Diagnosis

Penile Cancer

Diagnosis of penile cancer

The diagnosis of suspected penile cancer is established by a lesion on the penis that is irregular, sometimes ulcerated and superinfected. The physician performs a physical examination of the penis to rule out other lesions, abnormalities or other benign conditions that may be mistaken for penile cancer. After this examination, a biopsy is required to confirm an accurate diagnosis of cancer.

If the signs point to penile cancer, the following tests are some that may be needed:

Biopsy:

In this diagnostic test, the physician removes a small sample of tissue to check for cancer cells to confirm for sure that it is cancer and to determine the nature of the lesion.

Imaging tests:

If the diagnosis is confirmed after biopsy, further imaging will be necessary:

• Computed tomography (CT) or computed axial tomography (CAT): uses x-rays to produce images of the inside of the body. This test will help detect if the cancer has spread.
• Magnetic resonance imaging (MRI): uses radio waves and magnets to take detailed pictures and get better images of a penile tumor. This test may use drugs to make the penis rigid (erect). MRI may also be used to check for cancer in other parts of the body.
• Ultrasound: uses sound waves to produce pictures of the inside of the body. It can help show how deep the tumor is in the penis and whether it has spread to nearby lymph nodes, which are small immune system tissues that cancer often spreads to first.

Ninety-five percent of penile tumors are of the squamous carcinoma type. There are, however, premalignant lesions that should be taken into account and closely followed and treated. These preneoplastic lesions are:

• Bowenoid papulomatosis of the penis.
• Lichen sclerosus.
• Penile intraepithelial lesions.
• Bowen's disease.
• Giant condylomas.

Once a diagnosis of penile cancer is confirmed, the grade of the disease is assigned. This will help the physician predict how quickly the cancer is likely to grow and spread. This grade is assigned a grade (1, 2 or 3) based on how closely the cancer cells resemble normal cells. Cancers with a higher grade (3) tend to grow faster.