcinoma in situ (also called penile intraepithelial neoplasia, PeIN). Cancer cells are present but have not grown through the basement membrane into surrounding tissue. Highly treatable.
• Ta — Non-invasive verrucous carcinoma. A low-grade, wart-like tumor that grows outward rather than inward.
• T1a — Tumor invades the lamina propria (the thin connective tissue layer just below the surface), but is well- or moderately differentiated and does not show lymphovascular invasion (LVI). Lower risk of lymph node spread.
• T1b — Lamina propria invasion with either lymphovascular invasion OR poorly differentiated (high-grade) histology. Higher risk of lymph node spread — this is a clinically important distinction.
• T2 — Tumor invades the corpus spongiosum, with or without involvement of the urethra.
• T3 — Tumor invades the corpora cavernosa, with or without urethral involvement. More advanced invasion requiring more aggressive surgery.
• T4 — Tumor invades other adjacent structures — the prostate, scrotum, pubic bone. Locally very advanced.

Regional Lymph Nodes (N)

• N0 — No palpable or radiographically suspicious lymph nodes.
• N1 — Up to 2 unilateral inguinal lymph node metastases, with no spread outside the node (no extranodal extension).
• N2 — 3 or more unilateral inguinal nodes, or bilateral inguinal node involvement.
• N3 — Extranodal extension of lymph node metastasis, OR pelvic lymph node involvement.

There is no widely used M (metastasis) staging for penile cancer because distant metastases are uncommon at presentation and historically classified within overall stage grouping. When distant spread does occur, the lung, liver, and bone are most common.

A critical clinical point: approximately 25% of men with clinically negative lymph nodes (cN0) on examination actually have occult micrometastases in the inguinal nodes that are too small to feel or see on imaging. This is why modern guidelines (EAU, NCCN) require pathological lymph node staging — not just clinical examination — for T1b and above. Treating a man as node-negative based on physical exam alone, when he actually has microscopic node disease, is one of the most important avoidable mistakes in penile cancer management.

7. Diagnosis

The diagnosis of penile cancer begins with a visit to a doctor — which too many men delay for months or even years out of embarrassment. If you have a lesion, sore, thickening, or discoloration on the penis that has not resolved in 3–4 weeks, please see a urologist. You will not be judged. The evaluation is straightforward.

Biopsy of the Primary Lesion

A tissue biopsy is essential before any treatment can be planned. No one should treat penile cancer based on visual appearance alone — several benign conditions can look similar. A punch biopsy (a small circular blade removes a core of tissue) or incisional biopsy (a small wedge of tissue) is performed under local anesthesia in an office or minor-procedure setting. The sample goes to a pathologist who determines: is it cancer? what subtype? what grade? is there lymphovascular invasion? These answers directly drive every treatment decision that follows.

Imaging

• Penile MRI with artificial erection — achieved by injecting prostaglandin E1 into the corpus cavernosum to produce erection, which separates the tissue planes and allows the MRI to clearly visualize the depth of tumor invasion. This is the best available modality for assessing whether the tumor has reached the corpus spongiosum or corpora cavernosa, which determines the T stage and whether organ-sparing surgery is possible.
• CT scan of the chest, abdomen, and pelvis — ordered for any tumor T2 or above, or when lymph nodes feel suspicious. CT maps lymph node enlargement and can detect distant spread, though it cannot detect microscopic node disease.
• PET-CT — increasingly used for lymph node staging and to guide management of suspicious inguinal nodes, particularly before planned surgery.

Lymph Node Staging

This is the most consequential part of the work-up, and it is where penile cancer management has become most sophisticated in recent years.

• If lymph nodes feel enlarged and suspicious: ultrasound-guided fine-needle aspiration (FNA) of the node can confirm or exclude metastasis before surgery is planned.
• If lymph nodes do not feel enlarged (cN0) but the tumor is T1b or higher: dynamic sentinel lymph node biopsy (DSLNB) is the preferred staging method at experienced centers. A radioactive tracer and blue dye are injected around the primary tumor; they travel via lymphatics to the first-draining ("sentinel") inguinal node, which is then identified intraoperatively and removed for pathological examination. If the sentinel node is negative, the rest of the inguinal nodes almost certainly are too — and a full groin dissection with its risks can be avoided. The DSEND multicenter study (Leijte 2007) established a sensitivity of about 95.5% for this technique in T2-T3 cN0 penile SCC. If the sentinel node is positive, a formal inguinal lymph node dissection is performed.

In centers without DSLNB expertise, modified inguinal lymph node dissection is the alternative for staging high-risk cN0 patients.

8. Treatment

Treatment of penile cancer has two parallel tracks that must both be addressed: the primary tumor on the penis, and the inguinal (groin) lymph nodes. Both require attention. Treating the penile tumor while ignoring the nodes — or vice versa — leaves a man undertreated.

Treatment of the Primary Tumor

Organ-sparing approaches are strongly preferred when they can achieve adequate margins. Modern evidence shows that with appropriate patient selection, organ-sparing surgery gives comparable cancer control to more radical penectomy, with dramatically better quality of life. The preference for organ preservation is embedded in both the European Association of Urology (EAU) and the National Comprehensive Cancer Network (NCCN) guidelines.

• Tis / PeIN (carcinoma in situ): Topical therapy with 5-fluorouracil cream or imiquimod is first-line for thin, superficial lesions. Laser ablation (CO2 or Nd:YAG) works well for glans-surface disease but carries higher local recurrence rates than wide local excision. Careful surveillance is essential after any organ-sparing approach.
• T1a (well-differentiated, no LVI): Wide local excision (WLE) with a 5mm surgical margin is the workhorse. For glans lesions not amenable to WLE, glansectomy (surgical removal of the glans) with neoglans reconstruction using a split-thickness skin graft provides both oncologic control and an acceptable cosmetic result. Radiotherapy — external beam or brachytherapy (internal radiation seeds/wires placed directly into the penis) — is an evidence-based alternative for glans T1–T2 lesions up to 4 cm, preserving the organ at the cost of a risk of late fibrosis and urethral stricture.
• T1b–T2 (LVI+, poorly differentiated, or corpus spongiosum involved): Partial penectomy — surgically removing the distal portion of the penis with clear margins of at least 5mm — is the most common surgical approach at this stage. The urethra is reconstructed to allow normal urination. If enough penile shaft is preserved, sexual function can often continue. For distal T2 disease involving only the corpus spongiosum, organ-sparing glansectomy is still considered at experienced centers.
• T3–T4 (corpora cavernosa involvement, or adjacent structures): Total penectomy with perineal urethrostomy — permanent rerouting of the urethra to an opening in the perineum (between the scrotum and anus) for urination. This is a significant procedure with major quality-of-life implications. For T4 disease that cannot be surgically removed, neoadjuvant chemotherapy (TIP regimen: paclitaxel, ifosfamide, cisplatin) is given first to shrink the tumor, followed by reassessment for surgery.
• Radiotherapy is an established, guideline-supported alternative to surgery for selected T1–T2 glans tumors up to 4 cm in patients who refuse surgery or are not surgical candidates. Brachytherapy (interstitial radiation) achieves local control rates comparable to partial penectomy in properly selected cases and is practiced at specialized centers in Europe. Late complications include urethral stricture, penile fibrosis, and (rarely) radionecrosis requiring penectomy.

Inguinal Lymph Node Management

The management of the inguinal lymph nodes is the most critical part of penile cancer treatment and the area where errors are most likely to cost lives. The decision tree depends on what the nodes feel like (clinical N status) and the pathological T stage.

• cN0, T1a (low risk): Surveillance — the risk of occult lymph node metastasis is less than 2% and the complication risk of lymph node surgery outweighs the benefit.
• cN0, T1b and above (intermediate to high risk): Dynamic sentinel lymph node biopsy. If positive: modified inguinal dissection. If negative: surveillance.
• cN1–N2 (palpable inguinal nodes): Radical inguinal lymph node dissection (iILND). This is major surgery — removing the lymph node packet in the groin — with significant risk of complications including lymphedema (chronic leg and scrotal swelling, affecting 20–30% of men), wound infection, seroma, and deep vein thrombosis. Bilateral dissection is performed when both groins have palpable disease. When 3 or more inguinal nodes are found to be positive, or when extranodal extension is present, pelvic lymph node dissection (external iliac and obturator nodes) is added, since the risk of pelvic involvement rises sharply.
• cN3 (pelvic node involvement, fixed/ulcerated groin disease): Neoadjuvant chemotherapy (TIP regimen) followed by surgery if the disease responds sufficiently; or primary chemoradiotherapy.

Systemic (Chemotherapy and Immunotherapy) Treatment

Systemic treatment plays a role in locally advanced and metastatic penile cancer, though it is not as well-developed as in some other solid tumors. Penile SCC is treated similarly to other squamous cell carcinomas of the head/neck and cervix, with regimens borrowed from those settings.

• TIP regimen (neoadjuvant/first-line metastatic): Paclitaxel 175 mg/m² on day 1 + ifosfamide 1.2 g/m² on days 1–3 + cisplatin 25 mg/m² on days 1–3, repeated every 21 days for 4 cycles. The landmark phase II study by Pagliaro et al. (2010) reported an overall response rate of 50% and a complete response rate of about 11%, with 30% of patients able to proceed to surgical resection.
• Other cisplatin-based regimens: Cisplatin + paclitaxel; cisplatin + 5-fluorouracil. These are used in the metastatic setting or when TIP is not tolerated.
• Pembrolizumab (immunotherapy): In the KEYNOTE-158 basket trial, pembrolizumab (anti-PD-1 checkpoint inhibitor) showed activity in squamous cell carcinomas of various sites, including the penis, with an overall response rate of approximately 12% in penile SCC. Responses tend to be durable when they occur, and PD-L1-positive tumors appear more likely to respond. Pembrolizumab is an option in the second-line or later setting.
• Cetuximab (anti-EGFR therapy): Penile SCC frequently overexpresses the epidermal growth factor receptor (EGFR). Cetuximab, used successfully in head-and-neck SCC, has been used in small series of penile cancer patients and is being studied further.
• Nivolumab (anti-PD-1): Small case series and retrospective reports suggest activity; formal prospective data are limited.

9. Complications

The complications of penile cancer come from both the disease itself and from its treatment. Understanding them in advance helps men and their families prepare, and helps ensure that supportive care is not treated as an afterthought.

Complications from Surgery

• Erectile dysfunction — partial penectomy results in ED in approximately 25–50% of men when enough penile shaft is preserved to allow intercourse; total penectomy results in the complete absence of penetrative sexual function. Men retain the capacity for orgasm after both procedures. Psychological support and, where applicable, sex therapy are important components of rehabilitation.
• Urethral stricture — narrowing of the urethra after penile surgery can cause difficulty urinating. It can usually be treated with dilation or surgical repair.
• Lymphedema — the most debilitating complication of inguinal lymph node dissection. Damage to the groin lymphatics causes chronic, often progressive swelling of the legs, scrotum, and lower abdomen. It affects 20–30% of men after full inguinal dissection and can be permanent. Treatment includes compression garments, manual lymphatic drainage massage, and meticulous skin care to prevent infections (cellulitis).
• Wound complications — groin incisions heal notoriously poorly because of poor blood supply, proximity to the perineum, and the need to clear all lymphatic tissue. Wound breakdown, infection, and seroma (fluid collection) are common and can extend hospitalization and recovery.

Complications from Radiotherapy

• Urethral stricture — radiation-induced scarring of the urethra is a well-recognized late complication, occurring in up to 20–30% of men treated with brachytherapy or external beam RT.
• Penile fibrosis — the tissue of the penis can become stiff and fibrous after radiation, affecting both function and appearance.
• Radionecrosis — in a small percentage of men, the radiated tissue does not heal well and develops tissue death, sometimes requiring penectomy. This is relatively rare with modern brachytherapy techniques but remains a risk.

Psychological Impact

The psychological burden of penile cancer — and especially of partial or total penectomy — is profound. Men may experience depression, anxiety, grief over loss of sexual function, altered body image, relationship difficulties, and social withdrawal. These are not minor side effects; for many men they are among the most significant aspects of living with or after penile cancer. Psychiatrists, psychologists, and sexual health counselors experienced in genitourinary oncology are essential team members. Partners and families are affected too and benefit from inclusion in support resources.

10. Prognosis

The outlook in penile cancer depends more than anything else on whether the cancer has spread to the inguinal lymph nodes, and if so, how extensively. Stage at diagnosis is the dominant factor determining whether a man can be cured.

• Localized disease (Stage I — T1, N0): Five-year survival is approximately 80–85%. Most men treated for stage I penile cancer are cured.
• Stage II (T2–T3, N0): Five-year survival is approximately 50–65%. Primary tumor control is usually achievable, but the risk of occult nodal spread means this group needs careful lymph node staging.
• Stage III (any T, N1–N2 — inguinal node involvement): Five-year survival ranges from approximately 30–50%, depending on the number of positive nodes and the presence of extranodal extension. Men with 1–2 positive nodes (N1) who undergo complete inguinal dissection have the best outcomes in this group.
• Stage IV (N3 or distant metastases): Five-year survival is approximately 5–15%. Locally advanced and metastatic disease is very difficult to cure, though long-term remissions do occur with chemotherapy followed by surgery.

The number of positive inguinal lymph nodes is the strongest single predictor of outcome. Men with 0 positive nodes after adequate staging have an excellent chance of cure. Men with 3 or more positive nodes, or with extranodal extension, have a much higher risk of pelvic node involvement and distant recurrence.

These statistics describe groups. They cannot predict what will happen to any individual man. Men do better than the statistics predict, and some do worse. What the statistics tell us with certainty is this: early diagnosis saves lives. The difference between the prognosis at stage I and stage III is stark, and that gap is determined almost entirely by how quickly a man sought evaluation and whether his doctors staged his nodes correctly.

11. Prevention

Penile cancer is, to a significant degree, a preventable disease. Several well-established interventions meaningfully reduce risk.

• HPV vaccination: The Gardasil 9 vaccine protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58 — including the highest-risk oncogenic strains. It is recommended for all children (girls and boys) ideally before sexual debut, and is approved for adults through age 45. Widespread HPV vaccination is expected to substantially reduce the incidence of HPV-driven penile PeIN and invasive cancer over the coming decades, as it already has for cervical and anal cancer rates in vaccinated populations. The protection is best when vaccination occurs before any HPV exposure.
• Neonatal circumcision: Removal of the foreskin at birth eliminates phimosis as a risk factor entirely and substantially reduces persistent HPV infection. The lifetime risk reduction is approximately 3-fold. This is a personal, cultural, and religious decision — not a medical mandate — but it is a genuine risk-reduction measure that should be included in informed discussions.
• Treating phimosis: In uncircumcised men, phimosis should not be ignored. Mild phimosis often responds to topical corticosteroid cream (e.g., betamethasone) applied to the tight foreskin over several weeks. More severe phimosis may require circumcision or a preputioplasty. Treating phimosis removes one of the most powerful risk factors for penile cancer.
• Penile hygiene: Regular retraction and cleaning of the foreskin removes smegma and reduces the chronic-inflammation pathway to cancer.
• Treating lichen sclerosus: If a man has LS (a pale, scarring, thickened foreskin or glans), treating it reduces the risk of malignant transformation. First-line treatment is topical high-potency corticosteroid (clobetasol propionate). Treated LS that persists or recurs despite treatment warrants biopsy to exclude early carcinoma.
• Smoking cessation: Smoking is an independent risk factor for penile SCC. Quitting reduces risk and improves overall health outcomes.
• Prompt evaluation of persistent lesions: Any penile lesion, sore, growth, or skin change that does not heal within 3–4 weeks deserves evaluation by a urologist. Early penile cancer is highly curable. The most preventable deaths from penile cancer are those where men waited months or years before seeking care.

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12. References & Research

Key Research Papers

1. Leijte JAP, Kroon BK, Valdés Olmos RA, et al. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol. 2007;52(1):170–177. PMID: 17316969. DOI: 10.1016/j.eururo.2007.02.063
2. Pagliaro LC, Williams DL, Daliani D, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol. 2010;28(24):3851–3857. PMID: 20368568. DOI: 10.1200/JCO.2010.29.5477
3. Hakenberg OW, Compérat EM, Minhas S, et al. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015;67(1):142–150. PMID: 25457021. DOI: 10.1016/j.eururo.2014.10.017
4. Crook JM, Haie-Meder C, Demanes DJ, et al. American Brachytherapy Society–GEC-ESTRO consensus guidelines for penile brachytherapy. Brachytherapy. 2013;12(3):191–198. PMID: 23522572. DOI: 10.1016/j.brachy.2012.11.008
5. Chipollini J, Azizi M, Lo Manzullo JD, et al. Penile sparing surgery for penile cancer: a multicenter international retrospective cohort. J Urol. 2018;199(5):1233–1237. PMID: 29180091. DOI: 10.1016/j.juro.2017.10.040
6. Djajadiningrat RS, Graafland NM, van Werkhoven E, et al. Contemporary management of regional nodes in penile cancer — improvement of survival? J Urol. 2014;191(1):68–73. PMID: 24099770. DOI: 10.1016/j.juro.2013.09.046
7. Spiess PE, Dhawan D, Kulkarni GS, et al. Management of penile cancer: a primer for urologists. Cancer. 2021;127(8):1218–1226. PMID: 33464563. DOI: 10.1002/cncr.33317
8. Daling JR, Madeleine MM, Johnson LG, et al. Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. Int J Cancer. 2005;116(4):606–616. PMID: 15825185. DOI: 10.1002/ijc.21009
9. Minhas S, Machan M, Sohn E, et al. Penile cancer: time to consider a change in approach to inguinal lymph nodes? J Urol. 2020;203(3):531–541. PMID: 31682551. DOI: 10.1097/JU.0000000000000612
10. Arya M, Kalsi J, Kelly J, Muneer A. Malignant and premalignant lesions of the penis. BMJ. 2013;346:f1149. PMID: 23482659. DOI: 10.1136/bmj.f1149
11. Albersen M, Parnham A, Joniau S, Sahdev V, Minhas S. Predictive factors for local recurrence after glansectomy and neoglans reconstruction for penile squamous cell carcinoma. Urol Oncol. 2018;36(4):141.e1–141.e7. PMID: 29290537. DOI: 10.1016/j.urolonc.2017.12.007
12. Hakenberg OW, Compérat E, Minhas S, et al. EAU-ASCO Collaborative Guidelines on Penile Cancer. Eur Urol. 2023;83(1):4–21. PMID: 36050086. DOI: 10.1016/j.eururo.2022.08.007

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13. Research Papers

The links below run live searches on PubMed, the U.S. National Library of Medicine's database of biomedical literature. Results update as new studies are published.

1. Penile cancer sentinel lymph node biopsy inguinal
2. Penile squamous cell carcinoma HPV circumcision
3. Penile intraepithelial neoplasia PeIN treatment
4. Partial penectomy organ-sparing penile cancer
5. Neoadjuvant chemotherapy TIP metastatic penile cancer
6. Pembrolizumab immunotherapy penile cancer
7. Penile brachytherapy radiation therapy organ preservation
8. Lichen sclerosus penile cancer risk
9. Penile cancer inguinal lymph node dissection lymphedema
10. Phimosis penile cancer risk

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14. Connections

• Cancer (Overview)
• Prostate Cancer
• Testicular Cancer
• Skin Cancer
• Cervical Cancer (HPV-related)
• Anal Cancer (HPV-related)
• Metastatic Cancers
• Oncology

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