Penile Cancer

Diagnosis

Diagnosis of penile cancer is made through one of the following methods:

• Physical examination and medical history: The initial evaluation of the patients is through a comprehensive physical examination of the penis and penile region. The genital areas of the patients are examined to detect any sign of penile cancer. The nearby lymph nodes are also evaluated for swelling. The oncologist will inquire about the occurrence of symptoms and their progression. The patients may be asked about their family history to determine the presence of risk factors for penile cancer.
• MRI: It is one of the preferred imaging tests to assess primary penile cancer. It also assists in staging penile cancer and determines if cancer has invaded the tunica albuginea (a fibrous tissue enveloping the testis). The evaluation may be improved by inducting artificial erection through intracavernosal injection of the prostaglandins. MRI also provides valuable information related to histologic subtyping and tumor grade that helps make appropriate treatment decisions.
• CT scan: CT scan helps obtain detailed images of the soft tissues. In diagnosing penile cancer, a CT scan assists in determining staging and potential metastasis. It allows the oncologists to detect if cancer has spread to the lymph nodes. CT scan also found its application during the biopsy, where it guides the needle to the abnormal tissues for taking samples (CT-guided needle biopsy).
• PET scan: This imaging modality involves using radioactive glucose, which is taken up by the cancerous cells throughout the body. It helps in the staging of penile cancer and helps in detecting if penile cancer has metastasized to other body organs. In some cases, the patients may undergo combined PET and CT scans for improved examination of penile cancer.
• Ultrasound: Ultrasound involves using sound waves to develop images of tissues. Ultrasound in penile cancer helps detect the level of cancer invasion deep into the penile tissues. It also provides crucial information about the spread of penile cancer to nearby lymph nodes by detecting the swollen lymph nodes.
• Chest x-ray: The oncologists recommend chest X-rays in patients diagnosed with penile cancer to determine if the cancer has metastasized to the lungs.
• Cystoscopy: Cystoscopy is performed with the help of a cystoscope, a tube with a video camera at the end. It helps detect abnormal tissues in the penis or nearby structures.
• Biopsy: Biopsy is a diagnostic procedure that involves obtaining a sample of abnormal tissue and sending it to the laboratory for a detailed histological examination. Different types of biopsy procedures are used depending on the type of lesions. An incisional biopsy involves removing a small area of abnormal tissues. It is used in cases of large and ulcerated lesions that are suspected of invading deep penile tissues. An excisional biopsy involves the removal of the complete lesions. It is used in small lesions, such as plaque and lumps. The cancer specialists may also perform lymph node biopsy to determine if cancer has spread to surrounding lymph nodes.