A-Z

Penile Cancer

Signs and symptoms of penile cancer

There are a number of symptoms that might suggest that a man has penile cancer. Penile cancer is rare and all of these symptoms could be caused by other conditions too, so if men experience any of these symptoms it is a good idea to see the doctor, who can advise whether further tests are needed. The earlier penile cancer is diagnosed and treated, the better the long-term prospects.
 
The most common symptom is some form of rash, wart-like growth or lump on the penis, particularly on the glans (head of the penis) or under the foreskin that doesn't heal within 4 weeks. Lumps can be present elsewhere in the groin. Nevertheless, rashes, warts and lumps may be harmless or signs of other conditions, which you can discuss with a doctor.

Other signs or symptoms of penile cancer include:
  • Bleeding from the penis or under the foreskin
  • A foul smelling discharge
  • A change in the colour of the penis or foreskin
  • Irritation (itching), discomfort or sharp pain (although some people have no pain)
  • Thickening of the skin of the penis or foreskin that makes it difficult to draw back the foreskin (phimosis)
  • Difficulty urinating (although many can urinate without difficulty); taking longer than normal, rash, wart or lumps covering the hole for peeing or urinary tract (water) infections
  • Blood in the urine
  • Permanent semi-erection
  • Swollen lymph nodes in your groin area

Many of the men noticed a rash or wart-like growth on the end of their penis. This was usually bright or crimson red although some men found that it was white or slightly discoloured compared to the rest of the glans. A rash or wart-like growth may be harmless although because it can be a sign of many conditions it is best to discuss it with your doctor. A few had this discolouration for much of their life, had it checked out when they were young and had no problems with it until their cancer. A white patch on the glans or foreskin, often accompanied by a tight foreskin may be caused by a skin problem on the penis called lichen sclerosus, lichen sclerosus et atrophicus or balanitis xerotica obliterans (BXO), which increases the risk of penile cancer and should therefore be monitored long-term by your doctor. A rash or wart-like growth may be harmless and last for a long time but any changes in appearance, or if it starts to bleed, leak fluid or becomes painful should be investigated. For others, the rash or wart-like growth was recent, having developed over a couple of weeks or years. Tom noticed a slight rash under his foreskin and went to his GP because it did not clear up. It can start out as a slight inflammation or a pinhead sized wart and grow larger. Sometimes, the rash or wart may decrease in size before growing again. The rash or wart may bleed, leaving spots of blood in underwear, or leak a white fluid or discharge.
 

Jordan had a discoloured patch on his penis for 28 years, which he had earlier checked out at his...

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Age at interview: 58
Sex: Male
Age at diagnosis: 57
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Going back... before my first daughter was born... there was a patch on the end of my penis, ah, just sort of discoloured. It was white, sort of, well… not as pink as the rest of it, whitish, about the size of a 5p piece.

Well the patch on the penis had been there, I’d say, 28 years, but it had never changed at all, so I didn’t bother about. I didn’t think anything of it. I did having said that, I did see the doctor because my wife said until I got it looked at, as she was carrying my daughter, before she was born. She said, ‘Get it looked at, otherwise I don’t want to make love. So [laugh] obviously that got me round to the doctor’s. The doctor looked at me and he said he didn’t see any problem with it. It was just a bit of discolouration and… it never went any further. And obviously for the, the last 27 years it’s not gone any further. So, it was when the lump started to grow, and... the bleeding and that sort of thing, that I actually... made the decision to do something about it.
 

 

Steve’s rash grew smaller then bigger while it was treated by his GP as skin discolouration on...

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Age at interview: 71
Sex: Male
Age at diagnosis: 65
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It would go smaller then go bigger again. You see you’d think you’d got it under control and it would grow back out again. So it’s... it was very weird. But that’s when I thought it was lichen sclerosus. I just thought we was curing it and then it would come back and they’d see. It was when it... it just got bigger, that’s when they decided it couldn’t be lichen sclerosus.

Some people found a lump on their penis or in their groin, which may have developed recently or been there for years. Les had a lump for a long time, which became itchy and sore.
 

When in the bath, John checked himself and was concerned to find a lump on the left hand side of...

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Age at interview: 58
Sex: Male
Age at diagnosis: 44
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I just happened to be thinking about things you hear on the radio and stuff about checking your body and stuff and I just seemed to find my way to doing that in the bath one day and I was just feeling around my groin and I just – I don’t know why I did it, I just did – and then I came across in my left hand side in the groin, I came across this lump and it just seemed really strange and I sort of pushed it and it was like really solid and I just thought ‘this doesn’t feel right’ and I felt the other side and there was nothing there and I just knew there was something.

While some of the earliest signs can be a mere irritation, they can become extremely painful. The pain may be felt when peeing, when urine gets onto the rash, wart or lump or the pain may just come and go throughout the day. Mark felt like he had a permanent semi-erection and the pain worsened over four weeks before it became unbearable. Before their diagnosis of penile cancer, some men self-treated or were prescribed topical creams to put on their penis, which caused considerable pain for some (see ‘Seeking help’). The cream Ian was using from his GP had him ‘on his knees’ in pain.
 

Paul talked about how the stinging, sharp pain on his penis came and went for a long period.

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Age at interview: 61
Sex: Male
Age at diagnosis: 59
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Well yeh because the tumour was on the side of my penis and it was getting larger and of course… again it’s going to sound crazy but I went through a lot of pain, all them, well 18 months or more.

I don’t know what’s the best way to explain it? Like a stinging pain, like a sharp pain, but it wasn’t there all the time. You know some days there was nothing, no pain at all then other times it would start up again.
 

 

Peter had a small itch on his penis that gradually worsened.

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Age at interview: 75
Sex: Male
Age at diagnosis: 72
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Well as I say like I started with a small itch in the penis and each night it got gradually worse so I thought I’d better go and see a doctor about it and they treated it with Canesten cream. But after a period of a matter of a few weeks it didn’t subside any, and in fact it got really worse and eventually it was little white spots that was on the end of the penis so the doctor then told me I would have to go and see a specialist.

Some of the men noticed that their foreskin tightened over a couple of weeks, months or years. Some men had lived with tight foreskins all their lives. James’s foreskin started to tighten about four years before he discussed it with his GP when consulting about something else. Circumcision of a tight foreskin sometimes reveals the cancer underneath.
 

John had always had a tight foreskin, and as part of his investigations he had a circumcision,...

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Age at interview: 58
Sex: Male
Age at diagnosis: 44
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And then for some reason they decided to do...my foreskin was tight and that was a thing I’d always known from a kid and it didn’t impair my love life or anything but, and I wasn’t the sort of person, you know you hear of these doctors on the radio saying “check yourself everyday”, I wasn’t the sort of person that used to look at my foreskin and see if it was alright but it was a fact that it was slightly difficult to pull it back. And... so one of the consultants, and the great thing about the National Health is you have all these people on it, all these different people, students, consultants, all these different people, so you’re getting people, all these people from different angles are thinking of ways to go forward, which I’ve always found brilliant actually and so you do, it’s a scatter approach so you do, you never know – there’s always hope in that I’ve found. And somebody came up with the idea that we should do – “maybe that’s the problem, let’s do a circumcision” and then they did a circumcision, a little bit, partial circumcision it’s called, so, and that revealed on the gland of my penis that the primary source was the cancer and you could see it.

While uncommon, penile cancer can make peeing difficult. It could take the men we spoke to a lot longer to pee and at times they may have gone to the toilet and come out without urinating. Ian had difficulty peeing and at times could not urinate even after using the toilet for five minutes. When peeing, some found that they could only do this when standing up or only when sitting down. After peeing, some found that they may have had a little dribble afterwards and Mark had to fold up tissue paper and put it in his underpants because he had a constant leak. In some cases, the rash, wart or lump grew over the hole on the end of the penis, preventing urine escaping and causing pain or would cause the urine to spray. As problems with urinating are also a sign of prostate cancer (see our website on Prostate cancer), some of the men had tests (see our website on The PSA test for Prostate cancer) to rule it out. In some cases, the men had symptoms of urinary tract infections, which were initially treated by their GP with antibiotics but soon came back.
 

Tim wasn’t too worried about his difficulties peeing but checked it out with his GP in case it...

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Age at interview: 54
Sex: Male
Age at diagnosis: 53
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It was just over a year ago, about a year and a half ago, and I’d slowly been having problems going to the toilet, weeing usually. Usually, it was after I’d been to the toilet, there was dribbles coming out. I had to go out to go straight back again. And I did a little bit of reading around and it fitted the symptoms of prostate cancer. I wasn’t too worried at that stage but ah, I thought I’d mention it to the doctors. I was seeing the doctor anyway for blood pressure, so I just mentioned it while I was there. He then sent me off to have blood tests and investigate that. Those all came back negative when I went to see him again. He, but in the meantime, problems slowly got worse, and it got to the stage where when I was standing to, standing up to wee, it was just taking ages and ages to pass water and I was thinking, ‘the next time I come I’m going to bring a book here to [laugh] it’s not going to come out again at all next, one day. So I went back to the doctor and then, well about that sort of time, I started to notice a growth right from the end of my penis. It looked like a sort of tiny wart. So when I went back to see the doctor, talking about the prostate cancer, but those tests had come back negative.

 

Frank’s first symptom was difficulty peeing, which worsened and became painful as the growth...

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Age at interview: 77
Sex: Male
Age at diagnosis: 72
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When I first realised something was wrong the main symptom, the first symptom was difficulty in urinating and then... gradually the – if I describe the penis, the opening of the penis started to close and it started to form a skin over it and within three or four weeks I was in tremendous pain... and the pressure of the urine when I needed to urinate was starting to force its way through the side of the member. Then it was at that point as I mentioned previously, that I realised something was quite serious. First of all the discomfort, secondly the difficulty in urinating and thirdly... the terrible pain.

 
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A GP suspected that James had a urinary tract infection and gave him antibiotics with which it...

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Age at interview: 67
Sex: Male
Age at diagnosis: 66
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And eventually I got a... waterworks infection. So I rang up the doctors and I couldn’t get in to see my doctor but I saw the nurse practitioner who prescribed some antibiotics. Which were... worked wonderfully. They saw the waterworks infection off. But within a fortnight it was back. Then I rang the doctors again and I still couldn’t see the, my doctor but I got a locum who was a young Indian doctor, who was quite switched on and on-the-ball. And he examined me and gave me a larger dose of the antibiotics to clear up the waterworks.

 

Mark's symptoms of pain, a semi-permanent erection, a white discharge and blood in his urine progressively worsened until he found he couldn't urinate, which left him extremely frightened.

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Age at interview: 48
Sex: Male
Age at diagnosis: 46
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I admitted myself to the local hospital on the 8th of October 2009, and… I’d considered that I’d been ill for… way before maybe five months before that. It manifested its way, it was strange really in as much that… it looked like, that I had a permanent semi-erection. The penis wasn’t soft. It was… it was hard to the touch. The skin... was... sort of adhering itself to something that was underneath it. It was the strangest thing. And indescribable pain, the pain got worse on the approach to the 8th of October. It was manageable... three or four weeks before but got progressively worse. I was... finding it difficult to urinate, I was urinating... blood... and copious amounts of blood as well. And a white fluid, I don’t know what the white fluid was. And... I should have… I should have gone... three or four weeks prior.

But I didn’t. They... said that when I got there... that they were pleased that I’d actually gone in reasonable time. But I, on the morning of the 8th of October I woke up with every intention of going to work. And at that time I was finding it sufficiently difficult to pass water. That I was getting in the shower, and I was, I was trying to urinate in the shower and I couldn’t pass any water at all. And I was absolutely terrified, because, everybody in the morning you want to get up and you empty your bladder, and I couldn’t do it… I kept calm, as calm as I possibly could. And I jumped in the car and got myself ready for work, and I drove to the local hospital. And admitted myself into A&E.
 

Some men said they had felt lethargic or generally ‘under the weather’ in the weeks leading up to their diagnosis. John and Jordan wondered whether this was related to their cancer although Jordan also thought it could be part of ageing.
 
Last reviewed July 2017.
Last updated January 2015.

 
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