Cancer of the Penis

Penile cancer is a rare cutaneous malignancy associated with HPV infection, poor hygiene, and chronic inflammation. It has a high rate of cure when treated in its earliest stages, but a markedly poor prognosis when it is invasive to subcutaneous tissue. It has multiple presentations that are similar to squamous malignancy found elsewhere on the body, however the nature of the genital malignancy makes early stage treatment a greater challenge. Surgery is a mainstay of early treatment, although radiation for penile sparing has gained some traction. Proper staging and, when required, lymphadenectomy, are important and should not be omitted. Locally advanced disease requires aggressive management and staging of the pelvic lymph nodes. Patients with spread into the pelvic nodes or beyond are typically not curable, however multiagent chemotherapy has shown promise in small scale studies. Because of the rarity of the disease, randomized studies are rare and small-scale series and anecdotal cases inform the mainstay of treatment.