How is penile cancer diagnosed?

If your health care provider thinks you might have penile cancer, you'll need certain exams and tests to be sure. Diagnosing penile cancer starts with your provider asking you questions. You will be asked about your health history, symptoms, risk factors, and family history of disease.

A physical exam will also be done. It includes checking your penis, testicles, groin, and belly (abdomen).

What is a biopsy?

A biopsy is the only way to know if you have penile cancer. Your health care provider will need to take a tiny piece of tissue, called a sample, for testing. This procedure is called a biopsy. The type of biopsy done depends on what is seen on your genitals. A local pain medicine will be used to numb the area when the biopsy is done.

Types of biopsies

There are two main types of biopsies for penile cancer.

• Excisional biopsy. The health care provider removes all of the abnormal area of skin or lump. This might be done if the area is small.

• Incisional biopsy. This type of biopsy might be done if the abnormal area is large, is growing deep into the penis, or has broken through the skin. Only part of the area or lump is removed.

Lymph node biopsy

This test is done to see if the cancer has spread to lymph nodes in the groin. It is done in one of the following ways:

• Fine needle aspiration (FNA). This biopsy can be done in a health care provider's office or clinic. FNA is not used to take a tissue sample from the penis. It's used to check nearby lymph nodes. During FNA, medicine might be injected into the skin of your groin to make the area numb. Then a thin needle is put into a lymph node under your skin. A syringe is used to pull cells and a few drops of liquid out of the lymph node. These are tested for cancer. If a swollen node is deep in your body, ultrasound or a computed tomography scan can be used to guide the needle to the right place.

• Surgery. Surgery might be done to look at and take out nearby lymph nodes. This is called lymph node dissection. A sentinel lymph node (SLN) biopsy may be done. It is the removal of the first lymph node (SLN) in a group of lymph nodes that receives drainage from the tumor. If cancer cells aren't present in the SLN, more lymph nodes may not be needed. If cancer is found, one or more lymph nodes in the groin will be removed.

After the biopsy, your provider will send the tissue to a pathologist. A pathologist is a doctor who will check the tissue under a microscope and test it for cancer cells.

Getting your test results

When your health care provider has the results of your biopsy, they will contact you. Your provider will talk with you about other tests you may need if penile cancer is found. This may include imaging tests to see if the cancer has spread. Make sure you understand the test results and your next steps.