What Are the Stages of Penile Cancer?

The stage of cancer tells how much and how far the disease has spread. By using exams and tests, a doctor can tell the stage of a man's penile cancer. A cancer's stage is one of the most important factors in deciding what treatment to have and estimating the prognosis (outlook). 

Both the Union for International Cancer Control and the American Joint Committee on Cancer have developed a standard way to find out how much a cancer has grown. This system is known as the TNM System. The T stands for tumor (depth or invasion of the tumor), N for nodes (number and location of lymph nodes involved), and M for metastasis (or distant spread).

Once a person's T, N, and M groups have been determined, this information is put together in what is called stage grouping. This is used to determine a person's overall disease stage. Stage grouping is shown in Roman numerals going from 0 (the earliest stage) to IV (the most advanced stage).

  • Stage 0. In Stage 0 (also known as carcinoma in situ), cancer cells are only on the surface of the skin.

  • Stage I. In Stage I, cancer cells have grown into the tissue just below the surface of the skin. It has not grown into blood vessels or lymph nodes. 

  • Stage II. In Stage II, cancer cells have spread to the deeper tissues of the penis, but not to lymph nodes or distant organs; or it has grown into tissue just below the surface of the skin and is either high-grade or has spread into the blood or lymph system, but is not found in lymph nodes or distant organs; or the cancer has grown into the urethra, but has not spread to lymph nodes or distant organs. 

  • Stage III. In Stage III, cancer cells have grown into the urethra and/or the deeper tissues of the penis. It may have spread to one or more lymph nodes, but it has not spread to distant organs. 

  • Stage IV. In Stage IV, cancer cells have spread to nearby structures (such as the prostate), to the lymph nodes deep in the groin, to other parts of the body, or some combination of these.

  • Recurrent. Recurrent cancer means that the cancer has come back after it has been treated.

Doctors consider the grade (how abnormal the cancer cells look under a microscope), stage, and a person's health—as well as the person's feelings and preferences—when recommending a treatment plan. Staging information helps doctors compare an individual situation to other men with penile cancer. Based on clinical studies done on groups of men in similar stages of the disease, a doctor can make some predictions about how the cancer may behave and how different treatments may work.