Stages of Penile Cancer

Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of the penile cancer to plan the best treatment.

There are several staging systems for cancer that describe the extent of the cancer. Penile cancer staging usually uses the TNM staging system. The cancer may be described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to your cancer. When talking to you about your diagnosis, your doctor may describe the cancer as one of these stages. 

Learn about tests to stage penile cancer. Learn more about Cancer Staging.

The following stages are used for penile cancer:

Stage 0 (carcinoma in situ)

Stage 0 is divided into stages 0is and 0a.

• In stage 0is, abnormal cells are found on the surface of the skin of the penis. These abnormal cells form growths that may become cancer and spread into nearby normal tissue. Stage 0is is also called carcinoma in situ or penile intraepithelial neoplasia.
• In stage 0a, squamous cell cancer that does not spread is found on the surface of the skin of the penis or on the underneath surface of the foreskin of the penis. Stage 0a is also called noninvasive localized squamous cell carcinoma.

Stage I (also called stage 1) penile cancer

In stage I, cancer has formed and spread to tissue just under the skin of the penis. Cancer has not spread to lymph vessels, blood vessels, or nerves. The cancer cells look more like normal cells under a microscope.

Stage II (also called stage 2) penile cancer

Stage II is divided into stages IIA and IIB.

In stage IIA, cancer has spread:

• to tissue just under the skin of the penis. Cancer has spread to lymph vessels, blood vessels, and/or nerves; or
• to tissue just under the skin of the penis. Under a microscope, the cancer cells look very abnormal or the cells are sarcomatoid; or
• into the corpus spongiosum (spongy erectile tissue in the shaft and glans that fills with blood to make an erection).

In stage IIB, cancer has spread:

• through the layer of connective tissue that surrounds the corpus cavernosum and into the corpus cavernosum (spongy erectile tissue that runs along the shaft of the penis).

Stage III (also called stage 3) penile cancer

Stage III is divided into stages IIIA and stage IIIB. Cancer is found in the penis.

• In stage IIIA, cancer has spread to 1 or 2 lymph nodes on one side of the groin.
• In stage IIIB, cancer has spread to 3 or more lymph nodes on one side of the groin or to lymph nodes on both sides of the groin.

Stage IV (also called stage 4) penile cancer

In stage IV, cancer has spread:

• to tissues near the penis, such as the scrotum, prostate, or pubic bone, and may have spread to lymph nodes in the groin or pelvis; or
• to one or more lymph nodes in the pelvis, or cancer has spread through the outer covering of the lymph nodes to nearby tissue; or
• to lymph nodes outside the pelvis or to other parts of the body, such as the lung, liver, or bone.

Stage IV penile cancer is also called metastatic penile cancer. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if penile cancer spreads to the liver, the cancer cells in the liver are actually penile cancer cells. The disease is called metastatic penile cancer, not liver cancer. Learn more in Metastatic Cancer: When Cancer Spreads.

Penile cancer can recur (come back) after it has been treated.

Recurrent penile cancer is cancer that has come back after it has been treated. If penile cancer comes back, it may come back in the penis or in other parts of the body, such as the liver or lungs. Tests will be done to help determine where the cancer has returned. The type of treatment for recurrent penile cancer will depend on where it has come back.

Learn more in Recurrent Cancer: When Cancer Comes Back. Information to help you cope and talk with your health care team can be found in the booklet When Cancer Returns.