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Diagnosis Cancer in the Penis
A initial sign of penile cancer is a change in the skin of the penis. This is most likely to be on the glans (tip) of the penis or on the foreskin (in uncircumcised men), but it can also be on the shaft, according to the American Cancer Society.
Signs of Penile Cancer include:
- An area of skin becoming thicker and/or changing color
- A lump on the penis
- An ulcer (sore) that might bleed
- A reddish, velvety rash
- Small, crusty bumps
- Flat, bluish-brown growths
- Smelly discharge (fluid) under the foreskin
Sores or lumps from penile cancer are not usually painful, but they can be in some cases. You should see a doctor if you find any kind of new growth or other abnormality on your penis, even if it is not painful.
A biopsy is needed to diagnose penile cancer. In this procedure, a small piece of tissue from the abnormal area is removed and sent to a lab, where it is looked at under a microscope to see if it contains cancer cells. The results are usually available in a few days, but may take longer in some cases.
The type of biopsy used depends on the nature of the abnormality.
For an incisional biopsy only a part of the abnormal area is removed. This type of biopsy is often done for lesions that are larger, are ulcerated (the top layer of skin is missing or the lesion appears as a sore), or that appear to grow deeply into the penis.
These biopsies are usually done with local anesthesia (numbing medicine) in a doctor’s office, clinic, or outpatient surgical center.
In an excisional biopsy, the entire lesion is removed. This type of biopsy is more often used if the abnormal area is small, such as a nodule (lump) or plaque (raised, flat area). If the abnormal area is only on the foreskin, your doctor might recommend circumcision (removal of the foreskin) as a form of excisional biopsy.
These biopsies are usually done in a hospital or outpatient surgical center. Local anesthesia (numbing medicine) or general anesthesia (where you are asleep) may be used.
Lymph node biopsy
If the cancer has invaded deep within the penis, nearby lymph nodes usually will need to be checked for cancer spread. This is done to help determine the stage (extent) of the cancer after the diagnosis. These lymph nodes can be checked either with fine needle aspiration or with surgery to remove them.
Fine needle aspiration (FNA): For this type of biopsy, the doctor places a thin, hollow needle directly into the lymph node and withdraws cells and a few drops of fluid. Local anesthesia may be injected into the skin over the node to numb the area.
If the enlarged lymph node is deep inside your body and the doctor can’t feel it, imaging methods such as ultrasound or CT scans can be used to guide the needle into the node.
Content for this article provided by the American Cancer Society.