Penile Cancer Staging

Staging is the process by which your cancer specialists determine how to treat your penile cancer and how far your cancer has spread. It takes into account the primary (original) tumor size, number of tumors and whether it has metastasized, that is, spread to the lymph nodes or distant parts of the body. Staging is based on the pathology report, physical exam, biopsies and imaging tests. Generally, a lower stage indicates a better prognosis (e.g., the likely outcome or course of a disease; the chance of a full recovery or recurrence).

Defining the Stages

Penile cancer is staged and treated based on how far the cancer has spread. The following stages are used to describe penile cancer:

  • Stage 0 (Carcinoma in Situ): Abnormal cells or growths that look like warts are found on the surface of the skin of the penis. These abnormal cells or growths may become cancer and spread into nearby normal tissue.
  • Stage I: Cancer has formed and spread to connective tissue just under the skin of the penis. Cancer has not spread to lymph vessels or blood vessels. The tumor cells look a lot like normal cells under a microscope.
  • Stage II: Cancer has spread:
    • to connective tissue just under the skin of the penis. Also, cancer has spread to lymph vessels or blood vessels or the tumor cells may look very different from (more aggressive than) normal cells under a microscope; or
    • through connective tissue to erectile tissue (spongy tissue that fills with blood to make an erection); or - beyond erectile tissue to the urethra.
  • Stage III:  Stage III is divided into stage IIIa and stage IIIb.
    • Stage IIIa: Cancer has spread to one lymph node in the groin. Cancer has also spread to connective tissue just under the skin of the penis. Also, cancer may have spread to lymph vessels or blood vessels or the tumor cells may look very different from normal cells under a microscope; or through connective tissue to erectile tissue (spongy tissue that fills with blood to make an erection); or beyond erectile tissue to the urethra.
    • Stage IIIb: Cancer has spread to more than one lymph node on one side of the groin or to lymph nodes on both sides of the groin. Cancer has also spread to connective tissue just under the skin of the penis. Also, cancer may have spread to lymph vessels or blood vessels or the tumor cells may look very different from normal cells under a microscope; or through connective tissue to erectile tissue (spongy tissue that fills with blood to make an erection); or beyond erectile tissue to the urethra.
  • Stage IV: In stage IV, cancer has spread to:
    • tissues near the penis such as the prostate, and may have spread to lymph nodes in the groin or pelvis
    • one or more lymph nodes in the pelvis, or cancer has spread from the lymph nodes to the tissues around the lymph nodes
    • distant parts of the body