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.
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.
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.
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.
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.
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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