What to Know About Surgery for Penile Cancer

Surgery is the most common treatment for penile cancer. Early stages of penile cancer can usually be cured by surgery alone. There are several kinds of surgery for penile cancer. The kind of surgery you will have depends on these things:

  • Your type of penile cancer

  • The size of the tumor

  • The stage of the tumor (whether the cancer has spread to the surrounding area or further into the body) 

These are the some of the kinds of surgery for penile cancer. Your surgeon will try to find a treatment option that will give you the best chance for a cure as well as preserve as much of your penis as possible:

  • Simple excision. The surgeon cuts the tumor out and may also take some of the nearby skin. He or she stitches the remaining skin back together. This is the same as an excisional biopsy.

  • Electrodessication and curettage. The surgeon uses a curette, which is a thin scraping instrument that looks like a vegetable peeler, to scrape the cancer away. Then, the doctor uses a needle to deliver an electric current that destroys any remaining cancer cells.

  • Cryosurgery. For this surgery, liquid nitrogen is applied to freeze and kill cancer cells. This is only used for precancerous abnormalities on the penis and for small cancers that haven't invaded deeply into the penis.

  • Mohs surgery. For this, the surgeon takes off a sample of the layer of skin that the tumor may have invaded and checks it under a microscope to see if it is cancerous. If it is, the surgeon continues to remove layers and look at the samples until he or she finds no more cancer. Mohs surgery is a slow process but it can save normal tissue near the tumor. It also may not change the look or function of the penis as much as some other surgeries.

  • Laser surgery. The surgeon uses a laser beam to kill cancer cells. Laser surgery is usually only used for cancers that are on the outer layer of skin or for some kinds of skin cancer.

  • Wide local excision. The surgeon takes out the cancerous tissue. The doctor also removes some healthy tissue on both sides to be sure that all of the cancer is taken out.

  • Circumcision. If the cancer is only on the foreskin of the penis, sometimes circumcision (a procedure to remove the foreskin) will remove all of the cancer.

  • Amputation (penectomy). Amputating or removing part or all of the penis is often the most effective way to treat penile cancers that have spread deep into the penis.

  • Inguinal lymphadenectomy (groin lymph node dissection). If any of the groin lymph nodes that drain the penis contain cancer cells, the surgeon may remove them. This can be determined by a procedure called sentinel node sampling. Lymph nodes in the groin area may be swollen. This swelling is often from an infection rather than cancer, so antibiotics are given. If the swelling doesn't go away in a few weeks, then a second operation, called an inguinal lymphadenectomy, is done to remove the lymph nodes.